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Posts for tag: root canal treatment

By Carl H. Tegtmeier, DMD
September 22, 2018
Category: Dental Procedures
EarlyActionNeededtoSaveYourToothfromRootResorption

Along with the gums, your teeth’s roots help stabilize them. Without them your teeth couldn’t handle the normal biting forces you encounter every day. That’s why a rare condition called root resorption must be treated promptly: this gradual breakdown and dissolving of root structure could eventually cause you to lose your tooth.

Resorption is normal in primary (“baby”) teeth giving way for permanent teeth or sometimes during orthodontic treatment. But the form of resorption we’re referring to in permanent teeth isn’t normal, and is highly destructive.

The condition begins in most cases outside the tooth and works its way in, usually at the gum line around the cervical or “neck-like” region of the tooth (hence the term external cervical resorption or ECR). ECR produces pink spots on the teeth in its early stages: these are spots of weakened enamel filled with pink-colored cells that cause the actual damage. The cells create cavity-like areas that can continue to enlarge.

We don’t fully understand what causes ECR, but there seems to be links with excessive force during orthodontics, tooth trauma (especially to the gum ligaments), tooth grinding habits or internal bleaching procedures. However, most people with these problems don’t develop ECR, so the exact mechanism remains a bit of a mystery.

The good news, though, is that we can treat ECR effectively, provided we discover it before it inflicts too much damage. That’s why regular dental visits are important, coupled with your own observation of anything out of the ordinary and immediate dental follow-up.

If the affected area is relatively small, we may be able to remove the cells causing the damage and repair the area with a tooth-colored filling. If it appears the pulp (the tooth’s innermost layer) is involved, we may need to perform a root canal treatment to remove infected tissue and fill the empty space with a special filling. You may also need other procedures to reduce the chances of gum recession around the affected tooth.

Proactive dental care is your best insurance against losing a tooth to root resorption. So keep an eye on your teeth and see your dentist regularly to keep your teeth and gums healthy.

If you would like more information on the signs and treatments for root resorption, 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 Resorption: An Unusual Phenomenon.”

NeedaRootCanalHeresaStep-by-StepGuideonWhattoExpect

You’ve recently learned one of your teeth needs a root canal treatment. It’s absolutely necessary: for example, if you have decay present, it will continue to go deeper within the tooth and it will spread to the roots and bone and could ultimately cause you to lose your tooth. Although you’re a little nervous, we can assure you that if we’ve recommended a root canal treatment, it’s the right step to take for your dental health.

There’s nothing mysterious — or ominous — about a root canal. To help ease any fears you may have, here’s a step-by-step description of the procedure.

Step 1: Preparing your mouth and tooth. We first take care of one of the biggest misconceptions about root canals: that they’re painful. We completely numb the tooth and surrounding tissues with local anesthesia to ensure you will be comfortable during the procedure. We isolate the affected tooth with a thin sheet of rubber or vinyl called a rubber dam to create a sterile environment while we work on the tooth. We then access the inside of the tooth — the pulp and root canals — by drilling a small hole through the biting surface if it’s a back tooth or through the rear surface if it’s in the front.

Step 2: Cleaning, shaping and filling the tooth. Once we’ve gained access we’ll clear out all of the dead or dying tissue from the pulp and root canals, and then cleanse the empty chamber and canals thoroughly with antiseptic and antibacterial solutions. Once we’ve cleaned everything out, we’ll shape the walls of the tiny root canals to better accommodate a filling material called gutta-percha, which we then use to fill the canals and pulp chamber.

Step 3: Sealing the tooth from re-infection. Once we complete the filling, we’ll seal the access hole and temporarily close the tooth with another filling. Later, we’ll install a permanent crown that will give the tooth extra protection against another infection, as well as restore the tooth’s appearance.

You may experience some mild discomfort for a few days after a root canal, which is usually manageable with aspirin or ibuprofen. In a week or so, you’ll hardly notice anything — and the tooth-threatening decay and any toothache it may have caused will be a distant memory.

