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Root Canal Treatment

If your dentist prescribes a root canal, then you’re probably wondering what a root canal is — or if you do know, maybe you’re nervous about the procedure. No need to worry, though, because root canals are a safe and common procedure performed millions of times every year. According to the American Association of Endodontics , root canals are as routine as getting a filling, relatively painless, and extremely effective as treatment for a damaged or infected tooth. So what exactly is a root canal?

A root canal is a procedure, typically performed by an endodontist , to repair a damaged or infected tooth while still preserving the remaining healthy parts of the tooth. To perform the procedure, the damaged or infected tooth is left in place within the gum line while an endodontist thoroughly cleans the canal surrounding the tooth’s roots.

Why You May Need a Root Canal

You may need a root canal if you have a damaged or infected tooth that affects the dental pulp of the tooth. Dental pulp is the soft core at the center of a tooth that extends from the crown of the tooth (the visible top part) down to the tip of the roots deep within the gumline and extending to the jawbone. This dental pulp contains nerves, blood vessels and connective tissue, so when a tooth becomes damaged (by cracking or by cavity), bacteria can enter and damage the tooth’s health.

If this bacteria or decaying material is left untreated within the tooth, you run the risk of getting an infection or having a tooth abscess manifest. These symptoms can lead to pulp death, bone loss and a full loss of the tooth itself. Other symptoms that may indicate a need for a root canal are swelling around the face and neck, holes in the tooth (which cause toothaches, tooth pain and temperature sensitivity) or even gum swelling.

Getting Started on Root Canal Treatment

A dentist or endodontist (“endo” being the Greek word for “inside” and “odont” meaning “tooth”) typically performs root canals. Once they take dental X-rays to assess the damage to the tooth, they will administer a local anesthetic to the affected area to help suppress any feeling. To keep the tooth clean and dry during the procedure, dental specialists use a small, rubberlike sheet called a dental dam in the mouth.

During the procedure, your dentist or endodontist will remove decay from the outer areas and then make an opening through the crown of the tooth. This is done so that the dentist or endodontist can access the dental pulp inside. Once the hole is made, the infected or diseased pulp is removed from the tooth.

Clearing the Root Canal of Infection

Once the dental professional removes the diseased or infected pulp, they flush and clean the pulp chamber and root canals. If necessary, they may reshape or enlarge the root canals to allow for better access for the filling process that comes later.

After a thorough cleaning, your dentist or endodontist may apply medication to the pulp chamber or the root canal to help clear any lingering infection they may have missed. If the original infection has spread to other areas of the mouth, you may get a prescription for antibiotics or have another procedure scheduled, depending on your dentist’s recommendation.

If your root canal procedure requires more than one visit, your dental provider may give you a temporary filling for the crown on top of the affected tooth. This temporary crown helps protect the tooth from food debris and saliva while you wait for your next procedure. While this crown remains in place, avoid biting or chewing with it until the full tooth has been both treated and restored to your dentist’s satisfaction.

Filling the Root Canals

Once the tooth has been properly cleaned and treated, it’s time to refill the tooth to restore its structural integrity. It’s possible that more anesthesia might not be needed for this part of the process. If you had a temporary crown and filling placed on the tooth, your dentist or endodontist will remove and replace with a compound of rubber and sealer paste that will fill the remaining area inside the tooth. Once the dental pulp area is refilled with this paste, they will add an adhesive filling to the root canals to make sure they’re protected from saliva or food debris.

Final Stage of Root Canal

By now, your dentist or endodontist has drilled into your tooth, hollowed it out, thoroughly cleaned it, and then refilled it with sealant and adhesive paste. Now the dentist must restore the tooth’s strength to protect it from future damage and allow it to be used normally again.

This starts by placing a crown on top. Crowns are made of several different kinds of material, most notably gold or porcelain fused to metal, but they can also be made of porcelain alone and can be tinted or colored to match the exact color of your other teeth so they don’t stand out.

Your dentist or endodontist may also recommend inserting a metal post into the tooth for added structural integrity before the crown is applied.

After Your Root Canal

Your tooth, and the surrounding area, may be a little sensitive for a few days after the procedure. This is completely normal, and over-the-counter pain medications can help alleviate any lingering pain or pressure you may experience. If the pain continues for longer than a day or two, you should contact your dentist or endodontist immediately for further recommendations.

