Posts for: June, 2014
Without a doubt, an effective root canal treatment can extend the life of a tooth for many years. But sometimes even a well-maintained tooth can fall prey to disease months or even years after a root canal treatment. While there are a number of reasons to account for this failure, a common one is so tiny it could have easily been missed during the first treatment.
A root canal is an open space within the tooth that contains the pulp. The pulp is a connective tissue with a network of nerve fibers connected to the root that alert the brain to environmental changes involving the tooth. It is most important during the tooth’s early development, but becomes less important as we age. The pulp is susceptible to infection from tooth decay or periodontal (gum) disease, which if left untreated can threaten the tooth’s survival. During a root canal treatment, we enter these spaces, clear out the diseased pulp and fill the canal with a bio-compatible filling; we then seal it off to deter further decay.
The treatment could ultimately fail, though, because of accessory or lateral canals missed during the procedure. Like a tree with smaller branches growing out of its larger limbs, accessory canals are smaller access ways that branch off of the main root canals. These accessory canals, which can occur anywhere along a main canal, can be quite small and not easily detected during an initial root canal treatment. They are especially susceptible to infection due to gum disease if they open into the periodontal membrane, the main attachment point between teeth and bone.
If we suspect the presence of accessory canals (either initially or after ensuing problems following a root canal treatment), this could require the skills of an endodontist, a dentist who specializes in the treatment of a tooth’s interior. Accessory canals are treated in much the same way as larger canals, but may require an endodontist’s specialized microscopic equipment and filling techniques. Effective treatment of these smaller accessory canals will certainly improve the chances of a successful, long-term outcome for the tooth.
If you would like more information on root canal treatments, 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 “Accessory Canals.”
If (heaven forbid) you were to lose your two front teeth in an accident, and you needed to choose a tooth replacement method, which one would you pick? Once upon a time, that question faced Taylor Hicks, the former American Idol winner who now plays a regular gig in Las Vegas. Back then, when he was a high-school basketball star, Hicks happened to receive a blow to the mouth at a playoff game. As fate would have it, he also happened to be the son of… wait for it… a dentist. So what did he do?
The down-to-earth song stylist recently told Dear Doctor magazine how, immediately after the accident, his father administered first aid, getting him back into the game before it ended. Then, a short while afterward, Hicks had the gaps in his smile fixed with dental implants.
We think he made a good choice. While there are other tooth replacement systems, none offer the benefits provided by dental implants. In case you need a reminder, here are some facts about dental implants:
- They have the highest success rate of any tooth replacement procedure — above 95%
- They are the most durable type of replacement tooth — with proper care, they can last for the rest of your life
- They look and “feel” completely natural, and require no special maintenance
- They are the only tooth replacement system that essentially stops bone loss in the jaw (a natural consequence of tooth loss), helping to maintain good oral health
- Over the long term, they can offer the best value for your investment in dental care
What makes dental implants work so well? Unlike bridgework or other methods, lifelike implant crowns are supported by a screw-like titanium metal insert, which actually becomes fused with the bone of the jaw. This not only provides the prosthetic teeth with a rock-solid anchorage, but it also helps provide the physical stimulation that bone needs to keep itself healthy. Lacking this stimulation, the jaw bone begins to atrophy and erode (melt away) — and if left untreated long enough, it can result in the appearance of premature aging and other oral health problems.
So if you have missing teeth — whether from an accident, disease, or another cause — contact us or schedule an appointment for a consultation, and find out whether dental implants might be right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Dental Implants.”
Your lower jaw is an integral part of eating, speaking and other tasks involving the mouth. But what happens if you suffer an injury to one of the two joints that connect it to the skull? The result could be serious pain and the inability to bring the upper and lower teeth together properly.
The exact types of injuries causing the pain and disability can vary, like the displacement of a tooth or a group of teeth. Another is swelling in the joint space that prevents the head of the joint (the condyle) from fully seating in the joint space; you could also experience a joint dislocation as the condyle is forced completely out of the joint space. Either swelling or dislocation can prevent the back teeth on the side of the affected joint from fitting together properly.
Another traumatic injury is a fracture of the bone at or near the joint; one of the most common is known as a “sub-condylar” fracture where the break occurs just below the condyle and results in more severe pain than inflammation or dislocation. A more serious fracture may involve the joint itself.
To treat the symptoms properly, it’s important to determine which of these injuries has occurred. This requires a full examination, including x-ray imaging, to determine if the injury involves soft tissue, bone or both. In the case of inflammation, we would prescribe anti-inflammatory and muscle relaxant medication. The latter is especially helpful because trauma often leads to muscle spasms that lock the jaw in place to reduce further damage (nature’s splint, if you will). A dislocation may also require gentle manipulation to seat the condyle back into the joint.
Fractures are treated generally by repositioning the broken portions of the bone into their normal position and then immobilizing them while they heal. Immobilization is accomplished by joining the upper and lower teeth together, either by external or internal means. The latter option requires a surgical procedure.
If you’ve suffered an injury that results in any of these symptoms you should contact our office immediately. Only a complete diagnosis can point the way to the proper treatment that will relieve your discomfort.
If you would like more information on the causes and treatment of jaw pain, 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 “Jaw Pain — What’s the Cause?”
Orthodontics is a specialty of dentistry dedicated to the diagnosis and treatment of misaligned teeth, or malocclusions. The goal is to help patients achieve better long-term oral health by improving teeth alignment. Sometimes, though, the misalignment is much more involved than the position of the teeth — it may be that the jaw structure is also misaligned. In that case, the skills of an oral surgeon may be in order.
The jaws are similar in shape to the arch of a horseshoe, hence the referral to either upper or lower sets of teeth as dental arches. In a normal jaw structure, the lower arch fits just inside the upper arch when you bite down and the teeth are able to function correctly. In some individuals, though, the lower arch closes in front of the upper arch, commonly known as an underbite. If the underbite is only slight, the malocclusion can be corrected by repositioning the teeth only, as with braces. If, though, the underbite is more severe it would require a surgical procedure to realign the jaws, also known as orthognathic surgery.
Orthognathic surgery can help relieve a number of functional complications caused by jaw-related malocclusions: difficulty chewing and swallowing; chronic jaw or head pain; or sleep apnea. It can also enhance the patient’s facial appearance by correcting an imbalance between the two lateral sides (asymmetry), or by minimizing a receding chin or protruding jaw.
Its primary benefit, though, is its effect on the patient’s bite and tooth alignment. For this purpose, the orthodontist and oral surgeon work together to achieve the best result possible. In some cases, the orthodontist may perform his or her work first by moving teeth into the proper position. This sets the stage for the oral surgeon to perform orthognathic surgery to complete the correction of the misalignment.
Each individual patient’s case is different — the best plan of action must begin with a full examination by an orthodontist, and a consultation with an oral surgeon if necessary. It may require time and the expertise of two specialties, but the final result will be better health and a better look.
If you would like more information on various orthodontic procedures, 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 “Jaw Surgery & Orthodontics.”