My Blog

Posts for category: Dental Procedures

3ReasonsaRootCanalTreatmentMightFailandWhatYouCanDoAboutIt

It's not an exaggeration to say the modern root canal treatment has saved millions of teeth over the last century. Without this procedure, there's not a lot we can do to stop advanced tooth decay from infecting and destroying a tooth.

What's more, a root canal treatment could extend the life of a tooth for decades. Notice we said could—although most root canals do have satisfactory outcomes, there's still a chance a tooth may become re-infected. Here are 3 possible causes for an unsuccessful root canal treatment, and what you can do to lessen their impact.

The severity of the infection. Tooth decay usually begins at the enamel layer, softened by the acid produced by bacteria. Untreated, the infection can then spread through the next tooth layer of dentin until finally infecting the innermost pulp. From there the infection can move through the root canals to the bone, dramatically increasing the danger to the tooth. Root canal treatments have a higher chance of success the earlier they're performed in the disease progression, so see your dentist at the first sign of pain or other tooth abnormality.

The root canal network. An effective root canal procedure eliminates all dead or diseased tissue in both the pulp chamber and the root canals (these are then filled to prevent future infection). But this may prove difficult with teeth that have intricate root canal networks because of a higher risk of overlooking some of the canals. It may be best in such cases for an endodontist, a specialist in treating interior tooth issues, to perform the procedure using their advanced techniques and microscopic equipment.

The age of the tooth. Root canal treatment can weaken a tooth's structural integrity, especially with older teeth. This can make them more susceptible to fracture and a higher chance of infection. We can avoid this outcome by placing crowns on root-canaled teeth: The crown provides structural strength to the tooth and can add further protection against infection. Older teeth may also benefit from the placement of a small support post within it to further add stability before applying the crown.

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 Treatment: How Long Will It last?

TooOldtoStraightenYourSmileNotIfYoureLikeTheseA-ListCelebrities

If you're well past your teen years, you probably have several reasons for not straightening your crooked smile: the expense, the time and the embarrassment of being a 30-, 40- or 50+- something wearing braces. But we have five reasons why adult orthodontic treatment can be a smart choice: Tom Cruise, Kathy Bates, Carrie Underwood, Danny Glover and Faith Hill.

That's right: Each of these well-known entertainers and performers—and quite a few more—underwent treatment to improve a poor dental bite. And not as teenage unknowns: Each on our list wore braces or clear aligners as famous adults (the paparazzi don't lie!).

Here are a few of the reasons why these celebrities chose to change their smile through orthodontics—and why you can, too.

Age isn't a factor. Straightening misaligned teeth isn't reserved only for tweens and teens—there are a growing number of adults well into their middle and senior years undergoing orthodontic treatment. As long as your teeth are relatively sound and your gums are healthy, it's altogether appropriate to undergo bite correction at any age.

A boost to your dental health. Gaining a more attractive smile through orthodontics is in some ways an added benefit. The biggest gain by far is the improvement straightening your teeth can bring to your long-term health. Misaligned teeth are more difficult to keep clean of dental plaque, which can increase your disease risk. They also may not function as well as they should while chewing food, which can affect your digestion.

Traditional braces aren't the only way. If the thought of displaying all that hardware makes you cringe, it's not your only option. One of the most popular alternatives is clear aligners, custom plastic trays that are nearly invisible on your teeth—and you can take them out, too. Another method growing in popularity are lingual braces: All the hardware is behind the teeth and thus out of sight. And you can, of course, opt for traditional braces—just ask Tom Cruise!

Oh, yes—a new smile! Orthodontics was truly the first “smile makeover.” It can improve your appearance all by itself, or it can be part of a comprehensive plan to give you an entirely new look. While the gains to your health are primary, don't discount what a more attractive smile could do for you in every area of your life.

The best way to find out if orthodontics will work for you is to visit us for an initial exam and consultation. Just like our A-list celebrities, you may find that orthodontics could be a sound investment in your health and self-confidence.

If you would like more information about orthodontic treatments, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “The Magic of Orthodontics: The Original Smile Makeover.”

By Todd G. Yoshino DDS
May 13, 2020
Category: Dental Procedures
Tags: tooth pain  
ToothPainHereAreSomePossibleCauses

“My tooth hurts…or maybe more than one. Or, it might be my gums.”

If you're having trouble describing the pain in your mouth, don't feel bad. Although our body's pain mechanism is great for alerting us to a problem, it can't always tell us the true cause and location of that problem.

That's especially true of tooth pain. It could be a sign, for instance, of decay within a tooth's inner pulp. When under attack, the nerves in the pulp often send out pain signals that could be sharp, dull, continuous, intermittent, seeming to come from one tooth or several.

If this is the case, depending on how deep the decay is, you could need a filling to resolve the problem or, if it's more extensive, possibly a root canal treatment to save the affected tooth. If you need a root canal, after removing the pulp's diseased tissue, the procedure calls for filling the empty pulp chamber and root canals to prevent future infection.

