Root canal treatment

Root canal therapy is an important treatment that can save a tooth with a diseased nerve and which in the past would probably have needed to be removed.

Inside each tooth is the ‘pulp’ which runs like a thread down through the root and provides nutrients and nerves to the tooth. It is the soft tissue that contains nerves, blood vessels and connective tissue.

If the pulp is diseased or injured, the pulp tissue dies.

The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp.

So, if you don’t remove it, your tooth gets infected and you could lose it.

After the dentist – or endodontist (a dentist who specializes in problems of the pulp) – removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Most of the time, a root canal is a relatively simple procedure involving one to three visits with little or no discomfort.

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums and enjoy regular checkups.

The power of panoramic x-rays

X-rays are extremely valuable for helping dentists identify issues that may not show up on normal oral examination.

The three most common types of dental X-rays are the bitewing, periapical and panoramic X-rays.

Panoramic X-rays give a broad overview of the entire mouth – supplying information about the teeth, upper and lower jawbone, sinuses, and other hard and soft tissues of the head and neck.

Unlike other X-rays, where the film is placed inside the patient’s mouth, the panoramic film is contained in a machine that moves around the patient’s head. So they are very easy to use.

Panoramic X-rays are often used to check wisdom teeth but they will also reveal deep cavities and gum disease. They are also useful to help patients with past or present jaw problems or those who require full or partial removable dentures, dental implants, or braces.

They can also be valuable in assisting people who are suspected of having oral cancer or have had recent trauma to the face or teeth.

Panoramic X-rays play an important role in thorough dental examinations and are recommended at least every five years or so for most patients.

How to make your smile brighter

Your smile makes a huge difference to what people think about you and how you feel about yourself.

And there are many options available to help you improve the look and brightness of your smile, including:

In-office bleaching: During chair-side bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent.

At-home bleaching: There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter. These include peroxide bleaching solutions, which actually bleach the tooth enamel. Peroxide-containing whiteners typically come in a gel and are placed in a mouth guard.

Whitening toothpastes: All toothpastes help remove surface stain through the action of mild abrasives. “Whitening” toothpastes include special chemical or polishing agents that are more effective at removing stains. However, unlike bleaches, they don’t alter the intrinsic color of teeth.

Start by speaking to your dentist. He or she will tell you if whitening procedures would be effective for you as whiteners may not correct all types of discoloration.

Why your routine dental cleaning is not routine

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appointment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a “dental prophylaxis,” or “prophy” and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

Why cavities aren’t just for kids

Tooth decay or cavities result from destruction of the tooth enamel and can lead to a range of problems from toothache to bad breath.

Cavities occur when foods containing carbohydrates (sugars and starches) such as milk, sugared drinks, cakes or candy are frequently left on the teeth.

Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Many people associate cavities with children but the changes that occur with aging make cavities an adult problem, too.

Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque.

Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.

Decay around the edges of fillings is also common to older adults. As many of them did not benefit from fluoride and modern preventive dental care when they were younger, they often have a number of dental fillings.

Over the years, these fillings may weaken, fracture and leak around the edges.

Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

You can help prevent tooth decay by following these tips:

– Brush twice a day with fluoride toothpaste
– Clean between your teeth daily with floss or interdental cleaner
– Eat nutritious and balanced meals and limit snacking

It’s also worth asking your dentist about supplemental fluoride, which strengthens your teeth, and about dental sealants, a plastic protective coating which is applied to the chewing surfaces of the back teeth to protect them from decay.

In addition, it’s important to visit your dentist regularly for professional cleanings and oral examination.

Taking care of your teeth and gums during pregnancy

Your oral health is an important part of your overall health and this is never more true than during pregnancy.

Good oral health habits not only help prevent oral problems during pregnancy, they also help the health of your unborn child.

What you eat during your pregnancy affects the development of your unborn child – including teeth.

Eating a balanced diet is necessary to provide the correct amounts of nutrients to nourish both you and your child.

Your baby’s teeth begin to develop between the third and sixth month of pregnancy, so it is important that you receive sufficient nutrients – especially calcium, protein, phosphorous, and vitamins A, C, and D.

There is a common myth that calcium is lost from the mother’s teeth during pregnancy.

In fact, the calcium your baby needs is provided by your diet, not by your teeth. If your diet does not provide enough calcium, your body will provide this mineral from stores in your bones.

If you have an adequate intake of dairy products – the main source of calcium – or take any supplements your obstetrician recommends – this will help you get the calcium you need.