Otherwise, your restored tooth and crown should be both functional and aesthetically pleasing. Practicing good and constant oral hygiene will ensure that your restored tooth will continue to work well for a lifetime.

Ask your dentist or endodontist if you may need a root canal in the near future or if there’s anything you can do to help prevent it.

What Is Periodontics?

Periodontics is an oral specialty focusing on inflammatory diseases that affect the gums and oral structures supporting the teeth. Periodontists are dentists who specialize in the diagnosis, prevention and treatment of periodontal disease. They also specialize in the placement of dental implants.

With extensive training beyond traditional dental school, periodontists often treat especially problematic periodontal cases, involving severe gum disease and patients with complex medical histories. Among the specialized services periodontists provide include:

  • Scaling and root planing, during which the infected surface of a tooth’s root is cleaned
  • Root surface debridement, involving the removal of damaged tissue
  • Crown lengthening services, soft tissue grafting and removal or re-contouring

Periodontists are also able to treat severe gum problems using an array of surgical procedures. They are also specially trained in the maintenance, placement and repair of dental implants.

Who Needs a Periodontist?

If you have significant gum disease or require dental implants, you should consider seeing a periodontist. Since gum disease can lead to other serious medical conditions, it’s important to talk with your general dentist if you have any symptoms of gum disease, including bleeding, swelling or tenderness.

If you are unhappy with the aesthetic appearance of your gums, a periodontist may also be able to recommend effective cosmetic treatments.

How do I get a Referral for Periodontics Care?

If your family dentist has identified potential periodontal issues during an examination, you should ask if a visit to a periodontist is in order.

From there, the professional staff at Gentle Dental can help you schedule an appointment with one of our expert neighborhood periodontists.

What Can I Expect at a Periodontal Appointment?

Once you arrive for your appointment, the periodontist will carefully review your patient history and thoroughly examine your mouth.

During the exam, the periodontist will check for gumline recession, jaw alignment issues and loose teeth. He or she will also use a small measuring instrument to measure the depth of the spaces – known as periodontal pockets – between the teeth and gums. X-rays may also be needed to assess the health of the bone below the gumline.

Once he or she has identified the problem, the periodontist will recommend an appropriate treatment plan to correct the issue.

How Much Will it Cost?

Overall costs will vary depending on the extent of the problem and required treatment. Since periodontal treatments are considered necessary, dental insurance typically covers all or most of the associated costs. If affordability is an issue, we are pleased to offer flexible financing plans, along with discounts for patients without insurance.

Five Types of Cosmetic Dentistry Procedures

Cosmetic dentistry is a method of professional oral care that focuses on improving the appearance of your mouth, teeth and smile. And although cosmetic dentistry procedures are usually elective, rather than essential, some cases of treatment also provide restorative benefits.

The most common procedures used in cosmetic dentistry are fairly simple, whereas others are more complex and require specialized care.

Inlays and Onlays

These are also known as indirect fillings, which are made by a dental laboratory, and they are used when a tooth has mild to moderate decay or there is not enough tooth structure to support a filling. Provided there is no damage to the tooth cusps, according to Choice One Dental Care, the inlay is placed directly onto the tooth surface. When the cusp or a greater portion of the tooth is damaged, however, an onlay is used instead to cover the tooth’s entire surface.

Inlays and onlays are made in a dental laboratory from composite resin material and attached to the teeth with adhesive dental cement. They provide support to strengthen teeth, restore their shape and avoid any further decay or deterioration.

Composite Bonding

Composite bonding refers to the repair of decayed, damaged or discolored teeth using material that resembles the color of tooth enamel. Your dentist drills out the tooth decay and applies the composite onto the tooth’s surface, then “sculpts” it into the right shape before curing it with a high-intensity light. Also referred to as simply “bonding,” per the Consumer Guide to Dentistry, this effectively covers the damage to the tooth and gives the appearance of a healthy tooth in its place. Bonding is one of the least expensive cosmetic dentistry procedures available to patients with tooth decay, chipped or cracked teeth and worn-down edges.

Dental Veneers

Typically manufactured from medical-grade ceramic, dental veneers are made individually for each patient to resemble one’s natural teeth, according to Bruce Wilderman, DDS. They look exceptionally realistic and can resolve numerous cosmetic problems, ranging from crooked teeth, to cracked or damaged enamel to noticeable gaps between two teeth. The dentist applies the veneer to the front of each tooth using a dental adhesive.