Another possibility for the pain is gum disease that has also infected the tooth. Gum disease usually begins with the bacteria in dental plaque, a thin biofilm that builds up on tooth surfaces, which infect the gums. If not treated promptly, the infection can advance below the gum line to the tooth roots and supporting bone. From there, it could invade the tooth and travel through the root canals to the interior pulp.

In this scenario, we'll need to treat the gum disease by removing plaque and tartar (hardened plaque) deposits from all tooth and gum surfaces. This is usually done manually with hand instruments or ultrasonic equipment, but it may also require surgical access to infected areas around the roots. If the tooth's nerve has become involved, we may also need to perform a root canal treatment as described above.

There are three key points to take from these two tooth pain scenarios. First, the only way to determine the true cause of your pain (and what treatment you'll need) is with a dental exam. Second, the sooner your pain is diagnosed and you begin treatment, the better your outcome—so see your dentist at the first sign of pain or other symptoms like swollen or bleeding gums.

And finally, you may be able to prevent these and other dental problems by removing disease-causing plaque through daily brushing and flossing and professional teeth cleaning every six months. Prevention through effective oral hygiene may help you avoid a future bout of mysterious tooth pain.

If you would like more information on treating tooth pain, 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 “Confusing Tooth Pain.”

SealantsProvideaLittleExtraProtectionforChildrenatHighRiskforDecay

Taking care of your child’s teeth is a high priority, not only for their health now but for the future too. And that means dealing with their teeth’s most common and formidable enemy, tooth decay.

Your focus, of course, should be on preventing decay through good oral hygiene practices, a healthy diet low in foods with added sugar and regular office visits for cleaning and checkups. But some children at higher risk or who’ve already encountered tooth decay may also need a little extra help in the form of dental sealants.

The most common use of sealants addresses a weakness in young teeth that disease-causing bacteria exploit. Deep grooves known as pits and fissures form within the biting surfaces of developing back teeth and in the rear of front teeth.  It’s very difficult to reach these areas with daily brushing, so some plaque may be left behind (hence the importance of semi-annual office cleanings).

Inside the mouth, these pits and fissures are in a warm and moist environment and are a haven for bacteria that feed on plaque and produce high levels of acid as a by-product. The acid softens enamel to eventually create a hole, or a “cavity” in the tooth. Children’s young enamel is highly susceptible to this process — it hasn’t developed enough strength to resist the adverse effects of acid.

A “pit and fissure” sealant made of resin fills in the grooves in the teeth to inhibit the buildup of plaque — a kind of “mini” filling. It’s an added layer of protection that complements other prevention efforts. But applying them isn’t an automatic practice — we only recommend it for children at high risk, especially where decay is beginning or it appears the conditions are conducive for it. When needed, though, it can be quite effective in preventing decay or minimizing its effects.

The best way to know if your child could benefit from a sealant is to have them undergo a complete dental exam. From there we can advise you on whether a sealant application is an important investment in their current and future health.

If you would like more information on dental disease prevention for children, 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 “Sealants for Children.”

GetAheadofaDevelopingCross-BitewithThisEarlyInterventionMeasure

Applying braces or clear aligners to move misaligned teeth is only part of an orthodontist's overall mission to eliminate poor bites (malocclusions). Sometimes a malocclusion isn't caused by the teeth at all—the size of the jaw is the problem!

One type in particular, a cross-bite, often happens because the upper jaw has developed too narrowly. As a result, many of the upper teeth fit inside the lower, the opposite of normal. But a tool called a palatal expander can alleviate the problem if it's applied at an early enough age.

The device works because the upper jawbone initially forms as two halves that fit together along a center line in the roof of the mouth (the palate) running from the back of the mouth to the front. These two bone halves remain separate during childhood to facilitate jaw growth, but eventually fuse around puberty.

Consisting of two sets of wire arms joined together by a hinge mechanism in the middle, the expander device is positioned up against the palate. The orthodontist extends each arm to press against the inside of the back teeth, then adds more outward pressure by turning the mechanism in the middle with a small key. During wear, the patient or caregiver will turn the mechanism in the same way to keep up the pressure on the two sides of the jaw.

This continual pressure keeps the two bones moving away from each other and maintaining a center gap between them. In response, more bone forms on the two halves to fill the gap. In time, the newly formed bone should widen the jaw enough to correct any developing malocclusion.

Timing is everything with a palatal expander—if not used before the jaw bones fuse, the patient will need a surgical procedure to separate the bones to pursue treatment. To catch the problem early enough, children should have an orthodontic evaluation on or before they turn six. An orthodontist may be able to identify this or other emerging bite problems and intervene before it becomes worse. Taking this approach can help save you and your child more expensive orthodontic treatment down the road.

If you would like more information on correcting poor bites, 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 “Palatal Expanders: Orthodontics is more than just Moving Teeth.”