July 24, 2010

What is a root canal?

The root canal is a narrow canal within the roots of all teeth that conveys the nerves and blood vessels to the tooth. When the pulp tissue within the tooth dies and starts to cause pain, the dead nerves and blood vessels should be removed and filled with an appropriate filling material, normally gutta-percha. This procedure is called a root canal treatment, or more commonly, a “root canal.”

This procedure is usually performed by general dentists in Fort Worth, or by an endodontist, a dental specialist trained to perform root canal treatments.

The dentist will conduct a thorough examination of your mouth to determine the exact cause of the pain or the swelling. He will then conduct pulp vitality tests to determine the health of the pulp in the tooth. Radiographs of the tooth will be taken to determine any infection of the roots of the teeth in the form of a dark spot on the x-ray near the roots. Only after a diagnosis has been established, the dentist proceed with root canal treatment.

Performing root canal treatment is vital to saving the tooth. Nothing can match the aesthetics and function of a natural tooth. Preserving the tooth is a more cost-effective and conservative procedure than extraction and replacing the tooth with a dental bridge. If the treatment has been a success, the root canal filling will stay for a lifetime. If pulp tissue has been left behind accidentally or if the root canal hasn’t been sealed properly from surrounding tissue, the treatment can fail.

People shudder at the thought of undergoing root canal treatment, due to the negative impression garnered by this procedure. Today, root canals are done only under local anesthesia. Infection and pain is controlled with the help of antibiotics and pain-killers. Sedatives are also available for anxious patients to allow them to undergo treatment comfortably.

What are the normal indications for root canal treatment?

  • Pulpal involvement of the dental decay. This is felt as a sharp pain while eating or drinking hot and cold food.
  • Tooth infection and dental abscess formation. Pimple formation on the gums is a sign of dental abscess. Persistent toothache and tenderness near the gums are other signs. Pain on chewing or application of pressure on the tooth, (towards the jaw bone) indicates the need for root canal treatment.
  • Tooth fracture and exposure of pulp. Tooth trauma can be identified by discoloration of the traumatized tooth. Traumatized tooth may or may not exhibit pain.
  • Tooth transplantation or tooth resection
  • Tooth avulsion
  • Gum abscess. This can be identified by the swelling on the gums that is painful to touch.
  • Severely weakened tooth following wide spread dental decay.
  • Very deep dental cavity that cannot be filled by normal means.
  • Accidental exposure of the pulp can also result in root canal treatment if the pulp becomes irreversibly inflamed.

July 16, 2010

How can you keep your braces clean?

Getting braces for orthodontic treatment to correct those wayward teeth can be a difficult time for any individual, particularly teenagers. Adolescents are generally less motivated and less concerned about maintaining optimum oral hygiene. Braces increase the surface area of the tooth surface and their rough surface acts as a magnet for plaque and cavities.

The presence of brackets on the teeth prevents the normal action of cheeks, lips and tongue from cleansing your teeth naturally. Plaque brings with it tons of germs that cause tooth decay and gum disease. It is common for orthodontists to refer patients to general dentists before and after orthodontic treatment to get their teeth cleaned and get all the decayed teeth filled. Braces, wires, springs, rubber bands make it difficult even for patients with good habits to maintain satisfactory oral hygiene.

Some amount of inflammation of the gums can be expected with braces. It is important for the dentist to recognize the problem before it progresses to become periodontitis (periodontal inflammation). Periodontal inflammation can delay healing and can cause pain and mobility of teeth during orthodontic treatment.

Steps to take to keep you braces and teeth clean:

• Brush your teeth twice daily. Use fluoridated toothpaste fortified with antibacterial medications to prevent tooth decay and inflammation. Angle your toothbrush 45 degrees towards the gum line and gently brush away plaque that has accumulated between the gums and braces. Try to brush after each meal and avoid eating between meals. If any of the components get dislodged, take it to your orthodontist to get it fixed. Remember to brush all the surfaces thoroughly. Wash out all the food debris after brushing. Use a two-tone plaque-disclosing solution to assess your brushing effectiveness.

• Specialized orthodontic brushes (where the bristles in the middle are lower than the bristles on the edges), and interdental brushes are available for more effective cleaning. Electric toothbrushes are a good alternative for people who hate brushing. Rubber tip stimulators help dislodge stubborn debris from between teeth.

• Floss your teeth daily, preferably at night. You don’t need special dental floss for regular flossing. Normal nylon dental floss with a floss-threader will help. Pass the dental floss beneath the orthodontic wire for brushing. It takes more time initially, but with constant practice you can reduce the time and effort needed to floss daily.

• Use oral irrigation devices like WaterPik, QuickBreeze or ShowerPik, which use a jet of water to dislodge debris from the tooth surface.

• Rinse your mouth with an over-the-counter mouthwash daily. Mouthwashes containing antibacterial agents like Triclosan can help further prevent gum disease. Always consult your dentist before prolonged use of mouthwash. Dentists who specialize on orthodontics in Fort-Worth can further guide you on how to properly maintain your teeth while undergoing orthodontic treatment.

July 1, 2010

What is sedation dentistry?

Sedation Dentistry refers to the practice of using sedatives to calm the patient before and during a dental appointment. Not all patients may need sedation dentistry for routine procedures. Certain patients who have “dental phobia” experience difficulty in approaching a dentist for their dental problem because of their fears. Sedation dentistry allows the dentist to work in an anxiety-free environment and reduces stress for both the patient and the dentist.

Sedation dentistry is used in conjunction with local anesthetics. The local anesthetics are applied after the patient has been sedated comfortably and he/she will not respond adversely to the subsequent injection. Multiple procedures can be completed in 1-2 sittings more efficiently under sedation. Anxious patients normally require multiple sittings for a single procedure due to their fears of the dental office.

A large segment of the population avoids seeking dental treatment because of their fear of dental drills, dental extractions, injections or sensitivity and pain during dental procedures. Films (e.g. “Marathon Man) and popular media have also contributed to the false perception that all dental procedures are painful.

There are different levels of sedation offered by your Fort Worth dentist. With minimal sedation, the anxiety of the patient is reduced to allow the dentist to work comfortably while the patient is completely aware of his surroundings and can respond to verbal and visual commands. With moderate sedation, the anxiety levels are further reduced. Minimal to moderate levels of sedation are usually needed to reduce moderate levels of anxiety. Deep sedation involves complete loss of consciousness so that the patient cannot respond to external stimuli. The patient will not remember anything that happened during the procedure when under deep sedation.

There are many different types of sedatives used in dentistry:
• Tranquillizers
• Depressants
• Anti-anxiety medications e.g. Diazepam
• Nitrous oxide

Sedatives can be administered through many routes. The most commonly used routes are:
• IV sedation
• Oral sedation
• Inhalation sedation
Most patients prefer oral and inhalation sedation because they can avoid needles.

The recovery time with inhalation sedation is very short compared to other means of sedation. Nitrous oxide or “laughing gas” is administered by breathing it in. Patients can return to their normal daily activities soon after the effects have worn off. Most patients will sleep during the procedure and may experience a brief amnesia and not remember what happened during the procedure.

Oral sedation takes up to 1 hour to sedate a patient sufficiently and takes longer for the effects to wear off. Patients under oral sedation are not advised to operate heavy machinery for at least 24 hours after the procedure.

Sedation dentistry is safe and the drugs used as sedatives are approved by the Food and Drug Administration. Sedation dentistry protocols have been followed for almost 30 years without major incidents. Any dental procedure can be done under sedation including routine dental cleanings and fillings, to complex procedures like dental implants and wisdom tooth removal.