Advanced Endodontic Associates, PA

If you have a root canal scheduled with our office, congratulations! You have taken an important first step toward saving your tooth and, thus, your smile and your oral health down the road! You may be wondering what to expect in terms of pain and what to do to relieve it after your procedure. Luckily, we have saved our best tips for you! Read on for information on home-care after a root canal.

How much pain will I have?

You will be happy to hear that after root canal treatment, most people report little or no pain. Advancements in endodontic instruments and techniques over the years have made this procedure similar to having a filling done. While it is considered normal to have soreness for a few days following the procedure, make sure you call us if you have extreme pain or pain that lasts more than a week.

Here are our recommended pain management tips following root canal treatment:

Over the Counter Pain Medicine

For the majority of patients, an over the counter pain medication such as ibuprofen (Advil) or acetaminophen (Tylenol) is all that is needed to curb soreness and pain after a root canal.

Prescription Pain Medicine

If we feel that you may need it, we will send you home with a prescription for a stronger pain medication than can be purchased over the counter. Be sure to follow the instructions carefully on the package.

Ice and Heat

For additional comfort at home, you may apply a cool or warm compress to the cheek in the area that the procedure was performed.

Salt Water Rinse

A teaspoon of salt in room temperature water can sometimes help with pain in the days following your procedure. Rinse and spit for reduced swelling and discomfort.

Be Pro-Active with Pain Medication

Have OTC pain medications ready to go at home. Take them before the numbing solution wears off completely so that you are not caught off-guard with pain. If we give you a prescription for pain medicine, fill it before going home, even if you think you won’t use it. Stay on top of timing and dosage until you feel that the soreness is gone.

And, as always, feel free to call us anytime with your questions. We are always happy to help!

You’re eating a scoop of ice cream or sipping hot chocolate, and suddenly your tooth hurts. Or maybe brushing your teeth makes you wince. These are common symptoms of tooth sensitivity, one of the most common complaints among dental patients. In fact over 40 million adults suffer from sensitive teeth at some point. This blog will help you understand just what this common problem is and what the cause may be.

Causes of Tooth Sensitivity. Tooth sensitivity is caused by the movement of fluid within tiny tubes located in the dentin (the layer of tissue found beneath the hard enamel that contains the inner pulp), which results in nerve irritation. When the hard enamel is worn down or if your gums have receded, the tiny tube surfaces become exposed so that eating or drinking cold or hot food or beverages, touching the teeth, or exposing them to cold air can be uncomfortable. Dental issues that may cause tooth sensitivity include: tooth decay, fractured teeth, worn fillings, worn tooth enamel, and an exposed tooth root. Excessive consumption of foods and drinks high in acid content, such as soft drinks or citrus juices, can also put you at risk for tooth sensitivity. Acid reflux may also result in the erosion of tooth enamel due to acid coating the teeth.

Treatment. If a tooth is highly sensitive for more than three or four days, it is best to see your dentist to diagnose the cause of your discomfort. We have a variety of options to manage tooth sensitivity, including in-office treatments and products you use at home. We may apply a desensitizing agent or a protective coating to your teeth. Or we may prescribe a fluoride gel or over the counter desensitizing toothpaste, which contains fluoride and potassium nitrate or strontium chloride. These ingredients help block the transmission of sensation from the tooth to the nerve. It is also best to avoid using hard bristled tooth brushes that can wear down tooth enamel and expose sensitive areas.

It is important for us to accurately diagnose the cause of your tooth sensitivity for accurate treatment. Sometimes a damaged tooth may require a filling, bonding, or even root canal if the decay is severe.   Proper dental hygiene is the best way to prevent tooth pain and sensitivity. Please let us know if you have any areas of your mouth that experience sensitivity or if you have any questions abut your dental health.

Tooth trauma can happen at any time. It could happen during a sports game, a car accident or as a result of something as simple and unexpected as a fall. The more information you have about correctly handling these situations the better. This knowledge could very well mean the difference between life and death for the tooth. The goal in treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth. In the previous tooth trauma entry we covered: avulsion (when a tooth is out of the socket). In this entry we will investigate a different kind of tooth trauma: an uncomplicated crown fracture. In this tooth fracture, the damage is limited to the crown of the tooth. There will be dentin exposed, but no pulp exposure.

