Posts for: June, 2020
Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.
You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.
But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?
First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.
Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.
Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.
Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.
You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.
If you would like more information on root canal therapy, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”
Periodontal (gum) disease can do unpleasant things to your mouth, including losing teeth. Its effects, though, may not be isolated to the oral cavity: Gum disease could make other diseases in the body worse.
Gum disease is a bacterial infection most often caused by dental plaque, a thin bacterial film that builds up on teeth in the absence of effective oral hygiene. At the outset it may infect your gums causing them to swell, redden or bleed. Eventually, though, the infection can advance deeper toward the tooth roots and bone.
There are various methods to treat gum disease depending on the extensiveness of the infection. But these methods all share the same objective—to remove all uncovered plaque and tartar (hardened plaque). Plaque fuels the infection, so removing it starves out the disease and helps the body to heal.
The damage gum disease can do to the teeth and the surrounding gums is reason enough to seek treatment. But treating it can also benefit your overall health. That's because the weakened gum tissues often serve as an open portal for bacteria and other toxins to enter the bloodstream. From there they can travel to other parts of the body and cause disease.
Gum disease also shares another feature with some systemic conditions: inflammation. This is the body's response to disease or trauma that isolates damaged tissues from healthy ones. But with gum disease, this inflammation can become chronic and ironically do more harm than good.
A gum infection may also increase the body's overall inflammatory response, in turn aggravating other diseases like diabetes, heart disease or arthritis. Treating gum disease lowers inflammation, which in turn could ease inflammation in other conditions. Likewise, reducing your body's overall inflammatory response by properly managing these other conditions might make you less susceptible to gum disease.
It's important then to prevent and treat gum disease as if your overall health depended on it—because it does. You can prevent it by brushing and flossing daily and undergoing regular dental cleanings to remove plaque. And see your dentist promptly at the first signs of gum problems. Likewise, follow a physician-supervised program to manage any inflammatory conditions.
If you would like more information on preventing or treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
Most dental procedures today only require local anesthesia to numb just the affected area. It's a safer approach than general anesthesia: the unconscious state created by putting someone "to sleep" can lead to some unpleasant complications.
But patient comfort involves more than preventing physical pain during a procedure. There's also the emotional factor—many people experience nervousness, anxiety or fear during dental visits. It's especially problematic for an estimated 15% of the population whose dental visit anxiety is so great they often try to avoid dental care altogether.
One option is to use general anesthesia for patients with acute anxiety rather than local anesthesia. This removes them consciously from their anxiety, but they must then be monitored closely for complications.
But there's a safer way to relax patients with high anxiety called intravenous or IV sedation. The method delivers a sedative medication directly into a patient's bloodstream through a small needle or catheter inserted into a vein. The sedative places the patient in a relaxed "semi-awake" state, taking the edge off their anxiety while still enabling them to respond to verbal commands.
Coupled with local anesthesia, they won't experience any pain and very little if any discomfort. And many of the sedatives used also have an amnesiac effect so that the patient won't remember the procedures being performed.
IV sedation does require monitoring of vital signs, but the patient won't need help maintaining their breathing or heart function. And although the medication can be adjusted to reduce any lingering after-effects, a patient will still need someone to accompany them to and from their visit.
For lesser anxiety or nervousness, dentists sometimes prescribe an oral sedative to take just before a visit. This can help take the edge off your nerves and help you relax. With either method, though, sedation can help you overcome fear and anxiety and have a more pleasant treatment experience.
If you would like more information on IV sedation, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “IV Sedation in Dentistry.”