Advanced Endodontic Associates, PA

Have you ever wondered: “Do I have to have root canal therapy?   What’s the worst that can happen if I don’t?”

We are glad you asked! Having a root canal may seem like an intimidating and painful experience, so we are not surprised when some patients are hesitant to go through with it.

But, the fact of the matter is that: root canal treatments save natural teeth. And saving your natural teeth is the most important thing we do as oral health professionals.

Still not convinced? Here are some more compelling reasons to follow through with that root canal treatment:

• An infected root won’t get better on its own. The pain may go away after some time, but that is not because the infection is gone, it is because the nerves are no longer working properly due to that infection.
• Abscesses and Systemic Infections: Left untreated, an infected tooth can spread to the gums, causing a serious abscess in the jaw that requires emergency treatment. In rare cases, that could spread even further, creating a systemic (whole body) infection, which has the potential to be life threatening.
• The role that natural teeth play in the overall health of your body during its lifetime is something that we are learning more about every day. This important role cannot be overstated. A lost, permanent tooth may not seem like a big deal to you now, but it creates a domino effect of health problems down the road. For example, a missing tooth causes nearby teeth to shift, exposing them to more decay and more tooth loss down the road. This can affect your ability to maintain a healthy diet and, in turn, affect the quality and even the span of your life.
• Money: Even if aesthetics don’t matter to you, a lost tooth will probably cost you more money in the long run than a root canal will, now. When a tooth is missing, the jaw underneath that site atrophies. This makes it more expensive to perform restorative procedures such as dental implants in the future, as they will require more extensive prep-work such as bone grafting.

The bottom line is that your natural teeth are best. Endodontic therapy is typically the best way to save a natural tooth. It is also the most commonly used procedure, that we as oral health professionals have to help you keep your natural teeth for life.

Many people think that a painful tooth means they need a root canal treatment. While that is sometimes true, it’s not always the case. In fact, there are many other reasons that teeth can hurt!

Here, we offer a guide to some common types of tooth pain and what that pain may be trying to tell you:

Sensitivity to hot and cold foods:

If the pain is short-lived, you probably do not have a serious problem, but more likely a loose filling or a small amount of gum recession that has resulted in root surface exposure. Use sensitive teeth toothpaste and a soft brush with an up and down motion. If this doesn’t help after a week or so, give us a call.

Heat sensitivity after an appointment:

Some types of dental work can inflame the pulp inside your teeth, causing sensitivity for several weeks. If it lasts longer than that, let us know.

Sharp pain when biting:

Sometimes sharp pain can be caused by a loose filling, other times it may signal that there is a crack in your tooth. Either of these scenarios requires evaluation by a professional, so please give us a call.

Pain/Sensitivity lasting longer than 30 seconds:

Often this means that the pulp (innermost part of your tooth) has been damaged. Without intervention, you may lose this tooth so it is important to call us to find out if you may need root canal treatment.

Frequent, dull aching in the jaw.

This can happen when excessive grinding of the teeth happens (bruxism), or it could even be a sign of a sinus headache or infection. Please call us for more information.

Severe pain, pressure or swelling of the gums:

This may mean that you have an abscessed, infected tooth that may have spread to other tissues in the mouth. This is a serious situation that requires an immediate call to our office for instructions.

It’s true: Enamel is the hardest substance in your body. However, it is not invincible! Our teeth are covered in enamel. It is the first line of defense against cavities and decay, the very substance that protects the interior, living parts of your tooth! No wonder it takes a beating! This all adds up to one fact: the better you take care of your tooth enamel, the longer you will get to keep your natural teeth! Fluoride is one way that we protect your tooth enamel, and even strengthen it. Fluoride has the ability to both protect your teeth from demineralization and re-mineralize it (strengthen the enamel).

In addition to using toothpaste with fluoride and having fluoride treatments in our office, here are five ways that you can help to protect your tooth enamel:

1. Avoid and rinse after acid: Fruit juices, sodas and acidic fruits soften the enamel in your mouth, and are very bad for your teeth. So if you do enjoy one of these treats, rinse after you are done with it. DON’T brush immediately, as your enamel will be vulnerable to breakage for the next hour.
2. Don’t chew things that aren’t food! If you have a habit of chewing things like pencils, ice, popcorn kernels and, yes, fingernails, PLEASE STOP! Your teeth were designed to grind and chew up food, not ultra hard substances. Chewing these items can chip away at enamel and even fracture a tooth.
3. Cut back on sugar: There are many reasons why you should reduce your sugar intake, and among the most important is for the health of your teeth! Sugar reacts with bacteria to create acid, and we know how bad that is for your tooth enamel!
4. Don’t be a teeth grinder. If you grind while you sleep, you are damaging your teeth enamel. Ask us about solutions to stop grinding!
5. Be gentle. In general, you should be gentle with your teeth, even when brushing. You may think that you need to brush hard to get all of the sugar bugs out of your mouth, but it’s not true. Hard brushing can lead to chipped enamel.

