One of the most common treatments we are asked about is a root canal and the unfortunate bad reputation associated with it. The truth is that the procedure actually relieves the pain associated with the problem and not visa versa. And here's why.

A root canal or endodontic treatment (“endo” – inside; “dont” – tooth) is a necessary procedure in which diseased pulp tissue — and the nerve, which responds by causing the pain — is removed. This is followed by cleaning and sealing the root canals. This usually results from pulp inflammation and infection as a result of a severe decay or in a heavily filled tooth. Root canal treatment is typically performed by general dentists who have taken specialized training or by endodontists, dentists who specialize in the diagnosis and treatment of root canal problems. We perform them here in our practice to save a tooth, literally, from further damage and/or loss.

Here is a quick overview of the procedure. We will begin by making a small opening in the chewing surface of your tooth so that we can access the tooth's root canal. We use small instruments to remove the dead and dying tissues of the pulp. The root canals are cleaned and disinfected. The canals are then sealed with a biocompatible filling material. Lastly, we will seal the access hole with a filling material. You will then need to get a permanent restoration or crown to protect the tooth fully.

If you feel that you have the symptoms of a root canal problem and may need a root canal treatment, contact us to schedule an appointment. And to learn more about the signs, symptoms, and what to expect after root canal treatment, read the article “Common Concerns About Root Canal Treatment.”

When choosing among different ways to solve a problem, knowledge is power. In the case of selecting the best repair for a dental problem, count on your team of dental professionals to advise you. But you as the patient make the final decision, and it helps to thoroughly understand the different options, their advantages and disadvantages. If you have a chipped or broken front tooth, your likely repair options are composite resin or porcelain veneer.

Composite resins are synthetic materials that can be colored to match your natural teeth. The material is bonded to the tooth surface using adhesives that become part of the tooth structure, strengthening the original tooth. The repair looks as good as, or even better than, your original tooth. Such repairs can be used to restore small to large chips and other damage caused by decay or trauma.

Since the composite resin repair is applied directly to the tooth in the dental office, the repair can be made in a single appointment. You do not need to use a temporary repair while waiting for the final replacement to be made at a dental laboratory. This also means that the repair will cost less.

Another advantage of composite resin is that less of the healthy tooth needs to be removed to prepare the tooth to receive the replacement, since it bonds directly to the original tooth structure.

Porcelain veneers are very thin layers of tooth-colored porcelain that are also bonded to the tooth. They are usually recommended in situations with more serious injury or risk to the tooth, such as teeth that have been fractured, treated for root canal, or injured in contact sports.

Application of porcelain veneers may require more tooth preparation (in which more of the original tooth material must be removed) before the restoration can be bonded in position. Bonded porcelain veneers are likely to be longer-lasting than composite resins. They must be fabricated in a laboratory, so they require more than one visit and cost more.

All of the above are factors to consider in choosing composite resin or porcelain veneer to restore your chipped or damaged tooth. As usual in making such decisions, the final choice will depend on your individual situation.

Contact us today to schedule an appointment to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth with Composite Resin.”

If you engage in frequent air travel, you have probably experienced pain in your ears and sinuses related to pressure changes. The pain is caused by “barotraumas” (from baro meaning pressure — also the root of the word “barometer” — and trauma meaning injury) and is also called a “squeeze.” Divers also sometimes experience this discomfort or pain.

The cause of barotraumas is air pressure (or water pressure, in the case of divers) on the outside of your body that is not equal to the pressure inside your body. Normally when pressure outside your body changes, your organs such as your blood, bones, and muscles transmit the changes equally from outside to inside. Some structures in your body, such as your middle ear spaces and your sinus cavities (spaces in the facial bones of the skull), don't transmit the pressure as well because they are filled with air and have rigid walls. The maxillary (upper jaw) sinuses are pyramid-shaped spaces in the bone located below your eyes, on either side of your nose.

You have probably tried to stop such pain in your ears by yawning, chewing, or moving your jaw back and forth. These maneuvers, called “clearing,” allow air to move from the back of your throat into your ear canals so that the pressure can equalize. Similarly, your sinuses have small openings near their lower borders, so that you can clear pressure changes within them. If you have a head cold or flu and the membranes lining your sinuses are swollen and inflamed, they may close off the openings and make it difficult to clear these spaces. This can sometimes lead to intense pain.

Because the lower walls of these sinuses are adjacent to your upper back teeth, these teeth share the same nerves as the maxillary sinuses. This sharing sometimes causes pain felt in your back teeth to be perceived as pain in the sinuses, or vice versa. Pain felt a distance from its actual stimulus because of shared nerves is called “referred pain.”

Be sure to make an appointment with us if you experience pain in any of your teeth. Any defect in a filling or tooth can allow air to enter the tooth. It could be referred pain from your sinuses, or the result of pressure changes on trapped air within a filling or a tooth. Such pain, called barodontalgia (from baro meaning pressure, don't meaning tooth, and algia meaning pain) is an early sign of injury in a tooth.

Contact us today to schedule an appointment to discuss your questions about tooth and sinus pain. You can also learn more by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”

Periodontal (gum) diseases are sometimes called “silent” because those who have them may not experience painful symptoms. But certain signs point to the existence of these common diseases. If you are experiencing any of the symptoms below, it is time to visit our office so these problems can be treated before they lead to serious infection and loss of teeth.

Gums that bleed during the brushing of teeth. Some people think that gums bleed from brushing too hard. In fact, healthy gum tissues will not bleed with normal brushing. The usual cause of bleeding gums is an accumulation of dental plaque in the areas where your teeth meet your gums. Plaque is a film of bacteria, called a biofilm, which accumulates on your teeth. If you are not brushing and flossing effectively, plaque irritates your gum tissues and causes an inflammation and swelling called gingivitis. This causes your gums to bleed easily on contact with a toothbrush or floss.

Gum tissues that appear red and swollen. If plaque is allowed to accumulate for 24 hours or more, the inflammation in your gum tissues becomes chronic. The continuous presence of bacteria makes it impossible for your body's natural defenses to fight the infection. Chronic inflammation leads to a breakdown of the normal attachment between the teeth and the gums, causing the formation of “pockets.” Inside these pockets the infection continues to attack the tissues that support your teeth. Eventually this can lead to a breakdown of the bone that surrounds your teeth.

Bad breath. Bad breath is another sign of accumulated plaque. The bacteria in plaque may emit gases that have an unpleasant odor.

Gums that are sensitive to hot or cold. Chronic inflammation can also cause the gums to recede, exposing the roots of the teeth in which nerves may be close to the surface, leading to sensitivity to heat and cold.

Teeth that are getting loose, or a painful area in the gums. If you experience these symptoms, the infection has progressed a long way from the “silent” stage. It is time to seek immediate professional help.

If you answered “yes” to any of the above questions, a professional dental examination is in order. With daily removal of plaque by effective brushing and flossing, along with frequent professional cleanings to remove any plaque that you were unable to catch, you will go a long way to preventing periodontal disease. Also, be aware that smoking tends to mask the effects of gum disease. Generally, if you smoke your gums will not bleed when brushing or flossing, nor will they show signs of swelling.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine articles “Bleeding Gums” and “Warning Signs of Periodontal (Gum) Disease.”