Which would you rather have — the flu or a root canal procedure? Nearly 80 percent of people recently surveyed by the American Association of Endodontists wisely chose the root canal. If this takes you by surprise, then let us bring you up to date on root canal treatment today. It’s nothing like the experience that once made it the butt of jokes and a benchmark against which other “undesirable” experiences were measured.
The term “root canal” actually has two meanings. It is part of the pulp-filled chamber at the center of every tooth containing nerves and blood vessels that keeps teeth vital (alive). It’s also the endodontic (endoÂ = inside; dont = tooth) procedure that treats inflammation and infection in this tissue. Common causes of pulp problems are traumatic damage (for example a crack, chip, or root fracture), deep decay, or gum disease.
The first sign of a problem is typically pain — ranging from acute and intense pangs when biting down, to lingering discomfort after consuming hot or cold foods, to a chronic dull ache and pressure, or tenderness and swelling in nearby gums. The primary pain may abate as the nerves in the pulp die, but the infection will continue, compromising the affected tooth, jeopardizing the health of the surrounding tissues, and often triggering secondary pain.
Pain-Relieving, Tooth-Saving Treatment
Endodontic treatment, by contrast, is no more uncomfortable than having a cavity filled. The tooth and surrounding area are numbed with a local anesthetic before the procedure begins. In order to access the diseased pulp, a small opening is made in the biting surface of the tooth. Tiny instruments are used to remove the pulp, clean and disinfect the root canal(s) and pulp chamber, and prepare the empty tooth interior to receive a biocompatible filling material to prevent bacteria from returning. A permanent crown may be placed over the tooth at that time, or a second visit may be needed. A crown (cap) is important to the tooth's long-term strength and functionality.
For a day or two following treatment you may experience temporary sensitivity, which often responds to an over-the-counter medication like ibuprofen. Occasionally, prescription medications, including antibiotics, may be needed.
All in all, doesn’t saving a tooth sound easier and more constructive than coming down with the flu?
If you would like more information about root canal treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “A Step-By-Step Guide To Root Canal Treatment.”
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
Our nerves serve a vital purpose, alerting us to bodily discomfort, injury or disease — we couldn’t remain in good health for long without them. But when they malfunction due to genetics or disease, they can themselves become a source of pain and discomfort.
One such nerve disorder that affects the face is known as trigeminal neuralgia (TN) or tic douloureaux (from the French for “painful”). The nerves in question are the trigeminal, a pair that travel up from the brain stem through the skull into each side of the face where they each branch into the upper, middle and lower parts of the face and jaw. The pain can radiate from one or more of these branches.
TN is characterized by recurring episodes of brief but severe pain with accompanying muscle spasms. It may begin as a short twinge recurring over weeks, months or years before becoming increasingly painful. The slightest actions can trigger a painful episode: chewing, speaking, shaving or even the wind blowing on your face.
While it may be hard to determine its exact cause, it often seems to result from an artery or vein pressing on the nerve, causing it to signal pain at the slightest stimulation and then failing to stop transmitting when the stimulation is removed. It’s also associated with other inflammatory disorders like multiple sclerosis where the protective insulation around a nerve is damaged.
Before receiving treatment you should undergo a complete examination to rule out any other facial pain causes like temporomandibular (jaw joint) disorders or a dental abscess. You may also need to undergo a neurological examination and possible MRI imaging to pinpoint the exact cause, like a tumor or blood vessel pressing on the nerve.
Although the condition may not be curable, there are several effective management treatments. The more conservative approaches usually involve medications to block the nerve’s pain signals or decrease its abnormal firing. If this isn’t sufficient to diminish symptoms, there are surgical options: passing a thin needle through the nerve to selectively prevent fibers from firing, or moving aside a blood vessel pressing on it. High-dose targeted radiation may also be effective, especially with older patients.
The best treatment approach will depend on the exact cause, your age and overall health. Whatever the approach, you can gain significant relief from the pain of TN.