Author: Service Lifter

Combined Root Canal & Gum Problems

Written by Service Lifter on April 12, 2023. Posted in Endodontics. No Comments on Combined Root Canal & Gum Problems

When you experience pain in your mouth, it’s sometimes abundantly clear which tooth is causing it. At other times, the sensation of discomfort is more diffuse, generalized or hard to pinpoint. On occasion, it can even be challenging to determine exactly what problem or combination of problems is causing the symptoms you’re experiencing. This may be the case when an infection exists in the root canals of a tooth as well as the gum tissue adjacent to it.

In this situation, the infection may have begun in the pulp of the tooth itself; or, it may have started in the gums. Over time, it has spread from one location to the other — and now it’s causing a confusing set of symptoms that are difficult to sort out. Regardless of where the problem started, a thorough analysis will be necessary before treatment can begin, to give you the best chance of saving the tooth.

Confusing Symptoms

Root Canal Infection Leading Cause to Gum Disease

From time to time, many people experience oral discomfort that’s dull or intermittent. Occasionally, a more insistent pain may be triggered by a stimulus like temperature (from hot or cold foods or beverages) or pressure (from biting down on something). Sometimes, it may feel as though the ache is coming from a group of teeth rather than one single tooth — or even from the sinus area above the back teeth.

These symptoms can indicate a number of dental issues, including root canal and gum problems, and shouldn’t be disregarded. However, if you manage to ignore the acute pain, in many cases it will fade in time. But this isn’t good news: It generally means that the infected tissue in the pulp of your tooth has died, and the nerve is no longer functioning. That’s when the problem may become more serious.

Chicken or Egg?

Gum Disease Leading to Root Canal Infection When the pulp tissue inside your tooth becomes severely infected, it’s possible for the disease to move through openings at the end (apex) of the root, and outside of the tooth. It can then spread to the periodontal ligament, which anchors the tooth to the surrounding bone and gum tissue. From there, the infection may extend to the gum tissue and cause periodontal disease, or even result in a painful gum abscess. At that point, you may have pain — even severe pain that will let you know exactly which tooth is affected.

But it’s also possible for the infection to be spread by the exact opposite pathway. In this case, an infection that originated in the gums (commonly due to periodontal disease caused by a buildup of plaque) may have has traveled through small passageways called accessory canals, which are located in between a tooth’s roots, or on the sides of the roots. The infection can then extend into the tooth’s pulp. If your teeth are fractured, it’s even easier for disease to spread.

Treatment Methods

When dental problems involves both root canals and gum disease, saving the affected tooth can prove challenging. This is when it matters where the infection started: If it’s primarily a root-canal problem that later moved into the gums, the outlook for the tooth is reasonably positive if it receives immediate treatment. If gum disease came first, however, the prospects often aren’t as good; by the time the infection has moved into the tooth, it’s possible that much bone has already been lost, making the tooth’s long-term prognosis poor.

In either case, the cause of the tooth pain will need to be diagnosed and an effective treatment plan developed. The sooner that happens, the better: Root canal and gum problems simply don’t get better on their own.

Anesthesia Wand

Written by Service Lifter on April 12, 2023. Posted in Technology. No Comments on Anesthesia Wand

If you’ve ever had needle phobia, you might like to learn about a new technology referred to as an “anesthesia wand,” which is a computer-controlled dental-injection tool. In fact, some people feel it is more of a “magic” wand because it doesn’t look like a typical injection and it works even better by making the entire process virtually painless.

Here’s how it works

Your anesthesia will be delivered through a syringe-free wand or pen-like device that is connected to a computer. Before the tiny needle attached to the wand is inserted, the computer delivers a small amount of anesthetic so that the insertion site starts going numb before the needle enters the skin.

Once the needle is in place, the computer delivers an accurate, consistent amount of anesthesia so that you remain comfortable — typically below the threshold of pain. The computer’s microprocessor automatically adjusts the injection pressure for different tissue densities, maintaining a constant, comfortable flow of anesthesia. This is important because the culprit with most injection anxiety is discomfort from anesthetic being injected too quickly, not from the needle entering the skin.