Teeth Whitening

One of the most basic cosmetic dentistry procedures, teeth whitening or teeth bleaching can be performed at your dentist’s office. Whitening should occur after plaque, tartar and other debris are cleaned from the surface of each tooth, restoring their natural appearance. Teeth can also be bleached to achieve an even lighter shade than this original color, according to the American Dental Association (ADA) Mouth Healthy site.

Over the years, teeth become stained and worn from food, drinks, medication and personal habits such as smoking. Whitening coats the teeth and this procedure can be done in the dental office or at home.

Implants

Dental implants are used to replace teeth after tooth loss. The dentist inserts a small titanium screw into the jaw at the site of the missing tooth, which serves as the support for a crown. These implants are almost indistinguishable from the surrounding natural teeth, and once the bone and supporting tissue fuse to the implant, they are permanently secured into place. Patients need to practice diligent oral hygiene during the implant placement period to clean plaque and food debris from the area. If you’re considering cosmetic dentistry procedures, it’s vital to find a cosmetic dentist who specifically offers the option you’re interested in. Talk with family and friends to find out if they can refer to you a dental professional, or check with the AACD for listings of dentists in your area.

Dental Implant

What are Dental Implants?
Dental implants are metal posts or frames that are surgically positioned into the jawbone beneath your gums. Once in place, they allow your dentist to mount replacement teeth onto them.

How do Dental Implants Work?
Because implants fuse to your jawbone, they provide stable support for artificial teeth. Dentures and bridges mounted to implants won’t slip or shift in your mouth — an especially important benefit when eating and speaking. This secure fit helps the dentures and bridges — as well as individual crowns placed over implants — feel more natural than conventional bridges or dentures.

For some people, ordinary bridges and dentures are simply not comfortable or even possible, due to sore spots, poor ridges or gagging. In addition, ordinary bridges must be attached to teeth on either side of the space left by the missing tooth. An advantage of implants is that no adjacent teeth need to be prepared or ground down to hold your new replacement tooth/teeth in place.

To receive implants, you need to have healthy gums and adequate bone to support the implant. You must also commit to keeping these structures healthy. Meticulous oral hygiene and regular dental visits are critical to the long-term success of dental implants.

Implants are usually more expensive than other methods of tooth replacement, and most insurance carriers typically cover less than 10 percent of the fees.

The American Dental Association considers two types of implants to be safe. They are:

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  • Endosteal implants — these are surgically implanted directly into the jawbone. Once the surrounding gum tissue has healed, a second surgery is needed to connect a post to the original implant. Finally, an artificial tooth (or teeth) is attached to the post-individually, or grouped on a bridge or denture.
  • Subperiosteal implants — these consist of a metal frame that is fitted onto the jawbone just below the gum tissue. As the gums heal, the frame becomes fixed to the jawbone. Posts, which are attached to the frame, protrude through the gums. As with endosteal implants, artificial teeth are then mounted to the posts.
Post are surgically placed below the gums
Artificial teeth grouped on a bridge, are mounted to the posts .
Implants offer a very stable and secure fit.
Implants serve as a base for single replacement teeth.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

How to Brush Your Teeth and Floss With Braces

Dealing with Plaque Around Your Braces
Take Care of Your Gums
Brushing With Braces
Flossing With Braces
Plan Regular Checkups
How to Take Care of Your Child’s Braces

If you or someone in your family wears braces, take heart. Before you know it, you’ll be flashing a confident smile if you keep these few things in mind.

Dealing with Plaque Around Your Braces

Once teeth are straightened by braces, it is easier to reach plaque on and between your teeth. But while wearing braces, plaque and food particles have additional places to accumulate and become trapped.
Be prepared to spend three times as long on your oral care while you have braces on your teeth. Don’t worry, it’s worth the time. If you don’t pay attention to oral hygiene while your teeth are being realigned, you increase your risk of gum disease. Plus, it can help your teeth look that much better when it’s finally time to get your braces removed.

Take Care of Your Gums After Braces with Electric Toothbrushes

While wearing braces, you might consider using the sensitive mode of your Electric Toothbrush. The sensitive mode oscillates at a lower speed for extra care and comfort along the gum line—and around the brackets and orthodontic wires.

Brushing with Braces

Using an Electric Toothbrush makes this routine easy.

