Posts for: January, 2015
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.”
A critical part of effective, daily oral hygiene, flossing removes bacterial plaque from between teeth that can’t be accessed with brushing. Unfortunately, it’s often neglected — string flossing requires a bit more dexterity than brushing and can be difficult to do properly.
It can be even more difficult for people with implants or who wear orthodontic appliances. For brace wearers in particular, getting access to areas between teeth with string floss is next to impossible; the metal brackets and tension wire also have a tendency to catch and retain food debris that’s difficult to remove with brushing alone.
Water flossing, using a device called an oral irrigator, is an effective alternative that addresses many of these difficulties. First available for home use in the 1960s, an oral irrigator delivers pulsating water at high pressure through a handheld applicator that forcefully flushes material from between teeth.
There’s no question that string flossing is effective in plaque removal between teeth — but what about oral irrigators? A 2008 study looked at a group of orthodontic patients with braces who used oral irrigators and compared them with a similar group that only brushed. The study found that five times as much plaque was removed in the group using the oral irrigators as opposed to the group only brushing.
Oral irrigators may also be effective for people who’ve developed periodontal (gum) disease. In fact, oral irrigators coupled with ultra-sound devices are routinely used by dental hygienists to remove plaque and calculus (hardened plaque deposits) in periodontal patients. As with regular oral hygiene, though, it’s important for patients with gum disease to include water flossing with daily brushing (at least twice a day) and regular cleaning sessions at the dentist to ensure removal of all plaque and calculus.
If you’re interested in using an oral irrigator, be sure to consult with us at your next appointment. Not only can we recommend features to look for in equipment, but we can also instruct you on the techniques to make water flossing an effective plaque remover.
If you would like more information on water flossing, 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 “Cleaning Between Your Teeth.”
Grinding, clenching, and gritting your teeth are common reactions to stress — but their results can be quite complex. Here are some questions and answers that will fill you in on what you may not know about this widespread problem.
My dentist said I was bruxing. What does that mean?
Bruxing means that your teeth are grinding upon each other. Many people carry out this habit subconsciously and are not even aware that they are doing it.
Is bruxing or gritting harmful?
Such habits are called “parafunctional” (from para, meaning outside, and function, meaning purpose). This is because these stress habits exert much larger biting forces — as much as ten times more — than in normal biting and chewing activities. This excess pressure can cause damage to jaw joints and muscles, resulting in muscle spasm and pain; and to the teeth, resulting in wear, fractures or looseness. They can also cause headaches, earaches, and even neck and backaches because of the pressures on various structures in the face and mouth.
What is the usual treatment for problems arising from these stress habits?
The first thing we want to do is relieve your pain and discomfort. Second, we want to stop future damage. Application of heat or cold is helpful, and mild anti-inflammatory and muscle relaxant drugs are prescribed for pain and muscle spasm. To prevent future occurrences, we may treat you with biofeedback or refer you to someone who can offer psychotherapy.
What is a night guard and how can it help?
A night guard is an unobtrusive thin plastic appliance that is made to fit over the biting surfaces of your upper teeth. These guards are so unobtrusive that they can even be worn during the day if your stress level is so high that you grind your teeth during the day. The guard is adjusted to leave the lower teeth free to move against the surface of the guard, but they cannot bite into the upper teeth. This prevents wear on the teeth and lets the jaw muscles relax, preventing the pain of muscle spasm.
Yes, you brush your teeth every day. But how much do you really know about this important habit? Test your knowledge with our quiz on dental vocabulary.
Choose the correct meaning for:
- Oral Hygiene
- Clean language
- The practice of keeping your teeth and gums clean
- A shade of lipstick
- A type of dental surgery
- A movie about a person’s life, such as “Ray Charles”
- A new kind of cling wrap
- An accumulation of bacteria that forms a whitish, sticky film
- A tooth whitener
- Dental plaque
- A type of instrument used to clean teeth
- Bacteria that accumulate on teeth and gums
- An award given at the Dental Oscar ceremony
- Your dentist’s framed diploma
- The body’s response to harmful bacteria
- A condition in which your gums become red and swollen and bleed easily
- A cause of gingivitis
- All of the above
- Periodontal disease
- Any disease caused by bacteria
- Tooth decay
- Whitish sores on the lips
- Gum disease caused by dental plaque
- Simple dyes that can stain plaque and make it visible
- Television reality shows
- Dental x-rays
- A section of your annual tax report
- Any infection in the oral area
- Tooth decay
- Inflammation of the gums that can lead to periodontal disease
- All of the above
- Dental caries
- Gum disease
- A task carried out during your teeth cleaning
- A technique of orthodontia
- Tooth decay
- A mineral that has been found to prevent tooth decay
- The location of a famous dental school
- A gasoline additive
- A type of house paint
- Inter-dental Area
- Referring to the area between your teeth
- The area regular proper flossing will keep clean
- Area that wood points and specially designed brushes can be used to clean
- All of the above
Answers: 1. b, 2. c, 3. b, 4. d, 5. d, 6. a, 7. c, 8. d, 9. a, 10. d
How did you do on our quiz? The more you know about keeping your teeth and gums clean and healthy, the better you will look and feel. Contact us today to schedule an appointment or to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor article, “Oral Hygiene Behavior.”