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 “A Step-by-Step Guide to Root Canal Treatment.”

By Carl H. Tegtmeier, DMD
May 26, 2017
Category: Dental Procedures
IfatAllPossiblePrimaryTeethareWorthSaving

Primary (baby) teeth might not last long, but their impact can last a lifetime. Their first set of teeth not only allows young children to eat solid foods, but also guide permanent teeth to form and erupt in the proper position.

Unfortunately, primary teeth aren't immune to tooth decay. If the decay is extensive, the tooth may not last as long as it should. Its absence will increase the chances the permanent teeth won't come in correctly, which could create a poor bite (malocclusion) that's costly to correct.

If a primary tooth is already missing, we can try to prevent a malocclusion by installing a “space appliance.” This keeps nearby teeth from drifting into the empty space intended for the permanent tooth. The best approach, though, is to try to save a primary tooth from premature loss.

We can often do this in much the same way as we would with a permanent tooth — by removing decayed material and filling the prepared space. We can also perform preventive applications like topical fluoride or sealants that strengthen or protect the tooth.

It becomes more complicated, though, if the pulp, the interior of the tooth, becomes decayed. The preferred treatment for this in a permanent adult tooth is a root canal treatment. But with a primary tooth we must also consider the permanent tooth forming below it in the jaw and its proximity to the primary tooth. We need to adapt our treatment for the least likely damage to the permanent tooth.

For example, it may be best to remove as much decayed structure as possible without entering the pulp and then apply an antibacterial agent to the area, a procedure known as an indirect pulp treatment. We might also remove only parts of the pulp, if we determine the rest of the pulp tissue appears healthy. We would then dress the wound and seal the tooth from further infection.

Whatever procedure we use will depend on the extent of decay. As we said before, our number one concern is the permanent tooth beneath the primary. By focusing on the health of both we can help make sure the permanent one comes in the right way.

If you would like more information on caring for children's primary 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 “Root Canal Treatment for Children's Teeth.”

By Carl H. Tegtmeier, DMD
June 21, 2016
Category: Dental Procedures
ReplacingaToothorSavingit-WhichShouldyoudo

Over a lifetime, teeth can endure temperatures ranging from freezing to near boiling, biting forces of as much as 150 pounds per square inch and a hostile environment teeming with bacteria. Yet they can still remain healthy for decades.

But while they’re rugged, they’re not indestructible — they can incur serious damage from tooth decay or periodontal (gum) disease, two of the most prevalent oral infections. If that happens, you could be faced with the choice of removing the tooth or trying to save it.

Because today’s restorations like dental implants are quite durable and amazingly life-like, it might seem the decision is a no-brainer — just rid your mouth of the troubled tooth and replace it. But from a long-term health perspective, it’s usually better for your gums, other teeth and mouth structures to try to save it.

How we do that depends on the disease and degree of damage. Tooth decay, for example, starts when high levels of acid soften the minerals in the outer enamel. This creates a hole, or cavity, that we typically treat first by filling with metal amalgam or, increasingly, composite resins color-matched to the tooth.

If decay has invaded the pulp (the innermost layer of the tooth), you’ll need a root canal treatment. This procedure removes infected material from the pulp and replaces the empty chamber and the root canals with a special filling to guard against another infection. We then cap the tooth with a life-like crown for added protection.

Gum disease, on the other hand, is caused by dental plaque (a thin film of bacteria and food particles on tooth surfaces), and requires a different approach. Here, the strategy is to remove all of the plaque and calculus (hardened plaque deposits) we can find with special hand instruments or ultrasonic equipment, and often over several sessions. If the infection extends deeper or has created deep pockets of disease between the teeth and gums, surgery or more advanced techniques may be necessary.

Though effective, some of these treatments can be costly and time-consuming; the tooth itself may be beyond repair. Your best move is to first undergo a complete dental examination. From there, we can give you your best options for dealing with a problem tooth.

If you would like more information on the best treatment approach for your 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 “Save a Tooth or Get an Implant?