In the instance of an uncomplicated crown fracture the first step an individual should try to accomplish is finding the piece of broken tooth. If a saline solution or distilled water is readily available, place the broken piece of tooth in this solution. Once you reach the dental professional, the rehydrated piece of tooth will be easier to bond, as the hydration increases its bonding strength.

What to expect during your visit, following an uncomplicated crown fracture:

• X-Rays will be taken
• Mouth will be checked for soft tissue lacerations and the presence of any other foreign bodies
• A sensitivity analysis will be performed
• The doctor or staff member will collect the tooth segment from you if you were able to find and preserve it
• We will assess the prognosis for the tooth

If the tooth is still vital, the process of reattaching the segment of tooth and the subsequent bonding will occur. Filling the dentin wound and applying calcium hydroxide to the vicinity of the pulp is the second to last step. Finally, smoothing and fluoridating small enamel defects.

Stay tuned in the upcoming months for the conclusion of the “What Now?” blog series!

For most people, the mere mention of a root canal sets off alarm bells in the body. These bells come in the form of nervous thoughts and sensations – that fight-or-flight response we’ve all heard about. While this is a totally normal response, most fear of root canals is based on mis-information. We feel that by giving you the right information, we can help you understand the process better and calm your fears about this routine procedure.

This is not just your average list of root canal FAQs. Here, we aim to tackle the toughest questions that you can throw our way.

I’ve heard that root canals aren’t as painful as they used to be. How can that be true?

• Better Instruments: Endodontic instruments have improved greatly over the years. They are more precise than ever, allowing us to target only necessary areas and avoid excess irritation.
• Better Anesthetics: The anesthetics we use today are more effective and less likely to cause negative reactions than in the past. In addition, we can use an anesthetic that has adrenaline or epinephrine added to it to make it last longer. The longer it lasts, the less pain you will feel.
• Better Imaging: Modern imaging allows for a more precise treatment and lessens the need to cause irritation in non-infected areas.
• Better Understanding: Today, we have a better understanding of both your body and the microorganisms that cause infected roots. This results in less invasive treatments and better overall care for you.

What can I do to calm my nerves?

• Know the Facts:
  • Over 15 million root canals are performed each year.
  • Root canals save your natural teeth and save money down the road.
  • Root canals are safe.
  • Root canals relieve pain caused by infection – they don’t cause pain!
• Ask Questions: Sometimes patients are unsure about a specific part of the procedure and remain silent. We want you to ask questions! Usually we are able to set your mind at ease if you simply ask us.
• Plug In: Many patients bring music and earphones to the appointment to help pass the time in the chair. Ask us if this is an option for you before your appointment.

Why not just remove the tooth?

When a tooth hurts, often a person’s first reaction is to get rid of the tooth. However, we know that missing teeth cause bigger health problems and expenses down the road. The first choice in dental care is ALWAYS to save the tooth when possible. Root canal treatment saves teeth. In fact, a tooth that has undergone endodontic treatment can last just as long as the healthy teeth in your mouth!

Your son is playing a championship game against the team he’s waited all season to play. The score is tied, and as the minutes wind down, the players have gotten more forceful in their actions. You blink, and all of a sudden your son is holding his mouth and a time-out has been called. You run down to him, and your mind is racing, “What happened? How hurt is he?” As you approach him, you see that in his hand he is holding an adult tooth that has been dislodged from the socket. As the sideline paramedics assess for signs of a concussion or hemorrhage you think, “Now what?”

The injury, and circumstances surrounding the injury may cloud your ability to choose your next action. You can rest assured knowing that when you mix today’s technology and the expertise you can expect from a coordinated team approach, the tooth’s fate is looking brighter already!

In the case of avulsion (when a tooth is out of the socket), the approach will most likely be a team effort. Your first course of action following the injury is to rinse off the tooth and try to place it back in the socket. If this is not possible, place the tooth in milk. If you’re expecting an injury like this (as a coach or school teacher etc. might), have Hank’s Balanced Salt Solution on hand to place the tooth in. Water should never be used to place the tooth in. Why milk? Milk maintains the correct fluid balance in the root of the dislodged tooth, which in turn increases the tooth’s chance of survival. Water causes the cells in the tooth to swell and die. If there is no option to place the tooth in any of the approved solutions, place the tooth in between the injured person’s cheek and gum to keep it moist.