To help prevent tooth decay and periodontal disease, brush your teeth thoroughly twice a day with fluoride toothpaste to remove plaque. Be sure to clean between your teeth daily with floss or interdental cleaners.

Make regular visits to your dentist during your pregnancy to ensure the best possible health for you and your baby.

The process of installing Invisalign

Invisalign is a system of clear mouthguards that can be used instead of braces to help straighten teeth.

The big advantage is that Invisalign looks better and is more comfortable than braces.

However, not everyone is a candidate for using the system so you with have to check with your dentist.

If an orthodontist certified in Invisalign says you can benefit from the system, they will take impressions of your mouth, write up a detailed specification and then send everything to a high-tech lab.

Next, the lab will show the orthodontist a preview of the appliances.

The lab then makes a series of “aligners” – depending on the situation, you may need between 12 to 48 aligners.

After the impression of the teeth is taken, it will normally require a visit to the orthodontist every six weeks.

Some patients will be advised to wear metal braces for a period and then switching to Invisalign when their mouth is ready.

For many people Invisalign provides an ideal way of making their smile look better.

What’s involved in getting a dental implant?

Dental implants are increasingly popular as a way to replace missing or damaged teeth.

Their great advantage is that they look natural and feel secure helping you to restore your smile and eat more easily.

Implants are an ideal solution for many people but they are not an option for everyone.

Placing implants requires some surgery so patients must be in good health, have healthy gums and have adequate bone to support the implant.

They must also be committed to taking action to maintain their oral hygiene and to visiting the dentist regularly.

The process for placing implants is as follows:

First, surgery is performed to place the anchor. This can take up to several hours. Following the surgery, you may need to wait up to six months for the bone to grow around the anchor and firmly hold it in place. Sometimes follow up surgery is required to attach a post to connect the anchor to the replacement teeth. Alternatively, the anchor and post may already be attached and are placed at the same time.

After the gums have had several weeks to heal, the next step is to fit specially-made artificial teeth to the post portion of the anchor. This can take a few weeks to complete as several fittings may be required.

Implant surgery can be done either in a dental office or in a hospital, depending upon a number of factors. A local or general anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed.

After your implants are fitted, your dentist will give you tips and advice on maintaining your oral hygiene.

Your dentist can help you decide whether you would be a good candidate for implants.

Caring for people who have special needs

People at any age can have a condition that makes it difficult for them to look after their own dental health.

This could affect people who suffer from a wide range of conditons such as stroke, spinal cord injury, multiple sclerosis, mental retardation, Down syndrome, genetic disorders, Alzheimer’s disease or arthritis.

However, people in all of these categories have the same dental needs as everyone else – they need daily brushing and flossing, regular dental visits and a balanced diet.

There are some steps caregivers can take to make it easier to look after people in those categories.

If the person is uncooperative or uncontrollable, try to explain what you are about to do and schedule the task for a time of day when they are rested.

Move in a calm, slow, reassuring manner to avoid startling them. Give praise and encourage them when they help themselves.

Support the person’s head, and take special care to prevent choking or gagging when the head is tilted back.

If the person is unable or unwilling to keep their mouth open, your dentist will explain how you can make and use a mouth prop.

Ask your dentist for advice on how to care for people with special needs and check if they have facilities for caring for these needs in the dental office.

How Invisalign can replace metal braces

The Invisalign system is a series of clear, thin, mouth guards that fit over the teeth and can gradually straighten them.

These have been called “invisible braces” as they can be an effective alternative to metal braces in some circumstances.

The big advantage of Invisalign is much improved appearance and comfort.

Invisalign mouth guards can be removed during eating and when brushing and flossing. As traditional braces may trap food and plaque, this is another major benefit of Invisalign.

While the system has advantages, it also has some drawbacks.

For example, it is more expensive – costing 25-50 percent more than metal braces.

Also the fact that you remove the mouth guards more often means that you may forget to wear them and it could take longer for you to achieve the desired results.

Invisalign is better suited to some people than others – for example, it may be particularly suitable for adults who have slight to moderate spacing or crowding of their teeth.

Your dentist will be able to tell you if you might be a suitable candidate for Invisalign.

You will get more detailed advice from an orthodontist who has been certified in the Invisalign system.

The facts about oral cancer

Oral cancer is not as well known as other types of cancer but it can represent a life-threatening risk if not identified early.