If you take care of your tooth enamel, it will take care of you!

Over the last 10-15 years, the field of endodontics has changed dramatically with considerable improvements in particular in the area of endodontic surgery! In fact, studies have shown that the traditional method of apicoectomy was fifty percent less successful than the current microsurgical success rate.

Why? The most important reason for the increased success rate has to do with the microsurgical materials and instruments themselves.

Here we offer a run-down of benefits of modern microsurgery over traditional apicoectomy methods:

• Visual Enhancements – The microscope offers a more accurate visualization (both magnification and illumination) of infected canals and irregular anatomies, which leads to better identification and treatment.
• Smaller Osteotomy – Better visualization and smaller instruments allows us to work within smaller osteotomies. This reduces the amount of bone that needs removing and therefore offers a quicker healing time and reduces the risk of tooth loss down the road.
• Better Access to Difficult Areas: With microsurgery, we have enhanced access to narrow spaces and other difficult anatomical sites for irrigation.
• Less Damage: Enhanced visualization allows us to avoid damaging nerves and the maxillary sinus.
• Better Cleaning of the Apical Canal Space: Traditionally it has been very difficult to fully sterilize the apical canal space because it is very complex in its anatomy.
• Enhanced Root-End Fillings: Ultrasonic tips are now specially designed to allow for preparation without reducing visibility – this results in a better seal of the filling.

All of these advancements help us save more teeth than we ever could before!

Can drinking coffee really help prevent oral cancer? What about different types of foods? Numerous studies have been published that claim certain foods and drinks can prevent oral cancer but when it comes to a disease that will affect 43,250 people this year, it’s important to get the facts.

Oral cancer, also referred to as mouth or head and neck cancer, occurs when there is a problem with the lifecycle of a normal, healthy cell. Cells are supposed to grow and divide into new cells as your body needs them but when this process goes wrong, your body over produces cells. These extra cells can cause a tumor to form. Depending on the type of cells in the tumor, it could be cancerous or benign.

Some studies may say they have proof that a specific food or drink helps to prevent mouth cancer but in reality the best way to prevent the disease is to avoid certain risk factors like smoking and drinking. Drinking in excess accompanied by smoking makes you highly susceptible to the disease and should be avoided.

Most oral cancers start in the tongue in what are called the flat cells and they can spread to other parts of the body if they aren’t caught early (in doctor lingo, cancer of these flat cells is called squamous cell carcinoma). Interestingly, when these oral cancer cells spread to other parts of the body such as the lungs, they are still considered oral cancer cells rather than lung cancer cells. Where these abnormal cancer cells begin is what they will always be referred to as, regardless of where they spread.

Doctors still don’t know why one person gets oral cancer while another person does not, but it is important to note that oral cancer is NOT contagious. Avoiding risk factors and eating healthy is key to preventing oral cancer. Make sure to visit us regularly so we can check for signs of oral cancer!

“What is an Apicoectomy? Is it surgery? Is it painful? And why do I have to have one?” In our practice, we hear these question almost every day, so we thought we’d take a moment here to clarify what an apicoectomy actually is.

Word Origin:

To better explain what an apicoectomy is, let’s look first at the origin of the word.   As is true with most medical terminology, the key to understanding this procedure lies within the origins of the word itself.

Your teeth are comprised of many parts, the main three being the crown (the part that you can see), the root canals (the long skinny parts that extend from the crown into the jaw) and the root tip, also called the “apex”, which comes from the Latin word meaning “tip” or “point”.

When a patient complains of infection or pain in a tooth that previously had root canal treatment, often it is because there is a problem in the apex area. So, during an “apicoectomy”, we remove (“ectomy”, from the Latin word excise) the apex (“apico”) along with any additional infected tissue that we find.

The Procedure:

Usually, local anesthesia is all we need to make you comfortable during the procedure, which takes about 30-90 minutes to complete. In fact, many patients have reported that the apicoectomy was even less painful than the original root canal treatment!

Recovery:

You may be sore or numb for a few days after the procedure, but usually over-the-counter anti-inflammatory drugs (NSAIDs) such as ibuprofen are all that is needed to control the pain. We will remove the stitches 2-7 days after the procedure, and most soreness and swelling will be gone by 14 days.

If you have any questions about apicoectomies or other procedures, please don’t hesitate to contact our office for more information!

People often wonder, “How does a tooth get to the point of infection?”

It’s a common misconception that teeth are not alive. That belief leads to confusion about how teeth become infected. Because you can’t “feel” the part that you can see (the crown), many people think that their teeth are not alive. Yet, the opposite is true. Most of the material that makes up your teeth is, in fact, made of living cells. Since the material is alive, it makes a great hosting site for bacterial infections!

Similar to hair and fingernails, there is a part of your teeth that is not alive – it is the outermost part, called “enamel”. This is the hard, white part that you can see. It is made of calcium phosphate, a very hard mineral that is perfect for breaking down food when you eat. Underneath that enamel, however, is where all of the live action happens!

