By Lexington Endodontics
May 23, 2020
Category: Dental Procedures
CrazyLittleThingCalledHyperdontia

The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.

The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.

Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces). Some people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.

Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.

After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.

Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.

If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”

By Lexington Endodontics
May 13, 2020
Category: Dental Procedures
WatchOutforRe-InfectionAfteraRootCanalTreatment

So, you've undergone a root canal treatment to save a decayed tooth. The tooth has a new lease on life — and the pain is gone too. But there's a reality you need to keep in mind — your tooth could become re-infected, putting you back in the same painful circumstance.

Root canal treatments are often necessary when decay works its way deep within a tooth, into the pulp. The excruciating pain a person feels is the infection attacking the bundle of nerves within the pulp tissue. If the infection isn't addressed promptly, it will continue to work its way to the root, eventually damaging the tooth beyond repair.

During a root canal treatment, we drill into the tooth to access the pulp chamber. After clearing it completely of its infected tissue, we then fill the chamber and root canals with a special filling and then seal off the access. A short time later we'll bond a crown over the tooth to protect it and to make it more attractive.

Most of the time, this preserves the tooth for many years. Occasionally, though, re-infection can occur. There are a number of reasons why: the first infection may have been more extensive than thought; the root canal network was more complex and some tinier canals weren't able to be identified; or the protective crown may once again get tooth decay contaminating the root canal.

If infection does reoccur it doesn't mean the tooth is lost. It's possible a second root canal treatment can successfully correct any problems, especially those that may not have been detected the first time. More complex cases might also require the services of an endodontist, a specialist in root canals. They're skilled in advanced techniques and have specialized equipment to handle even the most complicated root canal networks.

In the meantime, if you notice signs of re-infection like pain or swelling around a treated tooth, contact us promptly for an appointment. You should also contact us if the tooth is injured in an accident. The sooner we can treat your tooth, the more likely the second time will be more successful.

If you would like more information on preserving a tooth through 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 “Root Canal Treatment: How long will it Last?

By Lexington Endodontics
May 03, 2020
Category: Oral Health
Tags: root resorption  
GetanEarlyStartTreatingRootResorptionBeforeitsTooLate

Baby (primary) teeth look and function much like their permanent counterparts. Besides having a visible crown, they also have roots that maintain contact with the jawbone.

But there are some differences, the biggest one being the normal process whereby primary tooth roots dissolve or, in dental terms, resorb. Root resorption eventually leads to the tooth coming loose to make way for the permanent tooth.

Adult tooth roots can also resorb — but it's decidedly not normal. If adult root resorption isn't promptly treated, it could also lead to tooth loss — but there won't be an incoming tooth to take its place.

Although it can begin inside a tooth, adult root resorption usually begins on the outside. One type, external cervical resorption (ECR), begins around the neck-like area of the tooth not far below the gum line. Its initial signs are small pink spots where the tooth enamel has eroded; those pink cells within the space are doing the damage.

We don't fully understand the mechanism behind ECR, but there are some factors that often contribute. People with periodontal ligament damage or trauma, sometimes due to too much force applied during orthodontic treatment, have a high risk of ECR. Some bleaching techniques for staining inside a tooth may also be a factor.

The key to treating ECR is to detect it as early as possible before it does too much root damage. Regular checkups with x-rays play a pivotal role in early detection. Advanced stages of ECR might require more advanced diagnostics like a cone beam computed tomography (CBCT) scan to fully assess the damage.

If the lesion is small, we can surgically remove the cells causing the damage and fill the site with a tooth-colored filling. If ECR has spread toward the pulp, the tooth's inner nerve center, we may also need to perform a root canal treatment.

Either of these methods intends to save the tooth, but there is a point where the damage is too great and it's best to remove the tooth and replace it with a life-like dental implant or other restoration. That's why it requires vigilance through regular, semi-annual dental visits to detect the early signs of root resorption before it's too late.

If you would like more information on adult tooth root resorption, 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 “Root Resorption.”

By Lexington Endodontics
April 23, 2020
Category: Dental Procedures
RootCanalsareaSafeWaytoSaveTeeth

Every year U.S. dentists perform around 25 million root canal treatments and save countless teeth from the ravages of decay. But if you search "root canal" on the Internet, you might encounter an unsettling charge against this tooth-saving treatment—that it causes cancer.

Root canal treatments are routinely used when tooth decay has infected the pulp, the innermost layer of a tooth. During the procedure, we access the pulp and remove all the infected tissue. We then fill the empty pulp and root canals, seal the access hole and later crown the tooth to prevent further infection. Without this intervention, the decay can continue to advance toward the roots and supporting bone, putting the tooth in imminent danger of loss.

So, is there any credibility to this claim that root canal treatments cause cancer? In a word, no: there's no evidence of any connection between root canal treatments and cancer—or any other disease for that matter. On the contrary: root canals stop disease.

As with other types of urban legends and internet hype, the root canal-cancer connection may have arisen from another discredited idea from the early 20th Century. A dentist named Weston Price promoted the notion that leaving a "dead" organ in the body led to health problems. From his perspective, a root canaled tooth with its removed pulp tissue fit this criterion.

In the mid-1950s, dentistry thoroughly examined Dr. Weston's theory pertaining to treatments like root canals. The Journal of the American Dental Association devoted an entire issue to it and found after rigorous scientific inquiry that the theory had no validity in this regard. Another study in 2013 confirmed those findings. In fact, the later study instead found that patients who underwent a root canal treatment had a 45 percent reduction in oral cancer risk.

Given the freewheeling nature of the Internet, it's best to speak with a dental professional about your oral health before trusting a post or article you've found online. Not only are they more informed than an unverified online source, they would certainly not knowingly subject you to a procedure to save a tooth at the expense of your health.

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 “Root Canal Safety.”

HughJackmanIsAllSmilesforHisNewBroadway-InspiredShow

To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.

With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.

The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…

Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.

A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.

And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.

One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.

If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”





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Lexington Endodontics

Lexington, MA Endodontist
Lexington Endodontics
922 Waltham Street, Suite 204
Lexington, MA 02421
(781) 325-8181