– It strikes an estimated 35,000 Americans each year
– More than 7,500 people (5,200 men and 2,307 women) die of these cancers each year
– More than 25% of Americans who get oral cancer will die of the disease
– On average, only half of those diagnosed with the disease will survive more than five years
– African-Americans are especially vulnerable; the incidence rate is 1/3 higher than whites and the mortality rate is almost twice as high

Although the use of tobacco and alcohol are risk factors in developing oral cancer, approximately 25% of oral cancer patients have no known risk factors.

There has been a nearly five-fold increase in incidence in oral cancer patients under age 40, many with no known risk factors.

The incidence of oral cancer in women has increased significantly, largely due to an increase in women smoking. In 1950 the male to female ratio was 6:1; by 2002, it was 2:1.

The best way to prevent oral cancer is to avoid tobacco and alcohol use.

Unusual red or white spots can form in and around the mouth. These are often harmless but they can be cancerous or pre-cancerous.

Identifying and removing these early enough is a major factor in reducing the incidence of cancer.

So knowing the risk factors and seeing your dentist for regular examinations can help prevent this deadly disease.

Why a dental abscess should be treated quickly

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatenting.

So if you have any signs of swelling in your gum, contact your dentist immediately.

Different types of fillings and restorations

Nowadays, thanks to advances in dental techniques and materials, patients have a much wider range of choices when they have to repair missing, worn, damaged or decayed teeth.

For example, materials such as ceramics and polymer compounds that look more like natural teeth help dentists create pleasing, natural-looking smiles.

The traditional materials such as gold, base metal alloys and dental amalgam are still widely used as they have many advantages.

The strength and durability of traditional dental materials continues to make them useful in many situations. For example, they are good when fillings are required in the back teeth because the pressure of chewing is high in that area.

The choice of the best option will depend on several factors such as the patient’s oral and general health, where and how the filling is placed and the number of visits needed to prepare and adjust the restored tooth.

The choice about which option is best depends on each individual’s needs so you should discuss the options with your dentist.

Should you be concerned about thumbsucking?

Some children suck on their thumbs and parents often wonder if it is harmful.

Sucking on something is a child’s natural reflex. It can help them feel more secure so they start to suck on their thumbs, fingers, pacifiers or other objects.

Since thumb sucking is relaxing, it may also help them sleep.

However, after the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and the alignment of teeth. It can also cause changes in the roof of the mouth.

Whether or not dental problems will result depends on the intensity of the sucking.

A child who vigorously sucks their thumb is more likely to have difficulties than one who rests their thumb passively in their mouth. Young children who suck their thumbs aggressively may even cause problems with their baby teeth.

If you notice changes in your child’s primary teeth, consult your dentist.

Usually children will stop sucking their thumbs between the ages of about two and four. They should have ceased sucking by the time the permanent front teeth are ready to erupt.

If your child is continuing to suck their thumbs, here are some tips:

– Praise them for not sucking, instead of scolding them when they are
– If they are sucking because they feel insecure, focus on correcting the cause of the anxiety
– For older children, involve them in choosing the method of stopping

If necessary, your dentist can help by encouraging the child and explaining what could happen to their teeth if they do not stop sucking.

Why dry mouth can be a problem and what to do about it

Your saliva plays an important role in your oral health and reduced saliva flow can lead to health problems.

Reduced saliva flow can lead to a dry mouth and this is a common problem among older adults.

It can be caused by various medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Dry mouth can be associated with various problems such as a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages.

Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Without the cleansing effects of saliva, tooth decay and other oral health problems become more common.

So, if dry mouth is not treated, it can damage your teeth.

Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can occur.

Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

How your oral health links with your general health

Research has shown strong links between periodontitis (advanced form of gum disease) and other health problems such as cardiovascular disease, stroke and bacterial pneumonia.

And pregnant women with periodontitis may be at increased risk of delivering pre-term and/or having babies with low birth weight.

However, just because two conditions occur at the same time, doesn’t necessarily mean that one condition causes the other. The relationship could work the other way.

For example, there is evidence that diabetics are more likely to develop periodontitis and have more severe periodontitis than non-diabetics.

Alternatively, two conditions that occur together may be caused by something else.

In addition, people who smoke or use alcohol have a higher than average risk of developing periodontitis and other conditions, including oral cancer.

Research is looking at what happens when periodontitis is treated in individuals with these problems.

The aim is to find out whether periodontitis does have an effect on other health problems.