What are some advantages of using an anesthesia wand?

One of the most important advantages is that it doesn’t look threatening, as it eliminates the initial anxiety upon seeing a syringe.
It can be used in conjunction with other conscious sedation methods (i.e. nitrous oxide) for a more comfortable treatment.
It provides painless injections for all routine dental treatments including root canals, crowns, fillings, and cleanings.
With the wand, you will receive a more consistent and comfortable injection, especially in more sensitive areas such as the front of your mouth or in your palate (roof of your mouth) where tissue is less elastic.
Due to the wand’s penlike grasp, it is easier to handle, rotate, and accurately glide the wand into precise, hard-to-reach places to deliver anesthetics.
Last but not least, many people who previously experienced a fear of injections are able to overcame their fear after the first use. This provides them with a better, less stressful dental experience.

Loose Teeth and Bite Problems

Written by Service Lifter on April 12, 2023. Posted in Cosmetic & General Dentistry. No Comments on Loose Teeth and Bite Problems

Because our smiles are the way we greet the world, even tiny imperfections in our teeth can cause self-consciousness. If you have a front tooth with an uneven edge, a canine that is too long or pointed, a slight overlap between two teeth, or any other minor cosmetic concern, tooth contouring might be the solution you’re looking for.

During the contouring procedure, a small amount of tooth enamel is removed to refine and reshape an imperfect tooth’s appearance and help it fit in with the surrounding teeth. Precision tooth sculpting can eliminate or markedly reduce small flaws such as:

Irregular edges
Minor chips
Unequal tooth length
Too-sharp canines
Worn or flat edges
Slight overlaps between teeth
Minor bite problems caused by the teeth touching unevenly

Contouring is typically used to reshape the upper front and canine teeth because these teeth are the most visible. If you are interested in tooth contouring, talk to your dentist about which teeth might benefit, how your enamel can be reshaped, and the changes this will make in the overall appearance and health of your smile.

Once you’ve decided to enhance your smile with contouring, your dentist will examine your teeth and gums. You might need X-rays and/or dental treatment before contouring to make sure your teeth and gums are healthy enough for the procedure.

The procedure itself generally takes about 30 minutes per tooth. Because only the enamel is involved, anesthesia may not be necessary. Using a laser or a specially equipped drill, your dentist will gently remove a very small amount of enamel to refine the shape of the tooth. After this subtle shaping, the tooth will be polished for a smooth, even finish.

You might feel some vibration during the shaping and polishing process, and temporary tooth sensitivity sometimes occurs afterward.

Besides improving the appearance of your teeth, contouring offers additional benefits:

Immediate results
Minimally invasive treatment
Little discomfort
Less expensive than other cosmetic options

Tooth contouring is not the answer for every patient. If you have thin enamel, more seriously damaged or irregularly shaped teeth, or require orthodontic treatment, your dentist can provide you with other options to create a beautiful, healthy smile.

But when minor cosmetic flaws make you feel self-conscious about your smile, skilled aesthetic contouring might be exactly what you need. If tiny imperfections in your teeth are having an outsized impact on your confidence, talk to your dentist about tooth contouring.

Tooth Contouring

Written by Service Lifter on April 12, 2023. Posted in Cosmetic & General Dentistry. No Comments on Tooth Contouring

Irregular edges
Minor chips
Unequal tooth length
Too-sharp canines
Worn or flat edges
Slight overlaps between teeth
Minor bite problems caused by the teeth touching unevenly

You might feel some vibration during the shaping and polishing process, and temporary tooth sensitivity sometimes occurs afterward.

Besides improving the appearance of your teeth, contouring offers additional benefits:

Immediate results
Minimally invasive treatment
Little discomfort
Less expensive than other cosmetic options

Types of Appliances

Written by Service Lifter on April 12, 2023. Posted in Orthodontics. No Comments on Types of Appliances

Elastics

Elastics are small rubber bands that help move teeth into proper alignment. Typically, one side is connected to the top jaw and the other side to the bottom jaw, and are helpful in creating an ideal bite.

