Here's the bad news: One of your teeth has tooth decay. But here's even worse news: The decay has entered the pulp and root canals in the heart of the tooth. You're well on your way to losing that tooth.
But cheer up—root canal therapy might save your decayed tooth. We use root canal therapy to remove the infection from within a tooth and then fill the resulting empty spaces to prevent further infection. This routine procedure has saved millions of teeth.
But alas, along the way root canals somehow became a cultural symbol for unpleasantness. In reality, there's nothing further from the truth—the procedure itself is painless, and may even stop any pain caused by tooth decay.
So, let's take the mystery out of root canal therapy—the more you know, the less wary you'll feel. Here's what to expect if you undergo this tooth-saving procedure.
Preparation. We start by numbing the tooth and surrounding gums with local anesthesia. While we're waiting for the anesthesia to take full effect, we isolate the tooth with a dental dam to prevent cross-contamination to other teeth.
Access. Next, we drill a small opening into the tooth to access the pulp and root canals. If it's one of the large back teeth, we drill the hole in the tooth's biting surface; in a narrower front tooth, we make the access opening in the rear surface.
Removal. We remove tissue from the pulp and root canals using special instruments. Afterward, we thoroughly disinfect the pulp and canal interiors with an antibacterial solution to ensure we've stopped the infection.
Filling. After re-shaping the root canals, we fill them and the pulp chamber with gutta percha, a rubber-like material ideal for this type of dental situation. We then fill and seal the access hole. In a few weeks, you'll return to have a permanent crown installed to further protect the tooth.
You may have some minor discomfort that's usually manageable with mild pain relievers, and should dissipate over a few days. The good news, though, is that we've more than likely saved a tooth that might have otherwise been lost.
If you would like more information on treating a decayed tooth, 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 “A Step-By-Step Guide to Root Canal Treatment.”
Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.
But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.
A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.
Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.
Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.
The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.
These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.
If you would like more information on TMD management and 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 “Chronic Jaw Pain and Associated Conditions.”
During the COVID-19 quarantines, stir-crazy celebrities have been creating some “unique” home videos—like Madonna singing about fried fish to the tune of “Vogue” in her bathroom or Cardi B busting through a human-sized Jenga tower. But an entertaining Instagram video from Kevin Bacon also came with a handy culinary tip: The just-awakened film and TV actor showed fans his morning technique for cutting a mango to avoid the stringy pulp that gets between your teeth. After cutting a mango in half, he scored it lengthwise and crosswise to create squares and then turned the mango inside out for easy eating.
With his mango-slicing video garnering over a quarter-million views, the City on a Hill star may have touched a nerve—the near universal annoyance we all have with food stuck between our teeth. Trapped food particles aren't only annoying, they can also contribute to a bacterial film called dental plaque that's the top cause for tooth decay and gum disease.
Unfortunately, it's nearly impossible to avoid stuck food if you love things like popcorn, poppy-seed muffins or barbecue ribs. It's helpful then to have a few go-to ways for removing food caught between teeth. First, though, let's talk about what NOT to use to loosen a piece of stuck food.
A recent survey of more than 1,000 adults found that when removing something caught between our teeth, we humans are a creative lot. The makeshift tools that survey respondents said they've used in a pinch included twigs, safety pins, screwdrivers and nails (both the hammer and finger/toe variety). Although clever, many such items are both unsanitary and harmful to your gums and tooth enamel, especially if they're metallic or abrasive.
If you want a safe way to remove unwanted food debris, try these methods instead:
Brush your teeth: The gentle abrasives in toothpaste plus the mechanical action of brushing can help dislodge trapped food.
Use dental floss: A little bit of dental floss usually does the trick to remove wedged-in food—and it's easy to carry a small floss container or a floss pick on you for emergencies.
Try a toothpick. A toothpick is also an appropriate food-removing tool, according the American Dental Association, as long as it is rounded and made of wood.
See your dentist. We have the tools to safely and effectively remove trapped food debris that you haven't been able to dislodge by other means—so before you get desperate, give us a call.
You can also minimize plaque buildup from food particles between teeth by both brushing and flossing every day. And for optimally clean teeth, be sure you have regular dental office cleanings at least twice a year.
Thanks to Kevin Bacon's little trick, you can have your “non-stringy” mango and eat it too. Still, you can't always avoid food getting wedged between your teeth, so be prepared.
We instinctively know when a smile looks normal—and when it doesn't. It could be that something simply looks out of place like crooked teeth. But we might also notice when something is missing—as with one or both of the canine teeth.
The canine teeth align just under the eyes and are recognizable by their pointed ends. When they're missing, the smile looks “incomplete.” But “missing” in this case could mean “invisible”—the teeth are there, but hidden within the gums because they failed to come in properly and became impacted. This often happens on a smaller jaw where other teeth have crowded into the space intended for them.
Fortunately, we may have a remedy, and not just for appearance's sake—any impacted tooth can cause health problems, from gum abscesses to root damage of neighboring teeth. Although this might necessitate their surgical removal, we might also be able to coax them through the gums into better position in the jaw, if they're in a reasonably good position. This could result in both a boost to a patient's oral health and a more normal looking smile.
First, though, a patient will need to undergo a thorough bite evaluation by an orthodontist. Besides pinpointing the impacted teeth's precise location with x-rays or CT technology, an orthodontist will also want to assess the positions and condition of the rest of the teeth. If the conditions are right and there's enough room in the jaw, the orthodontist may recommend drawing the impacted canines into proper alignment in the jaw.
The process starts when an oral surgeon exposes the impacted teeth by surgically cutting through the gum tissue. They then attach a small bracket to the tooth with a tiny metal chain attached, the other end of which is looped over orthodontic hardware attached to other teeth. The tension on the chain by the hardware gradually nudges the teeth downward out of the gums. This is usually done in coordination with other measures to fully correct the bite.
If the procedure is successful, bringing the canines out of impaction reduces the problems those teeth could cause the person's oral health. But just as important, it can restore normality to their smile.
If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”
Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.
One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.
But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.
But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.
There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.
A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.
If you would like more information on tongue ties and other oral abnormalities in 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 “Tongue Ties, Lip Ties and Breastfeeding.”
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