As in other parts of medicine, lasers are beginning to change the way we provide dental care. More and more dentists are using lasers to make earlier diagnoses of dental disease or provide surgical treatment. One area prime for change is the treatment of teeth with deep decay and in danger of being lost.
For decades now, the best way to save teeth in this condition is with root canal treatment. In this common procedure we access the pulp, remove the infected tissue with specialized hand instruments, and then fill and seal the pulp chamber and root canals with a special filling.
We can now potentially improve the efficiency and increase the success rate of this treatment with laser technology. With their focused light, lasers emit a concentrated burst of energy that's extremely precise. In many instances laser energy can remove the target diseased tissue without damaging nearby healthy tissue.
In this form of root canal treatment, we use lasers to remove tissue and organic debris within the pulp and then shape the root canal walls to better receive the filling. We can also utilize the heat from laser energy to soften and mold the filling, so that it better conforms within the walls of the root canals.
Using lasers in root canal treatments may require less local anesthesia than the traditional approach and also eliminates disturbing or discomforting sounds and vibrations. Dentists who've used the new technology also report less bleeding during the procedure and less pain and occurrences of infection afterwards.
But there are a couple of disadvantages for using lasers in root canal treatment. For one, light travels in a straight line — and many root canal networks are anything but straight. More complex root canal networks may still require the traditional approach. Laser energy could also increase the tooth's inner temperature, which could potentially damage tissues even on the tooth's outer surfaces.
Used in the right circumstances, though, lasers can be an effective means to treat diseased teeth. Â As laser technology continues to advance and becomes a mainstay in dental care, you may soon find it part of your next dental procedure.
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
It’s absolutely critical to stop tooth decay and repair any damage to tooth structure. Hopefully, we’ve caught it early in the enamel and dentin where we’re able to repair any holes or “cavities” that might have developed by filling them.
But what if the decay has crept deeper into the interior of the tooth? In this case, you’re at a much higher risk of eventually losing the tooth. If the decay has spread into the bone, a root canal treatment is usually your best option.
The first sign that decay has invaded the pulp, the innermost layer of the tooth, and the root canals may be a severe toothache. It’s different from the wince of pain or discomfort caused by sensitivity to temperature or pressure. Inner decay pain is constant and often excruciating. This is because the infection is attacking the nerves bundled within the pulp chamber.
The pain can last for several days, and then suddenly stop altogether. No pain is good news, right? Wrong — the pain has stopped because the infected nerves have finally died and can no longer signal the brain. The infection, though, is very much alive and will continue to advance toward the root where the damage may eventually cause you to lose the tooth.
A root canal treatment removes decay in the pulp chamber and canals. We first drill an access hole to enter the pulp chamber. Once inside, we use special instruments to completely remove all tissue and disinfect the empty chamber. We then fill the chamber and root canals with a special filling and seal the access hole to prevent further decay. A few weeks later we install a custom crown to protect the tooth further.
If you have a toothache, or you’ve had one that suddenly went away, you should schedule an appointment for a dental examination as soon as possible: this is the only way to accurately determine the cause of the pain. If a root canal is deemed necessary, the sooner we perform it, the less chance the infection will cause you to lose your tooth.
If you would like more information on root canal treatment, 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 “Signs and Symptoms of a Future Root Canal.”
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?”
Determining which of your teeth is causing your toothache isn’t always easy — or even if it’s a tooth at all. The pain could be coming from a tooth, the gums, or both. Only a thorough dental examination can pinpoint the exact cause and best course of treatment.
If a decayed tooth is the problem, the pain may be coming from nerves and other tissue deep within the tooth’s pulp. The symptoms could be dull or sharp, constant or intermittent, specific to one area or spread out. It’s even possible for the pain to suddenly subside after a few days. This doesn’t mean the infection has subsided, but rather that the infected nerves have died and no longer transmit pain. Pain can also radiate from the actual source and be felt somewhere else — the pain in your sinuses, for example, could actually originate from an infected back tooth.
If the source is periodontal (gum) disease, the infection has begun in the gum tissues. As they become more inflamed they lose their connectivity with the teeth, bone loss occurs and the gums may “recess” or draw back. This exposes the tooth root, which without the protective cover of the gum tissues becomes highly sensitive to changes in temperature or pressure. As a result you may encounter sharp pain when you eat or drink something hot or cold, or bite down.
Treating these issues will depend on the actual infection source. An infected tooth often requires a root canal treatment to clean out the pulp and root canals of dead or infected tissue, fill them with a special filling, and seal and crown the tooth to prevent future infection. If the source is gum disease, we must manually remove the bacterial plaque causing the disease from all tooth and gum surfaces to stop the infection and allow the gums to heal. In advanced cases, surgical procedures may be necessary to repair damage and encourage new gum and bone growth.
Where dental disease has spread from tooth to gums or vice-versa, you may need treatments for both areas to address your overall condition. Whatever the treatment course, we can put an end to your tooth pain and restore health to your teeth and gums.
If you would like more information on the sources of mouth pain, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”
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