Starting on the outside and working our way in, we find dentin (alive), and then the pulp cavity and root canal, through which nerves and blood vessels flow.

Generally speaking, if the enamel is intact, bacteria cannot get through to the pulp to cause problems. However, if there is a crack in the outer part of the tooth due to injury or decay, this creates a pathway for bacteria to enter into the innermost part of the tooth (the pulp cavity and canal) causing infection of the living tissue.

That is when endodontic treatment becomes essential! The only way to remove the infected material is manually, by accessing the canal itself, irrigating and then filling, or closing off access, to the inside of the tooth again.

As with any dental or medical procedure, occasionally, endodontic treatment does not live up to its expected results and the root has to undergo retreatment. You may have noticed pain in the tooth or you may have no pain at all. Either way, with detailed imaging, we can see when root canal therapy has failed and when it is time for retreatment.

Why does it happen? Some of the most common reasons for a root canal to fail include:

• Narrow canals: If your canals are too narrow or curved, this may have made it difficult for the original procedure to be performed thoroughly.
• Inadequate Seal: After cleaning a root canal, we fill it with a restorative material. If that material doesn’t make a complete seal, reinfection is possible.
• Complicated Anatomy: If your canals are shaped abnormally, the original treatment may have missed areas that needed cleaning.
• Delayed Restoration: If there was a delay between the initial treatment and the placing of the crown or other restoration, reinfection may have occurred.
• New Decay, Cracks or Fractures can introduce new infections into the root area.

Surgical vs. Non-Surgical Retreatment

Our first choice is always to save your natural tooth using the least invasive means possible. Natural teeth are far superior to their artificial counterparts when it comes to nutrition, lifestyle, aesthetics and the long-term health of your jaw.

During endodontic retreatment, we will need to essentially “reopen” your tooth to access the root area, removing the original restoration in the process. If your canals are too narrow or obstructed, we may need to perform an apicoectomy (surgical treatment) instead of a traditional, non-surgical root canal.

And, lastly, if neither of these methods presents a viable option to save your tooth, really our only other course of action is to remove the tooth. Since the removal of a tooth causes additional restoration work down the road, which can be more expensive, we always try to save the tooth first!

If you are experiencing pain in a tooth that previously underwent root canal therapy, give us a call! We can help you decide if retreatment is right for you!

When the announcement is made that a root canal is in order, many patients feel instant apprehension, and often wonder if what they are headed for is some type of surgery. In fact, most often when a root canal is recommended, it is a “non-surgical root canal” that we are talking about. Luckily, the average case that we see responds successfully to this minimally invasive type of endodontic therapy.

You may be wondering, “What is the difference between a surgical and non-surgical root canal?” We are glad you asked!

We invite you to think of non-surgical root canal therapy as a really deep filling. While not exactly the same and certainly a more in-depth procedure, there are basic similarities. Both start off with drilling into the tooth, then cleaning, and then filling the hole. During a non-surgical root canal procedure, we simply drill farther than we would during a filling so that we can access the root canal (the hollow area inside the tooth with nerves) to clean it. In both cases, anesthetic is used to ensure your comfort and in both cases we fill the hole to prevent further infection.

Sometimes, however, the infection is either too significant or we simply cannot see the fracture or source of pain in an x-ray, and that is when a surgical root canal is advised. During this procedure, an incision in the gum is made so that the canal can be accessed from the side and infected tissue can be removed safely.

The good news is that most inner tooth infections, even minor ones, cause just enough pain that patients tend to get themselves to the dentist or endodontists ASAP for help before the problem gets out of hand. That is why the majority of root canal procedures are “non-surgical”.

If you are having tooth pain, give us a call to see how we can help!

As with any other health related topic, there are many common myths that seem to follow root canals around, so we are here to set the record straight!

Here are five of the most common questions we hear in our practice every day:

1. 
   

   After a root canal, is my tooth dead?

No. Many people believe that root canal therapy kills teeth. But the opposite is true. During a root canal procedure, we remove only the infected tissue inside of the tooth, leaving healthy nerves and blood vessels to grow and heal from within.

2. 
   

   Are root canals very painful?

The root canal procedure itself is not the source of the pain. It is the inflammation caused by infection that is causing the pain, which is why we are doing the root canal in the first place – to relieve that pain. However, it is true that you will still experience some pain as the site heals after the therapy, sometimes lasting a few days to a few weeks.

3. 
   

   I’ve heard that the pain will never go away completely, is that true?

No. A successful root canal will eliminate the underlying pain. If you are still experiencing pain after the normal healing time, we will investigate other causes such a fractured tooth.

4. Does root canal therapy take more than one visit?

    

Sometimes, but more often than not we can complete the procedure from start to finish in one single visit to our office!

5. Are root canals expensive?

    

The cost varies depending on many factors, including how bad the infection is, whether it is the first treatment or a retreatment, and your insurance options. However, root canal therapy is less expensive than extraction and replacement down the road.