Forsus™ Nitinol Flat Spring

A Forsus is a small rod with a spring surrounding it, and is meant to replace or prevent the need of a headgear or even jaw surgery. These are typically used to address overjet or an overbite.

Headgear

A headgear is used to treat patients with either an overbite, where the front jaw extends well beyond the lower jaw, or an underbite, where the lower jaw rests in front of the top jaw. Headgear gently “pulls” on the orthodontic appliance in your mouth to encourage ideal jaw placement.

Herbst® Appliance

This appliance attaches to the back teeth and applies constant forward pressure on the lower jaw, and constant backwards pressure on the upper jaw in order to correct an overbite.

Palatal Expander

This device is used to widen the upper jaw. Adjustments are made periodically to maintain pressure on the jaw so that it keeps growing. Once you’ve achieved desired expansion, you will wear the appliance for several months to solidify progress made.

Positioners

Similar in feel to clear plastic retainers, positioners are used to complete final tooth movement and placement without the need for braces.

Retainers

Made from plastic, metal, or a combination of both, retainers are necessary to help keep your teeth in place once your braces come off.

Separators or Spacers

Separators or spacers are tiny rubber bands that are placed between your back teeth. The bands push the teeth apart, making space for metal bands, which hold other appliances in place, like braces or palatal expanders.

Twin Block Appliance

The twin block appliance is made of two acrylic blocks that work together to advance the lower jaw position and correct an overbite. This appliance is made to be worn full time, including while eating, though it is removable for easy hygiene.

Mara Appliance

MARA stands for Mandibular Anterior Repositioning Appliance. It is not removable and anchored to the molars, requiring periodic adjustment by your orthodontist. It works to encourage lower jaw growth to correct severe overbites.

Crowns

Written by Service Lifter on April 12, 2023. Posted in Cosmetic & General Dentistry. No Comments on Crowns

Decayed, broken, and missing teeth affect your oral health and your self-confidence. When a tooth has suffered structural or cosmetic damage, a dental crown can restore a tooth’s function and appearance.

A crown is a custom-made “cap” that covers the entire visible surface of a tooth. Your dentist might recommend a crown to:

Strengthen and protect a tooth if extensive decay hasn’t left enough healthy tooth structure for a traditional filling
Protect a cracked, broken, or brittle tooth from further damage
Restore and reinforce a tooth after a root canal procedure
Cover a deeply discolored or irregularly shaped tooth
Complete a dental implant procedure
Serve as an anchor for a dental bridge

Most crown placements require two appointments. During the first visit, tooth preparation includes reshaping the top and sides of the tooth so the crown fits comfortably. If too much healthy tooth structure has been lost, the dentist builds up the tooth with filling material so that it will support a crown securely.

An impression or a computer model is made of the prepared tooth, and a temporary crown, typically made of composite resin, is put in place to protect the tooth while the finished crown is fabricated at a dental lab. Every crown is custom designed to make sure it fits comfortably, aligns with the surrounding teeth, and doesn’t interfere with bite or jaw movement.

At a second visit, the dentist puts the finished crown in place and makes any needed adjustments to ensure that it fits properly before bonding it to the tooth. When the placement is ideal, the crown is secured in place using a special dental cement.

Crowns are made of several different materials. Your choice of crown can be based on factors such as durability, visibility, natural appearance, and cost:

Metal crowns: Because they are alloys of gold, platinum, or other metals, these crowns are the longest lasting. They’re often chosen for back molars where they are less visible.
All-porcelain/All-ceramic: These color-matched, translucent crowns are the most realistic looking option, especially for front teeth. They are also suitable for those with metal allergies.
Porcelain fused to metal: These crowns have a porcelain layer applied over a metal core. Matched to your natural enamel color, these crowns look very realistic, although they’re not as translucent as all-porcelain crowns.
Stainless steel: Typically used for baby teeth, pre-formed stainless steel crowns are a durable, cost-effective option when a crown is needed for a primary tooth.
Composite resin: Made of color-matched resin, these crowns are a more affordable choice than porcelain or metal. Generally, however, they are only used as temporary crowns since they’re much less durable than other options.