After you have arrived at our office, it’s time for us to take over. The investigation phase begins. If a concussion or hemorrhage has not been ruled out, now is the time. When the coast is clear, it is time to move onto a gathering of both radiographic evidence of the injury and clinical documentation about the patient and the incident. From that extracted information, we can make a diagnosis and a subsequent treatment plan. As we mentioned before, depending on the type and severity of the injury, the process may involve a dental professional team.

The aim of treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth.

In the next few months we will cover other types of tooth injuries and treatments. Stay tuned!

We all know that foods high in sugar and acid are bad for teeth, but did you know that some foods are actually good for them? Incorporating these dental friendly foods into your family meals can both fight tooth decay and prevent gum disease. Here are five oral health friendly foods!

Almonds, Brazil Nuts, and Sesame Seeds. These foods contain phosphorous, magnesium, potassium, zinc, and most importantly, calcium. Dietary calcium is not only good for your bones, it may actually contribute to tooth remineralization and fight tooth decay. Make sure to get the unhulled variety of sesame seeds, which are incredibly high in calcium.

Strawberries, Kiwi, and Citrus Fruits. These fruits have the highest concentration of Vitamin C, which helps to increase collagen in gum tissue and prevents gum disease.

Onions. Toss some raw onion on your salad or eat them on your hamburgers. Onions contain powerful bacteria fighters because of their sulfer-containing compounds and are natural cavity fighters.

Shitake Mushrooms. Recent studies show a natural sugar found in shitakes, called lenithan, specifically targets the bacteria which causes gingivitis (gum inflammation) and tooth decay while leaving non-harmful bacteria alone.

Apples and Celery. Water rich fruits and vegetables stimulate saliva production, which rinses teeth of bacteria. With their high fiber content, they act as natural tooth brushes, scrubbing your teeth as you chew, removing plaque and bacteria that may otherwise build up.

These simple everyday foods are great choices for snacks or to add to meals your family already enjoys. Put onions or shitakes as toppings on your pizza. Serve celery and apples with peanut butter and make a smoothie with your strawberries and kiwi. Nuts can be eaten as a snack on their own or try them as nut butter spread on toast. You can even throw nuts and sesame seeds in a stir fry for added texture and flavor as well as the nutritional benefit.

Green Tea. Besides these five teeth healthy foods, you can even get a boost for your oral health by drinking this powerhouse liquid! Green tea contains “catechins” that actually fight inflammation and control bacterial infections. One Japanese study found that regular green tea drinkers had less incidence of periodontal disease compared with people who drank the tea irregularly. So try drinking green tea instead of that second cup of coffee or have a refreshing green iced-tea on a hot afternoon.

Besides brushing and flossing, what you eat can make a difference to your oral health. It’s nice to know you can eat foods that taste good and be doing something good for your teeth at the same time. Now that’s something we can all smile about!

Just saying the word “Apicoectomy” is a mouthful! But don’t be put off by the name, it’s a simple and routine procedure that is effective in treating infections that may occur following root canal treatment.

What is an Apicoectomy? Teeth are held in place by roots that reach into your jawbone. The tip of the root is called the “apex” and this is where nerves and blood vessels enter your tooth. These nerves and vessels travel through a canal inside the root and into the crown, or visible part of your tooth. During root canal treatment, inflamed or infected tissue is removed from the canals. Canals are very complex, with many tiny branches, and occasionally infected debris remains in the tooth and prevents healing or causes re-infection. During an apicoectomy, the root tip, or apex, is removed, along with the infected tissue, and is replaced with a filling to reseal the end of the root.

Who needs an Apicoectomy? An apicoectomy is done only after a tooth has had at least one root canal. In many cases, a second root canal is considered before an apicoectomy. With advances in imaging, we can often detect infected canals that had not been appropriately treated in the past and treat them without the need for surgery. But if an infection persists, it is often near the root tip, and an apicoectomy is an important surgical procedure that can save your tooth from extraction.

