By Carol Haddad, DMD
July 19, 2021
Category: Dental Procedures
Tags: root canal  
DontFeartheRootCanal-ItCouldJustSaveYourTooth

Root canals often get a bum rap. Although the procedure saves millions of teeth every year, it's often erroneously portrayed as an unpleasant experience. And if that wasn't enough, a long-discredited medical theory has found new life on the internet asserting root canals are a health danger.

First off, root canals play an immensely important role in treating teeth with advanced decay. If not promptly treated, a cavity can turn into a major infection of the interior tooth pulp and root canals, and ultimately the supporting bone. Teeth with this level of decay are not long for this world.

A root canal treatment stops this disease process in its tracks. After numbing the tooth and surrounding gums, we drill a small hole into the tooth's interior and then remove all of the infected tissue within the pulp and root canals. After disinfecting these areas, we fill them with a rubber-like substance called gutta percha.

After sealing off the access hole—and later capping the tooth with a life-like crown—the tooth is secure from further decay. And, by the way, the procedure doesn't hurt, thanks to local anesthesia. If anything, any pain caused by the decay attacking the tooth's nerves has now been alleviated.

So, what about the idea floating on the Web that root canals are dangerous? The "root" for this conjecture is a theory by Weston Price, an early 20th Century dentist, that leaving a "dead" body part in the body leads to various health problems (including cancer). That would include a root-canaled tooth, which has had the living tissue in the pulp removed.

There's just one problem—Weston's theory was fully investigated in the 1950s and overwhelmingly discredited. The supposed cancer threat was also reviewed in a 2013 study, which found no link between root canals and increased cancer risk. In fact, dental patients who had undergone several root canals had a diminished risk.

Like all other health procedures, root canals have some risks of complication. But those complications are far from life-threatening—it's tooth-saving benefits are often worth the risk. So, fear not if your dentist says you need a root canal. It won't hurt and it won't endanger your health—and it could save your tooth.

If you would like more information on root canal therapy, 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 Safety.”

By Carol Haddad, DMD
July 09, 2021
Category: Dental Procedures
Tags: braces  
LingualBracesAThirdChoiceforMovingTeeth

First, there were braces; then came removable clear aligners—both great ways to straighten teeth. But braces with their metal brackets and wires aren't the most attractive look. And, although nearly invisible aligners improve appearance, they don't work in every bite situation (although their range has improved of late).

But now a third choice has emerged: lingual braces. Like their traditional counterparts, lingual braces are fixed in place—but on the back side of the teeth rather than the front. Instead of "pushing" teeth toward new positions, they "pull" them, arriving at the same "destination" by another path.

This new method came about simultaneously by two different orthodontists a world apart and for different reasons. A Beverly Hills dentist was looking for an invisible form of treatment similar to clear aligners for his appearance-conscious patients. A Japanese dentist wanted an alternative that would reduce the risk of damage or injury posed by traditional braces to his martial arts patients.

Lingual braces (referring to their proximity to the tongue) address both of these concerns. All of the brackets and wiring are positioned out of sight. And because they're shielded by the teeth, they're not as likely to be damaged or cause injury following hard contact to the face—a great benefit for athletes, law enforcement officers and, yes, martial artists.

Even so, lingual braces won't replace the other two methods any time soon. You'll need to consider other factors, such as that lingual braces can cost up to a third more than traditional braces. And although their availability is steadily growing, not all orthodontists have been trained to offer lingual braces, so you may have to widen your search radius for a provider near you.

You may also find it takes a bit of time to get used to the feel of lingual braces. Upper braces can affect speech ability, at least initially, and the lower ones can interfere with tongue comfort. Most people, though, do adjust to them within a week or so.

But by and large, lingual braces do offer a fixed option that's out of sight, out of mind. With this newer orthodontic choice, you now have three good options for achieving a healthier mouth and a more attractive smile.

If you would like more information on methods for straightening 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 “Lingual Braces.”

DontBeWaryofaRootCanal-HeresHowItCouldSaveYourTooth

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.”

ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.

The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").

Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.

The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.

Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.

Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.

It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.

Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.

If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”

By Carol Haddad, DMD
June 09, 2021
Category: Oral Health
Tags: gum recession  
GumRecessionCanHarmYourOralHealthandYourSmile

Your gums don't just attractively frame your teeth—they protect them as well. If they shrink back (recede) from their normal covering, portions of the teeth could become exposed to bacteria and other hazards.

Unlike the visible crown, which is protected by enamel, the tooth root depends largely on the gums as a shield against bacteria and other hazards. When the gums recede, it exposes the roots and makes them more susceptible to disease or trauma. It may also cause sensitivity to hot and cold foods as the now exposed dentin gets the full brunt of temperature and pressure sensations once muffled by the gums.

There are actually a number of causes for gum recession. In rare cases, a tooth may not have erupted normally within its bony housing, which inhibits the gums from covering it fully. Thinner gum tissues, passed down genetically, are also more susceptible to recession. And a person can even damage their gums and cause them to recede if they brush too aggressively.

The most common cause, though, is advanced periodontal (gum) disease. This bacterial infection arises from dental plaque, a thin biofilm that accumulates on tooth surfaces, usually because of poor hygiene practices. As the infection and resulting inflammation in the gums worsens, they lose their attachment to teeth resulting in a number of harmful outcomes that include recession.

The first step then in treating gum recession is to treat the underlying problem as much as possible. In the case of gum disease, effective treatment could stop mild to moderate recession and sometimes reverse it. For more extensive recession, a patient may need gum grafting surgery to help regenerate lost gum tissue.

You can help prevent gum disease, and thus lower your risk for recession, with daily brushing and flossing to remove bacterial plaque. Likewise, see your dentist at least twice a year for dental cleanings to remove any residual plaque and tartar (hardened plaque).

You should also visit your dentist promptly if you notice swollen or bleeding gums, or more of your teeth surfaces showing. The earlier your dentist diagnoses and begins treatment for gum recession, the better your chances for a healthy and more attractive outcome.

If you would like more information on maintaining good gum 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 “Gum Recession.”





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