Because a crown improves both the form and the function of a tooth, it is one of the most popular restorative treatments available. Talk to your dentist to discover how a crown can enhance the health and the appearance of your smile.

Nitrous Oxide For Children

Written by Service Lifter on April 4, 2023. Posted in Oral Surgery, Pediatric Dentistry. No Comments on Nitrous Oxide For Children

Some children are just too fearful to receive necessary dental care. In that type of situation, conscious sedation with nitrous oxide may be recommended to help make your child’s experience of dental treatment stress-free.

Nitrous oxide, a colorless gas with a slightly sweet odor, has been used in medicine for about a century. It’s a safe and effective method of administering conscious sedation, which means that a child (or adult) will stay awake during the procedure, but feel completely relaxed — even happy. All bodily functions remain normal during the administration of nitrous oxide, and its effects wear off quickly afterwards.

How Is Nitrous Oxide Administered?

As a form of conscious sedation, nitrous oxide is inhaled through a small mask that fits comfortably over a child’s nose. The gas is mixed with oxygen as it is being delivered, and both gases are always kept at a level that is safe for the body. In just a few minutes, the patient may start to experience a floating sensation, and perhaps some tingling in the hands and feet. That’s a sign that the sedation is working. Once it has been verified that your child is calm and comfortable, and that the dose is correct, the dental procedure can begin.

Nitrous oxide itself isn’t a substitute for a local anesthetic in children or adults as it’s considered an anxiolytic, which means it makes anxiety disappear. However, for some pediatric procedures, a child receiving nitrous oxide may not need an anesthetic injection. Even if they do need a numbing shot, they won’t mind at all while under sedation with nitrous oxide. Yet they won’t be asleep — they’ll be able to speak, be aware of what’s going on, and they will remain in control during the procedure. In fact, the dose can be fine-tuned to just the level of sedation they need to make them comfortable yet alert.

When the procedure is over, the flow of nitrous oxide is decreased to zero, and the oxygen will be increased. After resting in the chair for a few minutes, the child will feel completely normal.

Who Can Benefit From Nitrous Oxide?

Any child whose anxiety would preclude dental treatment can benefit from conscious sedation with nitrous oxide. Before your child is treated, you will be asked for a complete medical history, including any medications your child is taking. Your child will be kept safe and comfortable throughout the procedure, and will likely not remember a thing about it afterwards.

Whitening Traumatized Teeth

Written by Service Lifter on April 4, 2023. Posted in Cosmetic & General Dentistry, Oral Health. No Comments on Whitening Traumatized Teeth

Teeth whitening is one of the most popular cosmetic dental treatments — and it’s easy to see why. Having whiter teeth can make you look years younger, and the procedure itself is among the most conservative (and cost-effective) cosmetic treatments dentistry offers. Sometimes, however, achieving a pleasing, even shade of lightness can be challenging; this is particularly true when a tooth that needs to be lightened has been subjected to an injury (dental trauma) in the past.

Dental trauma encompasses any damage to the tooth that’s caused by an external agent, whether accidental or intended. It may be due to a fall, a sports injury — or even a past orthodontic procedure. According to some studies, around a quarter of Americans aged 6 to 50 years old have experienced some traumatic dental injury, with most occurring before age 19. Traumatized teeth may react to whitening procedures differently from undamaged teeth, which can make them difficult to treat. However, several effective treatments are available.

Diagnosing a Discolored Tooth

The first step in the process of lightening a traumatized tooth is a thorough exam to find out what’s causing the dark staining — and one of the first things we will determine is whether or not the tooth’s pulp is “vital,” or alive. This is readily revealed by radiographs (x-rays) or other tests. If the tooth is still vital, external bleaching can often yield satisfactory results — even if it’s just one tooth that needs to be whitened. In-office treatments or take-home trays are effective, but office procedures generally take much less time to produce good results.