What is the follow up? Most apicoectomies take 30 to 90 minutes, depending on which tooth it is and how complicated the root structure is. Your endodontist will use ultrasonic instruments and surgical microscopes to see the area clearly, which will increase the chances of success. The area may bruise and swell slightly in the area around the tooth. Follow up includes over the counter pain relievers or prescription medication. Stitches will be removed 2 to 7 days after the procedure, and full recovery can be expected within 2 weeks. While apicoectomy sounds complicated, most people report that the recovery is easier than that of the original root canal.

If you are having any pain or swelling from a tooth that has had a root canal procedure, please don’t hesitate to call us! We can review your treatment options and answer any questions you may have. Fortunately, an apicoectomy is usually a permanent solution and should last for the life of your tooth!

The future of dental imaging has arrived, right here in our office! 3D imaging is increasingly becoming the standard in endodontic care. In fact, from the endodontist’s office to the general practitioner’s, 3D imaging is rapidly changing the way that dentistry is performed.

3D Pictures for 3D Structures

The structures of the mouth and teeth, including the root systems, are three dimensional, yet traditionally they have been photographed in a two-dimensional manner. With the invention and increasing availability of 3D radiographs, we are now able to take patient care to the next level at our practice by providing better outcomes than ever before!

About CBCT

Also known as Cone Beam Computed Tomography (CBCT) and similar to medical CAT Scans, 3D dental imaging works by rotating around the patient while taking hundreds of pictures per second from different angles. A computer then takes those images and combines them to create a three-dimensional model in the form of a digital picture.

Complex Canals: A Better View

Not surprisingly, 3D imaging gives us a much better view of what is going on inside of your teeth. For example, we are able to see complex canals in much better clarity and with more contrast than ever before. The images also provide a better view of periapical lesions and additional anatomical structures in the axial, coronal and sagittal sections.

Here are some of the benefits of CBCT 3D Machines:

• Less Radiation than with CAT Scans
• Compact Machines
• Allow for Better View of Root Canals
• Precise Diagnoses
• More Predictable Treatment Plans and Prognoses

We are proud to provide the newest in technology for our patients to ensure the best care possible!

Everyone knows that developing a positive and effective brand is the key to a business’s growth. What is often less clear is how to actually create this brand, and what it specifically encompasses. A brand is a constantly evolving marketing strategy to entice people to want to buy your services, and in essence “buy into” and become a part of you. In the same way a charming person easily makes friends and alliances, a practice with personality garners business and success.

By humanizing your practice and considering it an extension of who you are, your branding efforts will be more successful, and your patients more satisfied.

Practice Identity

Your brand is the image and feeling that is conjured when a patient thinks about your practice. Their expectations and experiences are encapsulated in this image, meaning who you are in their eyes is manifested in everything you do to make your practice personal, professional, and special.

The relationship you establish with patients, as well as every impression your practice portrays, from aesthetics to cleanliness, warmth to quality of care, contributes to their perception of your work. Whereas people often misconceive a brand as a logo or catchy phrase, it is actually all of these views and feelings your patient develops that add up to create an overall identity– a brand, if you will.

When considering your brand, think personal. There are many ways you are going to impact your patients’ perceptions, and one of the most positive ways to do so is to take the time to interact with your patients on a personal level. Ask about their weekend or summer plans as you prepare for exams and procedures. Consider offering individualized goody bags, filled with products targeted at a patient’s specific age group and oral condition. Send birthday and holiday cards to regular patients- these touches will set you apart and show patients you care.

A meaningful brand can be so powerful that even when you leave your practice, the identity you established will live on.

Practice Differentiation

Equally as important as differentiating your practice through personalized experiences, is emphasizing the unique service you provide. Finding a niche and sticking to it has actually been proven more effective than attempting to market yourself in an all-encompassing way.

What makes you unique? Perhaps you are on the cutting edge of new technology in your field. Maybe you employ sedation dentistry, or are an unmatched expert in placing dental implants in your area. Do you offer innovative solutions to cosmetic dental issues? Whatever it is that makes you special and that appeals to patients in your area should be your branding emphasis.

Remember that branding is an ongoing process, and that once your identity is established, it must also be maintained. Keep yours fresh and progressive by monitoring success through patient surveys, and constantly re-imagining your image.

Practice Marketing

You can probably think of countless examples of catchy tag lines that have stuck with you over the years. What they have in common is simplicity. Simply but memorable marketing aides will propel your brand. Keeping your market “small,” though seemingly counterintuitive, is actually more beneficial than trying to accomplish too much.

