A deeply decayed tooth is in serious trouble, and something a regular filling may not fix. You may instead need a root canal, a common tooth-saving procedure performed by general dentists or, in more difficult cases, endodontists (specialists in interior tooth treatment).
Regardless of who performs it, though, the basics are the same: The dentist accesses the tooth's decayed interior by drilling a hole and removing diseased tissue from the pulp and root canals through it. They then fill the empty spaces with a rubber-like substance before sealing the tooth and later crowning it to prevent re-infection.
For most, a root canal gives a decayed tooth a new lease on life that can last for years, if not decades. Occasionally, though, a root canaled tooth may become reinfected from tooth decay. There are a number of possible reasons for this unfortunate outcome.
For one, the decay might not have been caught until it had advanced into root canal filling, resulting in contamination. Although root canal treatment may still be effective, the chances of success are much lower than for a decayed tooth diagnosed before it had advanced this far.
Teeth with multiple roots or complex root canal networks are also difficult to treat. The challenge is to ensure all the root canals within the tooth have been thoroughly treated. These types of situations are usually best undertaken by an endodontist with microscopic equipment and advanced techniques that can better infiltrate intricate root canal networks.
These and other situations could make it more likely a root-canaled tooth is reinfected. Depending on the extent of damage, it may be best to extract the tooth and replace it with a dental implant or other restoration. But it's also possible to repeat the root canal—and the second time may be the charm.
As with many other dental conditions, the best outcome regarding a reinfected tooth after root canal is early detection and treatment. You can increase your chances of this with regular dental visits that include monitoring of any root-canaled teeth. You should also see your dentist as soon as possible if you notice pain or gum swelling associated with the tooth.
Root canals are highly effective at saving decayed teeth. But the rare reinfection is possible—so be on the alert.
If you would like more information on root canal treatment, 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 “Root Canal Treatment: How Long Will It Last?”
Mike Tyson made a splash when he faced off against sharks during the Discovery Channel's Shark Week 2020. But there's bigger news for fans of the former undisputed world heavyweight champion: After a 15-year absence, he will enter the ring again for two exhibition matches in the Fall. However, it's not just Tyson's boxing action that made news during his 20-year career. His teeth have also gotten their fair share of press.
Tyson used to be known for two distinctive gold-capped teeth in the front left side of his mouth. He made headlines when he lost one of the shiny caps—not from a blow by a fellow pugilist but from being headbutted by his pet tiger as Tyson leaned in for a kiss. Tyson's teeth again garnered attention when he had his recognizable gold caps replaced with tooth-colored restorations. But the world champion may be best known, dentally at least, for his trademark tooth gap, or “diastema” in dentist-speak. Several years ago, he had the gap closed in a dental makeover, but he soon regretted the move. After all, the gap was a signature look for him, so he had it put back in.
That's one thing about cosmetic dentistry: With today's advanced technology and techniques, you can choose a dental makeover to suit your individual taste and personality.
An obvious example is teeth whitening. This common cosmetic treatment is not a one-size-fits-all option. You can choose whether you want eye-catching Hollywood white or a more natural shade.
If your teeth have chips or other small imperfections, bonding may be the solution for you. In dental bonding, tooth-colored material is placed on your tooth in layers and then hardened with a special light. The material is matched to your other teeth so the repaired tooth fits right in. This procedure can usually be done in just one office visit.
For moderate flaws or severe discoloration, porcelain veneers can dramatically improve your appearance. These thin, tooth-colored shells cover the front surface of the tooth—the side that shows when you smile. Veneers are custom-crafted for the ideal individualized look.
Dental crowns can restore single teeth or replace missing teeth as part of a dental bridge. Again, they are manufactured to your specifications. With restorations like crowns and veneers, the smallest detail can be replicated to fit in with your natural teeth—even down to the ridges on the tooth's surface.
And if, like Mike Tyson, you have a gap between your teeth that makes your smile unique, there's no reason to give that up if you opt for a smile makeover. Whether you would like a small cosmetic enhancement or are looking for a more dramatic transformation, we can work with you to devise a treatment plan that is right for you.
If you would like more information about smile-enhancing dental treatments, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Cosmetic Dentistry: A Time for Change.”
It's normal for your child to breathe through their mouth if they're winded from play, or if they have a stuffy nose from an occasional cold. But what if they're doing it all the time, even at rest? That could be a problem for their overall health—and their oral health as well.
Although we can breathe through both the nose and the mouth, our bodies naturally prefer the former. The nasal passages filter out allergens and other harmful particles, as well as warm and humidify incoming air. Nose breathing also helps generate nitric oxide, a highly beneficial molecule to physical health.
We switch to mouth breathing when we're not receiving sufficient air through the nose. For chronic mouth breathers, something has obstructed or restricted the nasal passages like allergies or enlarged tonsils or adenoids.
