Posts for: June, 2021
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.”
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.”
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.”