  • Get started: Remove elastics, bands, or removable parts of orthodontic appliances.
  • Clean your braces: Carefully clean around wires and pins.
  • Brush each wire: Move top to bottom, and all the way around upper and lower teeth.
  • Brush your teeth: Dental professionals recommend brushing your teeth for two minutes, twice daily. That means each quadrant of your mouth gets 30 seconds. Oral-B Electric Toothbrushes have a built-in timer that pulses every 30 seconds to let you know when to switch areas of the mouth. As you’re brushing, make sure to clean all areas of the tooth. Some people find they get the best clean going tooth by tooth.
  • Rinse, and then check your teeth: Rinse thoroughly. Examine teeth and braces in the mirror, and remember to look for any remaining food particles.

Flossing With Braces

Although flossing with braces is tricky, you can get the hang of it with practice if you follow these steps:

  • Floss once a day:Use waxed floss (unwaxed floss is more likely to get caught and shred in your braces), dental tape or a product specifically designed to clean around your braces. Use waxed floss and thread it carefully under the main wire before passing between two teeth. Don’t snap it—simply move up and down gently, remove, and move on to the next pair of teeth, which is self-threading or regular floss with a floss threader to place above and below the orthodontic wire.
  • Use enough:About 18 inches of floss should suffice
  • Thread it carefully: Take the floss and carefully thread it under the main wire of the braces before passing it between two teeth. Then remove the floss and re-thread it under the main wire to pass between the next pair of teeth
  • Be sure not to snap the floss– simply move it up and down gently against the side of each tooth

Parents: Do the flossing for younger children who lack the coordination to thread the floss under the main wire of their braces.

Plan Regular Checkups

Seeing your orthodontist for checkups and adjustments is essential. He or she can repair broken pieces, answer general questions, and address any irregularities such as cavities or every meal or snack if you wear braces. And some dentists recommend a fluoride mouthwash to help control plaque buildup in the places that are tough to reach with a toothbrush.

How to Take Care of Your Child’s Braces

Do you have a child with braces? The following points will help make your child’s daily brushing routine effective:

  • Before brushing – Your child should take off elastics and any other removable parts of their orthodontic appliance. For removable appliances, take them out after every meal for cleaning.
  • Brush teeth – They should clean each tooth individually. First, they should place their brush at a 45-degree angle from the gum line, then apply gentle pressure whilst moving in a circular motion. They should do this for about 10 seconds, using the same brushing action on all outer and inner tooth surfaces, and tilting the brush as needed to better reach the insides of smaller front teeth.
  • Clean the braces – Your child should hold the brush at a 45-degree angle to clean around the wires and brackets of their braces. They need to brush from the top of each wire down to the bottom. They should take the time to ensure that all plaque and debris is removed, and that they work all the way around upper and lower teeth. For removable braces, clean them over a sink filled with water. This helps to prevent damage to the brace if you accidentally drop it. Brush the brace with a toothbrush and fluoride toothpaste to remove all food and debris. Be careful not to damage the wires. Once it’s clean, put the brace back in the mouth.
  • Interdental brushes once a day – Have their dental professional show them the best way to clean between the teeth and braces. Also, they should follow the instructions on the product package. They may also want to use an interdental product designed for braces and orthodontic work, like a single-tufted toothbrush or floss.
  • Protecting your child’s teeth – Braces put their teeth at greater risk of developing decay, therefore they need to keep their teeth strong by using fluoride toothpaste. Brushing should be undertaken twice a day at a minimum and preferably after every meal.
  • Fluoride concentration – If their dentist or orthodontist feels they are at greater risk of tooth decay, they may increase the fluoride concentration by (i) prescribing a stronger toothpaste, (ii) applying fluoride varnish to their teeth two to four times a year when they visit them or (iii) asking them to use a fluoride mouthwash at a different time than tooth brushing.
  • Spit, but do not rinse after brushing – Rinsing after brushing will wash away the fluoride toothpaste which is needed to strengthen their teeth. This dilution effect is why even a mouthwash straight after brushing is bad news as it dilutes the fluoride around their teeth.
  • Keep up regular visits with their dentist and orthodontist.

Taking Care of Your Braces

Braces Do More Than Improve Your Smile
The Basics: Brushing and Flossing
Visit the Orthodontist Regularly

You should be prepared for the fact that taking care of your teeth will be more difficult once you get braces. Braces have countless tiny spaces to trap food, and this trapped food causes plaque, which can lead to many other dental problems. Because of this, it’s very important to brush your teeth after every meal (snacks count, too), to rinse with mouthwash, and to floss at least once a day. This may seem tedious or excessive, but neglecting your oral hygiene can lead to serious oral health problems, force you to spend additional time in braces, or cause unsightly staining on your teeth. The extra responsibility needed to care for braces properly is something that both you and your child should be prepared for.