If one caused the other, improvement in periodontal health would also improve other health problems.

While the research is not yet conclusive, the potential link between periodontitis and systemic health problems, means that preventing periodontitis may be an important step in maintaining overall health.

In most cases, good oral health can be maintained by brushing and flossing every day and receiving regular professional dental care.

How cancer treatment affects oral health

When someone is undergoing cancer treatment, it’s important that they involve their dentist in their program of care.

They should schedule a dental exam and cleaning before the treatment actually begins and then repeat it periodically during the course of treatment.

It’s important that they tell the dentist that they are being treated for cancer and that they also discuss any dental procedures, such as extractions or insertion of dental implants, with the oncologist before starting the cancer treatment.

It’s therefore a good idea to ensure that the dentist and oncologist have each other’s details to enable them to discuss any issues to help the patient.

And the dentist and physician should be informed about any issues such as bleeding of the gums, pain, or unusual feeling in the teeth or gums, or any dental infections.

Maintaining excellent oral hygiene during cancer treatment is vital to reduce the risk of infection and to help aid the treatment process.

Things to look out for during pregnancy

Every woman wants to maintain their own health during pregnancy and to take whatever steps are necessary to give the baby the best possible start.

There are a few factors in your oral health to look out for during this time.

One consideration is that it’s common for pregnant women to have the urge to eat between meals. The risk is that frequent snacking on carbohydrate-containing foods can encourage tooth decay.

Bacteria in your mouth called plaque can convert the sugar and starch in your mouth into an acid that attacks tooth enamel. After repeated attacks, tooth decay can result.

So, when you need a snack, try to choose foods that are nutritious for you and your baby such as raw fruits and vegetables and dairy products.

During pregnancy, your body’s hormone levels rise considerably. Gum problems, such as gingivitis, are especially common during the second to eighth months of pregnancy. They may cause red, puffy or tender gums that bleed when you brush.

This is an exaggerated response to plaque caused by higher levels of progesterone in your system. Your dentist may recommend more frequent cleanings at some stages to help you avoid problems.

Occasionally overgrowths of gum tissue, called “pregnancy tumors,” appear on the gums during the second trimester. These localized growths or swellings are usually found between the teeth and are thought to be related to excess plaque.

They bleed easily and are often surgically removed after the baby is born.

Studies indicate that pregnant women who have severe periodontal (gum) disease may be at increased risk for pre-term delivery, which in turn increases the risk of having a low-birth-weight baby.

So it’s particularly important to maintain good oral health during pregnancy. Make sure you clean your teeth carefully and visit your dentist regularly.

Caring for people who have special needs

People at any age can have a condition that makes it difficult for them to look after their own dental health.

This could affect people who suffer from a wide range of conditons such as stroke, spinal cord injury, multiple sclerosis, mental retardation, Down syndrome, genetic disorders, Alzheimer’s disease or arthritis.

However, people in all of these categories have the same dental needs as everyone else – they need daily brushing and flossing, regular dental visits and a balanced diet.

There are some steps caregivers can take to make it easier to look after people in those categories.

If the person is uncooperative or uncontrollable, try to explain what you are about to do and schedule the task for a time of day when they are rested.

Move in a calm, slow, reassuring manner to avoid startling them. Give praise and encourage them when they help themselves.

Support the person’s head, and take special care to prevent choking or gagging when the head is tilted back.

If the person is unable or unwilling to keep their mouth open, your dentist will explain how you can make and use a mouth prop.

Ask your dentist for advice on how to care for people with special needs and check if they have facilities for caring for these needs in the dental office.

What to expect when having a tooth extracted

The process of having a tooth extracted may seem worrying but you’ll find it much easier if you know what to expect on the day and afterwards.

Your dentist will make the process as comfortable as possible for you by numbing the area around the tooth to be extracted.

In most cases, a small amount of bleeding is quite normal and your dentist will advise you what process to follow to allow healing as quickly as possible.

Generally, you should avoid anything that might prevent normal healing.

For example, it’s best not to smoke, rinse your mouth vigorously or drink through a straw for 24 hours afterwards as these could delay healing.

For the first few days, if you need to rinse your mouth, do it gently. If you are suffering pain or swelling, apply a cold cloth or an ice bag.

If necessary, your dentist will recommend something for any pain.

At the beginning, don’t clean around the socket where the tooth has been removed but you should brush and floss the other teeth as usual.

Modern procedures make having an extraction and the follow-up more comfortable than ever before.