Monday, February 10, 2014

What is a root canal?

You have probably heard people talk about needing a dental procedure called a root canal, but you might not know what they're actually referring to.  This post is going to explain the basics of the procedure and the reasons why dentists do it.

When people talk about needing to have a root canal, they often do so with a sense of dread.  Unfortunately the root canal procedure has received a bad reputation as being a very unpleasant dental procedure.  The truth is that for most patients a root canal feels pretty much the same as having a filling done, though it takes a little longer.

A tooth has several layers.  The outer two layers (enamel and dentin) are hard and form a protective shell around the innermost layer, the pulp.  The pulp contains nerves and blood vessels.  The nerves and blood vessels in the pulp run through the roots of the tooth and connect to larger nerves and blood vessels in the jawbones.  The root canal refers to the space where the pulp lives inside the roots of the tooth - a narrow opening called a canal.

A root canal procedure is required when something damages the nerves and blood vessels in the pulp of the tooth, causing them to die.  This can happen for several reasons, such as an injury, but the most common reason is tooth decay.  If a cavity becomes very large, eventually it will reach the pulp inside the tooth.  When this happens, the pulp is no longer protected from bacteria in the mouth, and it becomes infected and eventually dies.  Sometimes this is painful (a toothache), but often it is not.  If left untreated, however, the infected tooth will eventually have to be extracted.

During a root canal, the dentist cleans out canals that contain the tooth pulp.  Cleaning the canals removes bacteria and prevents the infection from getting any worse.  Once the canals are clean, the dentist fills them with an inert material (the most commonly used one is called gutta percha).  After that, the dentist can place a permanent filling or crown on top of the tooth.

The anesthetic (numbing medicine) that dentists use blocks pain signals from the nerves inside the pulp, so the patient does not feel pain while the roots are being cleaned out.  From the patient's perspective, the procedure will seem very similar to having a filling done.

Of course, it's ideal to avoid dental problems in the first place with good preventive care, but for teeth with severe decay, sometimes the only solution is a root canal.  It's a valuable treatment option for dentists to be able to provide patients, and nowadays not something to be dreaded.

Wednesday, February 5, 2014

Sedation dentistry

This is the second post explaining options for patients to help them manage their fear of dentistry.  We will discuss other options beyond local anesthesia and nitrous oxide.

Anxiolysis (Anxiety reduction)

For patients who are mildly anxious about dental treatment, the dentist can prescribe a single dose of anti-anxiety medicine to be taken before the appointment.  The most well-known medicine of this type is Valium, but there are several others.  Medicines like this help patients feel calm and less concerned about their dental appointments.  Because of their sedative effect, patients must be accompanied by somebody who can drive them to and from their appointment.

Pill sedation

Pill sedation is similar to anxiolysis, but the medication is intended to achieve a more powerful sedative effect.  Patients will be somewhat aware of what is going on around them during the dental procedure, but may not remember it.  Patients who receive this type of sedation must be escorted to and from their appointment.  This works well for patients who have severe anxiety about dental treatment.

IV sedation

IV sedation is similar to pill sedation, but the medicines are administered through an IV rather than a pill.  This allows the medicine to take effect more quickly and be controlled more closely by the dentist.  The dentist can increase or decrease the medicine during the procedure to adjust the level of sedation.  Patients who receive IV sedation are not likely to remember their appointments.  Again, patients will require an escort for this type of sedation.

General anesthesia

 General anesthesia is the same type of sedation that is used for major surgeries.  With this type of sedation, patients are sedated so deeply that they are completely unconscious throughout the procedure.  General anesthesia is usually only done in hospital operating rooms, and as a result it is much more expensive than other sedation methods.  For dental procedures, general anesthesia is typically only recommended under special circumstances, due to the additional cost and risk associated with it.

 Summary

 Sedation is a great option for patients who are scared about having dental work done.  As you can see, there is a range of sedation options to choose from.  Your dentist will want to meet with you first to discuss the options and decide what will work best.  Fear shouldn't stop you from having the dental care you need and want.  Give your dentist a call today!