Root canal treatments are an essential part of dental care — countless teeth with deep decay would be lost each year without it. Now, this traditional dental care procedure is advancing to a new level of precision through lasers.
Root canal treatments have a simple goal: access a tooth's infected pulp and root canals, clean out the infected tissue and fill the empty pulp chamber and canals with a special filling. Once filled, the access is sealed and a porcelain crown later placed for additional protection against re-infection.
In the traditional procedure, we perform these steps manually with a dental drill and hand instruments. We may also need to remove a good portion of tooth structure, both healthy and infected tissue. A laser, on the other hand, is a highly focused beam of light with the ability to interact with healthy and infected tissues differently: destroying infected tissue while having no effect on nearby healthy tissue. The end result: we may be able to remove less healthy tissue with lasers than with the conventional procedure.
Lasers are also helpful with softening and precisely molding the filling material within each canal's particular shape. And, early reports seem to indicate a higher degree of comfort for patients (less drill noise and need for anesthesia), less bleeding and faster recovery times than the conventional approach.
But as a tool for root canal treatments, lasers do have a couple of disadvantages. While light travels in a straight line, root canals are rarely straight — conventional instruments with curved designs usually accommodate odd canal shapes better than a laser. Lasers can also raise temperatures within a tooth that can damage healthy tissue, both within the pulp and outward into the dentin.
Still, lasers for root canal treatments appear promising with some dentists using a combination of lasers and manual techniques to garner benefits from both approaches. While you won't see lasers replacing the traditional root canal treatment anytime soon, the future looks bright for more efficient ways to treat deep tooth decay.
What’s the first thing that comes to mind when you think of the month of May? Balmy breezes? Sweet-smelling flowers? How about root canal treatment?
The last item might seem out of place…but for the last ten years, Root Canal Awareness week has been celebrated in May. So let’s take a closer look at this important—and often misunderstood—dental procedure.
What we commonly call a “root canal” is a special treatment that can save diseased teeth which might otherwise be lost. But the root canal itself is actually a set of hollow, branching passages deep inside the hard outer tissue of the tooth. The tiny “canals” contain the tooth’s soft pulp, including nerves, blood vessels and connective tissue. These tissues help teeth grow during childhood but aren’t necessary in healthy adult teeth—and, what’s worse, they can become infected via deep cavity or a crack in the tooth’s outer layers.
When bacteria infect the pulp tissue, the inflammation often causes intense discomfort. In time, the harmful microorganisms can also pass through the tooth’s root and into the tissue of the jaw, resulting in a painful abscess. Eventually, if it isn’t treated, the tooth will likely be lost.
Root canal treatment is designed to remove the infection, relieve the pain…and save the tooth. It is usually performed under anesthesia for your comfort. To begin the procedure, a small hole is made in the tooth’s enamel to give access to the pulp; then, tiny instruments are used to remove the diseased tissue and disinfect the tooth. Finally, it is sealed up against re-infection. Following treatment, a cap (or crown) is often needed to restore the tooth’s full function and appearance.
Despite some rumors you may have heard, root canal treatment is neither very painful nor likely to cause other health problems. So if you come across these discredited ideas, remember that dentists and dental specialists called endodontists perform some 25 million root canal procedures every year—and this treatment method has been validated for decades.
Of course, like any medical procedure, root canal treatment is not 100% successful. While the procedure has a very high success rate, it’s possible that additional treatments will be needed in some cases. However, the alternative—extracting the tooth—has similar potential downsides; plus a replacement tooth will be needed to avoid the health and lifestyle troubles caused by missing teeth. But one thing is certain: Ignoring disease in the tooth’s soft tissues isn’t a good move, because the infection won’t go away on its own—and down the road it will only get worse.
So this May, while you’re taking time to smell the flowers, spare a thought for the often-misunderstood root canal. If you’d like more information on root canal treatment, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
Hopefully, you’ve developed a long-term care relationship with your family dentist. Better known as a general dentist, these professionals are the central players in maintaining your oral health, and your first stop when you have a problem with your teeth or gums.
But there are times when a particular dental situation calls for a specialist, a dentist with additional training (as much as three years or more in their area of specialty) and the equipment and advanced techniques for your particular need. Here, then, are some of the other kinds of dental professionals your general dentist may refer you to if you need specialized care.
Periodontist — From the Latin peri (“around”) and dont (“tooth”), this dentist cares for the supporting structures of the teeth, particularly the gums and bone. Besides treating advanced cases of periodontal (gum) disease, they’re also adept at reconstructive and cosmetic gum procedures or the placement of dental implants.
Orthodontist — Although known commonly as the “braces” doctor, orthodontists have a much wider concern: the interaction and alignment of teeth and jaws. With a keen understanding of growth and development, orthodontists can employ a number of treatments, including braces, to bring teeth into better positions that will improve function and appearance.
Endodontist — Teeth damaged from disease or injury may need treatments that involve the interior of the tooth — the pulp and root canals. While your general dentist can perform basic root canal treatments, an endodontist has the added knowledge and equipment to treat more difficult cases.
Prosthodontist — As with a prosthetic limb that replaces a lost arm or leg, prosthodontists specialize in replacing lost teeth (prostho means “artificial”). Prosthodontists can skillfully create functional, life-like dentures, as well as natural tooth and implant crowns to replace portions of visible teeth.
Oral Surgeon — These dentists are skilled in the diagnosis and surgical treatment of conditions involving the head and neck (the “maxillo-facial” region). They often work in consultation with general dentists and other specialties for treating complex mouth conditions. Besides tooth extraction and other dental procedures, oral surgeons can also surgically correct jaw alignment or treat trauma to the face and neck area. They also place grafts to stimulate bone growth for future implants.
If you would like more information on how dental specialties can benefit your health, 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 Dental Universe.”
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”
Baby (primary) teeth look and function much like their permanent counterparts. Besides having a visible crown, they also have roots that maintain contact with the jawbone.
But there are some differences, the biggest one being the normal process whereby primary tooth roots dissolve or, in dental terms, resorb. Root resorption eventually leads to the tooth coming loose to make way for the permanent tooth.
Adult tooth roots can also resorb — but it's decidedly not normal. If adult root resorption isn't promptly treated, it could also lead to tooth loss — but there won't be an incoming tooth to take its place.
Although it can begin inside a tooth, adult root resorption usually begins on the outside. One type, external cervical resorption (ECR), begins around the neck-like area of the tooth not far below the gum line. Its initial signs are small pink spots where the tooth enamel has eroded; those pink cells within the space are doing the damage.
We don't fully understand the mechanism behind ECR, but there are some factors that often contribute. People with periodontal ligament damage or trauma, sometimes due to too much force applied during orthodontic treatment, have a high risk of ECR. Some bleaching techniques for staining inside a tooth may also be a factor.
The key to treating ECR is to detect it as early as possible before it does too much root damage. Regular checkups with x-rays play a pivotal role in early detection. Advanced stages of ECR might require more advanced diagnostics like a cone beam computed tomography (CBCT) scan to fully assess the damage.
If the lesion is small, we can surgically remove the cells causing the damage and fill the site with a tooth-colored filling. If ECR has spread toward the pulp, the tooth's inner nerve center, we may also need to perform a root canal treatment.
Either of these methods intends to save the tooth, but there is a point where the damage is too great and it's best to remove the tooth and replace it with a life-like dental implant or other restoration. That's why it requires vigilance through regular, semi-annual dental visits to detect the early signs of root resorption before it's too late.
If you would like more information on adult tooth root resorption, 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 Resorption.”
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