Another important element of successful branding is consistency. Everything from your website to mailings, your logo, color schemes, and office atmosphere should be considered and coordinated. Get feedback as you revamp your image to ensure that all print marketing pieces accurately depict the brand you are attempting to create.

Keep your logo in plain site, allowing it to grow into the minds of your patients. You can achieve logo visability with promotional items such as magnets and coffee cups emblazoned with your symbol. You can also use social media to enhance your branding. Facebook is a great tool for keeping your practice in your patients’ lives. It also allows patients a look inside your practice and the more personal elements of your business and office-workings. You can even develop a custom Facebook business page in the likeness of your practice website! Color schemes and design can be imitated to ensure complete branding cohesion.

Practice Reputation

Once a person develops a positive association with a brand, any single negative experience they may have is negated by their overall sense of faith in the brand. In the same way a person will remain loyal to a favorite potato chip company, despite an isolated purchase of a stale bag, a patient will remain loyal despite any minor mishap that may occur during their visit, such as a longer-than-usual wait time.

Patients who trust your brand will also be more inclined to accept treatment, regardless of cost or other factors. When they hear you explain the importance of a procedure to their oral and overall health, a trusting patient will not question your expertise. In the same way people often pay more for brands they know and trust, patients will be willing to use your services for the quality care you ensure.

By bolstering your reputation through an outstanding brand, you will achieve trust and loyalty from your patients. This will lead to patient retention and increased referrals, a cycle essential to growth.

Practice Expansion

By “practicing” these tips, providing consistently excellent customer service, and constantly considering the ways you and your team members are enhancing or detracting from your brand, your practice will see returns in patient loyalty and referrals, the cornerstone of a successful dental business.

Nobody likes coming to the dentist to have a cavity filled! Many of our patients ask us how stop a cavity before it happens. Many people have heard of fluoride but wonder how it works and if it is safe. We wrote this blog to answer your questions about fluoride and to help you understand its benefits and how to use it effectively.

Fluoride occurs naturally in certain foods. You might be surprised to learn that it can be found in black teas and raisins, and in our water sources, such as lakes and rivers. And, because it provides such good protection from tooth decay, it has been added to dental products to help prevent cavities.

Fluoride works for both children and adults. It’s true! Before teeth even erupt through the gums, fluoride taken in from certain foods and supplements makes tooth enamel stronger and therefore more resistant to decay. After teeth erupt, brushing with fluoride toothpaste helps rebuild (remineralize) weakened tooth enamel, reversing early signs of cavity formation. In addition, the fluoride you consume becomes a part of your saliva, constantly bathing your teeth with tiny amounts of the cavity fighter. While it is critical for infants and children to be exposed to fluoride when primary and permanent teeth are forming, new research indicates that topical fluoride is just as important in fighting tooth decay for adults!

Use the correct amount of toothpaste to benefit your teeth. While all toothpaste removes plaque (a thin film of bacteria that can cause gum disease and tooth decay), only toothpaste with fluoride can prevent tooth decay by making teeth stronger. Make sure you’re using the correct amount of toothpaste with your children!

• For very little ones, under 3 years of age, parents and caregivers should begin gently brushing teeth as soon as they come into the mouth with an amount of fluoridated toothpaste the size of a few grains of rice.
• For children ages 3 to 6, a pea-size amount of toothpaste is best. Everyone should brush their teeth twice a day and make sure to supervise children to help instill good habits.

Some mouth rinses also contain fluoride. You may already be protecting your teeth with fluoride without even knowing it! However, mouth rinses should not be used with children under the age of 6, as they may not be able it use it appropriately. 

You may have fluoride in your water. Your community may have chosen water fluoridation (simply adding fluoride to drinking water) as a public health benefit. Water fluoridation is safe, effective, and healthy. The Center for Disease Control has noted water fluoridation as one of the ten best public health achievements of the 20^th century.

For your best dental hygiene routine, ask us during your next visit about the right fluoride products for you and your family. Your oral health is our priority so we want to answer any questions that you have. Armed with the right information, your family can have healthy teeth for life. Contact our office to schedule your next visit! We can’t wait to see you soon!