In many cases, however, discoloration of a traumatized tooth is itself an indication that the nerves in the tooth’s pulp have died. In this case, before whitening treatment can start, a root canal procedure will be necessary to remove the dead or dying tissue and prevent infection. It can also happen that a tooth that appeared normal will begin to discolor many months (or years) after a root canal has been performed. In either situation, it may be possible to whiten a non-vital tooth with a procedure called internal bleaching.

Whitening From the Inside Out

Because a non-vital tooth’s stains are intrinsic (inside, rather than outside, the tooth), we need to put the bleaching agent itself inside the tooth. Internal bleaching is a routine procedure, here’s how it works:

Access to the pulp chamber (the small passageway in the tooth’s center) will be gained by making a small hole in the back of the tooth. Then, any debris from the chamber will be removed and rinsed away, and a special cement will be added to prevent the bleaching agent from leaking into the tooth’s roots.

Next, some bleaching agent (commonly sodium perborate) will be placed in the empty pulp chamber, and temporarily seal it in. At this point, you can get up and leave the office… which is why this procedure is sometimes called the “walking bleach” technique. However, you’ll return in a few days for another round of bleaching; it may take up to four visits to get the degree of lightening you want.

When the tooth reaches the desired color change, a more permanent restoration will be placed on the tooth to seal that little hole — usually a tooth-colored filling material of composite resin. Many times, this relatively conservative procedure will give your tooth all the lightening it needs. If it’s not enough, the tooth can be bleached externally as well, or you can even consider a veneer or crown. The goal is to recommend the most appropriate cosmetic dental procedure, and get you the best possible results.

Periodontal Flap Surgery

Written by Service Lifter on April 4, 2023. Posted in Oral Health, Oral Surgery, Periodontal Therapy. No Comments on Periodontal Flap Surgery

When advanced gum disease (periodontitis) develops, your teeth are in danger: At this stage, the ligaments and bone tissue that surround them are being destroyed, and you could even begin losing teeth! If the disease can’t be controlled by non-surgical treatments like cleaning and scaling, then periodontal flap surgery may be your best treatment option.

Flap surgery is today’s leading method for treating and repairing periodontal pockets. What are these “pockets?” They are areas below the gum line where gum tissue has detached from the teeth, resulting in an uncleansable space where harmful bacteria can proliferate. These bacteria cause inflammation of the tissues, resulting in sensitivity, bleeding, and pain. Left untreated, they can cause a host of problems including gum disease, loss of the tooth-supporting bone structure, and possibly even systemic (whole-body) problems.

When periodontal pockets develop, the first step in treating them is usually via cleaning and scaling (also referred to as root debridement) with a manual or ultrasonic instrument. If this isn’t effective, then periodontal surgery is considered. Flap surgery isn’t a cure for periodontal disease — but it helps create an environment that makes it easier to maintain your periodontal health. And even if you’re prone to gum disease, proper professional treatment and regular care at home can help keep your teeth healthy for as long as possible.

The Goals of Flap Surgery

One major objective of flap surgery is to eliminate or reduce the pocket itself. To access it, a flap-like incision is made in the gum tissue. This allows diseased tissue to be removed from inside the pocket, and provides access to the teeth’s root surfaces for a thorough cleaning, which helps to eliminate harmful plaque and calculus (tartar). Afterward, the “flap” is closed, sealing the area. This begins the healing process, which takes place rapidly.

Another goal is the regeneration of periodontal ligament and bone tissue which may have been lost to the disease. A variety of techniques may be used to accomplish this, including high-tech methods of bone grafting and chemicals referred to as growth factors. These approaches help restore the gums to their normal form and function, and promote the healthy and secure anchoring of teeth.