Braces Do More Than Improve Your Smile

They also play an active role in correcting overcrowded and misaligned teeth. This is important because an abnormal bite (also known as “malocclusion”) may cause other problems, such as impaired plaque removal around misaligned teeth, which can lead to gum inflammation and cavities.

Taking good care of braces can help prevent damage to the braces themselves and the teeth underneath as well as make the braces more comfortable to wear. Learning the basics of orthodontic care will help you follow your dental professional’s recommendations to keep your teeth and gums healthy during the time you’re wearing braces.

The Basics: Brushing And Flossing

Careful cleaning is required with braces, because plaque bacteria are easily trapped inside and around them. The following procedure will make daily brushing and flossing both simple and effective.

  • Prepare to brush. Take off elastics and any other removable parts of your orthodontic appliance.
  • Clean your braces. Hold your brush at a 45-degree angle to clean around the wires and pins of your braces. Brush from the top of each wire down to the bottom. Take your time to ensure that all plaque and debris are removed, and that you work all the way around upper and lower teeth.
  • Brush your teeth. Clean each tooth individually. First, place your brush at a 45-degree angle the gum line, then apply gentle pressure as you move in a circular motion. Do this for about 10 seconds. Use the same brushing action on all outer and inner tooth surfaces, tilting the brush as needed to better reach the insides of smaller front teeth.
  • Floss once a day. Have your dental professional show you the best way to floss, or follow the instructions on the product package. You may also want to use a flossing product designed for braces and orthodontic work, like a floss threader.
  • Rinse and check your teeth. Rinse thoroughly with water or mouth rinse, and examine your teeth and braces in the mirror.
  • Professional Care: Dentist And Orthodontist Visits

Visit the Orthodontist Regularly

During the time that you have braces on your teeth, you will need to visit the orthodontist regularly for adjustments to your appliance. After a routine orthodontic adjustment, you may experience some tightness or even a slight amount of pain. If this discomfort or pain does not quickly dissipate, or becomes extreme, you should consult your orthodontist. Concerns about your appliances, and any problems with broken parts, should also be brought to your orthodontist’s attention immediately.

It’s also important that you continue with regular visits to your general dentist while undergoing orthodontic treatment. Routine checkups are necessary to spot cavities and signs of gum disease. Your dentist or hygienist may also perform frequent fluoride treatments to provide additional protection to tooth surfaces from decay while you’re wearing braces.

Your home oral care techniques will be monitored by your dental professional and changes will be recommended as necessary. As always, be sure to follow their instructions.

Types of Braces

Today’s orthodontics offer more kinds of braces than ever before. Check out your options

Metal braces/Traditional braces
Ceramic Braces
Lingual Braces
Invisalign

Metal braces/Traditional braces

These are the metal brackets and wires that most people picture when they hear the word “braces.” However, modern brackets are smaller and less noticeable than the notorious “metal-mouth” braces that many adults remember. Plus, new heat-activated archwires use your body heat to help teeth move more quickly and less painfully than in the past.

Pros: Least expensive type; colored bands give kids a chance to express themselves
Cons:Most noticeable type of braces

Ceramic Braces

Ceramic braces are the same size and shape as metal braces, except that they have tooth-colored or clear brackets that blend in to teeth. Some even use tooth-colored wires to be even less noticeable.

Pros: Less noticeable than metal braces; move teeth much faster than clear plastic aligners (Invisalign)
Cons:More expensive than metal braces; Brackets can stain easily if patients don’t care for them well

Lingual Braces

Lingual braces are the same as traditional metal braces, except that the brackets and wires are placed on the inside of teeth.

Pros:Invisible from outside
Cons:Difficult to clean; more expensive; not appropriate for severe cases; can be more uncomfortable at first; regular adjustments take longer and are more difficult than with traditional braces

Invisalign

Invisalign consists of a series of 18 to 30 custom-made, mouth guard-like clear plastic aligners. The aligners are removable and are replaced every 2 weeks.

Pros: Almost invisible; Patients can eat and drink whatever they want


Cons: Will not work for serious dental problems; only available for adults and teens, not children; more expensive option; can be easily lost and costly to replace; treatment may potentially take longer.