Mouth breathing especially can affect a child's oral health because of the relationship between the tongue and jaw development. During nose breathing, the tongue rests against the roof of the mouth (palate), where it serves as a kind of mold around which the growing upper jaw can develop.
When breathing through the mouth, however, the tongue falls against the back of the bottom teeth. If this becomes chronic, the jaw may develop too narrowly, depriving the incoming teeth of enough room to erupt and leading to a poor bite.
If you notice things like your child's mouth falling open while at rest, snoring, irritability or problems with concentration (associated with poor sleep due to blocked nasal passages), then consider having a doctor examine them for a possible nasal obstruction. You should also check with your dentist to see if your child's jaw development has been affected. If caught early, there are interventional measures that could get it back on track.
Even after correction of a nasal obstruction, a child may still find it difficult to readapt to nose breathing because of a "muscle memory" for breathing through the mouth. In that case, they may need orofacial therapy to retrain their muscles for nose breathing.
It's important to stay aware of any signs of chronic mouth breathing with your child. Diagnosing and treating the condition early could help them avoid other problems later in life.
If you would like more information on the effects of mouth breathing on jaw development, 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 “The Trouble With Mouth Breathing.”
Even with dedicated daily home care and regular dental cleanings, some children still have problems with cavities. And, that could morph into an even more serious problem in the future: Primary teeth lost prematurely to the disease could cause incoming permanent teeth to erupt out of position and form a poor bite.
To avoid this, parents often need a little extra help protecting their children's teeth from cavities. One way is with a dental sealant applied to larger teeth by their dentist.
A dental sealant is a protective coating of plastic or glass-like material that partially fills in the pits and crevices of the biting surfaces of larger teeth like molars. Even with diligent brushing it can be difficult to clean these surfaces of plaque, thus allowing bacteria to hide out in deep crevices. By "smoothing" out these areas with a sealant, they're easier to rid the teeth of decay-causing plaque.
Your child can undergo a quick and painless sealant application during a routine visit. After applying the liquid form of the sealant to the teeth with a brush, the dentist uses a curing light to harden the coating into a durable defense against decay.
Dentists have been applying sealants for several years now, which begs the question—do they work? At least two major studies say yes.
These independent studies both surveyed thousands of pediatric patients over several years. And, they both concluded that children with sealants experienced significantly fewer cavities than those without sealants. Furthermore, the protection appeared to last at least four years after the application.
A sealant application does involve a modest cost per tooth. But compared to what you'll spend to treat cavities, or even expensive orthodontic treatment later, sealants are well worth the cost.
If your child continues to develop cavities regardless of home and dental care, then talk with your dentist about sealants and other ways to minimize cavities. Taking these extra steps could help prevent a problem now, and a bigger problem in the future.
If you would like more information on dental care for children, 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 “Sealants for Children.”
Millions of Americans live with osteoporosis, a degenerative bone disease that can turn a minor fall into a potential bone fracture. Literally meaning "porous bone," osteoporosis causes the natural marrow spaces in bone tissue to progressively grow larger and weaken the remaining bone.
Many osteoporosis patients take medication to slow the disease's process. But due to the dynamic nature of bone, some of these drugs can have unintended consequences—consequences that could affect dental care.
As living tissue, bone is literally "coming and going." Certain cells called osteoblasts continuously produce new bone, while others called osteoclasts remove older tissue to make way for the new. Drugs like bisphosphonates and RANKL inhibitors interrupt this process by destroying some of the osteoclasts.
As a result, more of the older bone remains past its normal lifespan, helping the bone overall to retain strength. But ongoing research is beginning to hint that this may only be a short-term gain. The older, longer lasting bone is more fragile than newer bone, and tends to become more brittle and prone to fracture the longer a patient takes the drug. This tissue can also die but still remain intact, a condition known as osteonecrosis.
The femur (the large upper leg bone) and the jawbone are the bones of the body most susceptible to osteonecrosis. Dentists are most concerned when this happens in the latter: Its occurrence could lead to complications during invasive procedures like oral surgery or implant placement.
Because of this possibility, you should keep your dentist informed regarding any treatments you're undergoing for osteoporosis, especially when planning upcoming dental procedures like oral surgery or implant placement. You might be able to lower your risk by taking a "drug holiday," coming off of certain medications for about three months before your dental work.
As always, you shouldn't stop medication without your doctor's guidance. But research has shown drug holidays of short duration won't worsen your osteoporosis. If you're already showing signs of osteonecrosis in the jaw, a short absence from your prescription along with antiseptic mouthrinses and heightened oral hygiene could help reverse it.
Fortunately, the risk for dental complications related to osteoporosis medication remains low. And, by working closely with both your dentist and your physician, you can ensure it stays that way.
If you would like more information on osteoporosis and your dental care, 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 “Osteoporosis Drugs & Dental Treatment.”
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