The Flap Surgery Procedure

Flap surgery is typically done under local anesthesia, sometimes accompanied by oral anti-anxiety medications; alternatively, it may be performed under intravenous conscious sedation. After anesthesia has taken effect, a small incision is made to separate the gums from the teeth. The outer gum tissue is gently folded back to give access to the roots and the supporting ligament and bone tissue.

Next, the inflamed gum tissue can be removed, and the tooth roots can be cleaned; if needed, the area may also be treated with antibiotics or other medications. Bone defects can be repaired with grafting material, and proper regeneration of the periodontal ligament can be encouraged by physical (barrier membranes) and chemical (growth factors) methods. Finally, the incision is closed and the procedure is completed.

Performed by an experienced hand, state-of-the-art flap surgery has an excellent track record and offers well-established benefits. It’s often the treatment of choice for relieving periodontal disease and helping to maintain your oral health — and preserve your teeth.

Root Canal Surgery (Apicoectomy)

Written by Service Lifter on April 3, 2023. Posted in Emergency Care, Oral Surgery. No Comments on Root Canal Surgery (Apicoectomy)

Occasionally, root canal treatment proves unsuccessful at resolving an infection in the tissues near a tooth’s roots. That’s when a minor surgical procedure called an apicoectomy may be recommended. Because this procedure is often performed with the aid of a microscope and other small specialized tools, it’s considered a type of endodontic microsurgery. Probably the most common type of root canal surgery, an apicoectomy involves removing a small portion of the apex (tip) of the tooth’s root, along with any surrounding hard or soft tissue that may be infected.

What would cause you to need an apicoectomy? There could be several reasons, including a canal that is blocked or inaccessible, an anatomical irregularity, or a fracture or crack in the tooth’s roots. The procedure is normally only recommended after one or more root canal treatments have been attempted, and have failed. Since this type of problem generally occurs near the apex of the root, the procedure is often an effective way to treat a persistent infection.

Before an apicoectomy procedure, diagnostic images (such as X-rays) of the affected tooth and surrounding bone, a careful review of your medical history including medications you take (both prescription and non-prescription), and other factors are reviewed. If an apicoectomy is recommended, the reasons for it will be explained to you.

The Apicoectomy Procedure

Root canal surgery is usually performed under local anesthesia such as a numbing shot, so you won’t feel any pain. To begin the procedure, a small incision is made in the gum, and the infection at the end of the tooth’s roots is exposed. The infected tissue is then removed, along with a few millimeters of the root tip itself. A dye may be used to help make cracks or fractures easy to see; if we discover that the tooth is fractured, it may be better to extract (remove) it at this time instead of completing the apicoectomy.

Next, a microscope and light are used to examine the tiny canals. They will be cleaned with an ultrasonic instrument, then filled with an inert material and sealed up with a small filling. To finish the procedure, a small bone graft may be placed at the affected site, and then the gum tissue covering the tooth’s root will be sutured (sewn) closed. X-rays may also be taken as the procedure nears completion. Afterwards, instructions on postoperative care will be given, and you’ll go home. Most apicoectomies take about 30 to 90 minutes to complete.

Following the procedure, you may experience some swelling and soreness in the area that was treated. Over-the-counter non-steroidal anti-inflammatory medications (such as ibuprofen) are usually all that’s needed to control any discomfort. You can probably return to normal activities the following day, but you may want to avoid eating hard or crunchy foods or brushing vigorously for a few days afterwards. If your sutures aren’t self-dissolving, you will be asked to return in about a week to have them removed.

The Goal: Saving Your Tooth

Although apicoectomy is typically a safe and effective procedure, there are slight risks with any type of minor surgery. That’s why apicoectomies are not recommended unless further root canal treatment won’t be effective. An alternative treatment in most cases would be extraction of the tooth. However, our goal as dentists is to help you preserve your natural teeth for as long as possible.

While there are excellent methods of tooth replacement (such as dental implants), these involve further and more complex treatments, and they can be costly. An apicoectomy is generally a permanent and cost-effective solution which can help the tooth last for the rest of your life.