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!

Tuesday, January 21, 2014

Sedation dentistry

One of the most common reasons people put off important dental work and avoid going to the dentist is because they are afraid.  Many people associate dentistry with pain and discomfort.  The truth is that most dental procedures can be done with little or no pain, but that doesn't matter if somebody is already very scared about visiting the dentist. The next two blog posts are going to explain some options for patients who have a lot of anxiety about dentistry.

Local anesthesia

Local anesthesia is the technical term for the numbing medicine that is given for most dental procedures.  This is commonly referred to as "novocain".  Novocain was the name of a popular anesthetic in the past, but in recent decades has been replaced by lidocaine, which works better.  There are several other types of local anesthetic that are also used by dentists, but lidocaine is the most commonly used.  Local anesthetics work by blocking the pain signal sent from nerves to the brain.  This allows the dentist to work on the teeth or gums without the patient feeling any pain whatsoever.  The patient is still fully alert and aware of what is happening.  Local anesthesia is used by all dentists for procedures that would otherwise be painful.

Nitrous Oxide

Nitrous oxide is also known as laughing gas.  Nitrous oxide has been used in dentistry for many years.  It provides a small amount of pain relief (analgesia), but its biggest benefit comes from the sense of relaxation and calm that it provides.  With nitrous oxide, patients are still awake, but they feel somewhat disconnected from their surroundings and are less concerned about what is happening around them.  It works very well for people who are mildly to moderately anxious about dental treatment.   Nitrous oxide is used in combination with local anesthesia for dental procedures.

With nitrous oxide, a small rubber nosepiece is placed over the patient's nose, and the patient breathes a combination of nitrous oxide and oxygen.  The amount of nitrous oxide can be adjusted for the patient's comfort.  After the procedure is finished and the nitrous oxide is turned off, it only takes about two minutes for the effects to wear off.  It's very safe and the most common unwanted side effect is upset stomach.

In the next post, we will discuss some other options for anxiety management that can make dental appointments easier.

Monday, January 13, 2014

Do I really have to floss?

Many people do not like to floss and we frequently hear people ask if it's really necessary, especially if they are regularly brushing their teeth and using mouthwash.  Some people complain that it hurts or makes their gums bleed, or that it just doesn't seem to be worth the hassle.

In our opinion, there is no substitute for flossing when it comes to keeping gums and teeth healthy and clean.  Throughout the day, plaque accumulates on our teeth.  This plaque can cause gum inflammation (gingivitis) that eventually leads to more serious problems.  This plaque sticks to the sides of teeth and the best way to remove it is by physically wiping it off.  This is what you do when you brush your teeth.  The bristles of your tooth brush cannot get between your teeth to clean them effectively, though.  That's what floss is useful for.  Floss goes in between teeth and removes the plaque that's stuck to the side of the teeth.  If the plaque is not removed, it can harden into tartar, which can usually only be removed during a dental cleaning.

If flossing is done correctly, it shouldn't be painful.  The floss should be pulled down between the teeth gently until you feel it "snap" past the spot where the teeth touch each other.  Then it should be pulled against the side of the tooth as it is moved up and down (think of making the floss into the shape of the letter "C").  You can slide the floss below the gumline until there is a slight resistance - don't try to force it any further.  Remember to clean both teeth before you pull the floss out from between the teeth.  There is no need to cut the gums or injure them with the floss.

If your gums bleed when you floss, it is most likely a sign of gingivitis.  If you keep flossing every day for about two weeks, you should find that there is much less bleeding than when you started.  You can actually see that your gums are getting healthier!

 Getting good at flossing takes a little practice, but once you're experienced, it can be done in a few minutes.  There are tools that can be used to make flossing easier as well.  If you're struggling or just uncertain, ask your dentist or hygienist the next time you go for a visit.

Monday, January 6, 2014

Happy New Year!

Happy New Year from everybody at Beautiful Dentistry!  At this time of year, we like to make resolutions to do things that will have a positive impact on our lives.  Don't forget to consider your oral health when you're making your resolutions.  If you haven't been to the dentist in a while or you have treatment needs that you've been putting off, this is the perfect time to get started.  Call us at (704) 633-2612 and we can help you set up an appointment!

Tuesday, December 17, 2013

What is a "deep cleaning"?

You may have heard people refer to getting a "deep cleaning" by their dentist.  "Deep cleaning" is a commonly used term for a procedure known as scaling and root planing.  Scaling and root planing involves going farther below the gumline to remove heavy deposits of tartar than what is normally done in a regular cleaning.

Not every patient needs scaling and root planing.  Some patients are more prone to tartar buildup (also known as calculus) and gum disease than others.  If gum disease is not treated, it can progress to periodontal disease and lead to deep pockets under the gum tissues around teeth.  In this situation, a deep cleaning is recommended to remove tartar and reduce gum inflammation, allowing gum tissues to heal.  Patients who do not have heavy tartar buildup and deep gum pockets do not need scaling and root planing - a regular cleaning is effective.  Getting regular cleanings will often prevent the need for a deep cleaning in the future.

Because scaling and root planing involves going deep below the gumline to clean teeth, numbing medicine is given to make the procedure comfortable, just like for a filling.  After the procedure is finished, gum tissues will often become noticeably healthier (firm and pink) in just a week or two.  After that, good oral hygiene at home and regular follow-up visits are important to maintaining healthy gums.


Monday, November 11, 2013

HOW DO CAVITIES FORM?

This post is going to explain a bit of the science behind cavities (also known as dental caries or tooth decay).  It might seem a little dry, but try to hang in there and by the end you'll have a much better understanding of how to care for your teeth.

Cavities result from acid damage to teeth.  The enamel that covers teeth is the hardest substance in the body, but long-term exposure to acid can dissolve enamel.  This acid can come from a number of places, but the most common source is the bacteria that live in the mouth.

There are many different types of bacteria that live in our mouths.  This is completely normal, and while good oral hygiene habits will reduce the number of bacteria in the mouth, they can never be eliminated completely.  Some of the bacteria that live in the mouth eat sugars and produce acid as waste.  These sugars come from the foods we eat - this includes obvious sources of sugar like sweets and sodas, but also fruit juice, bread, pasta, and other starches.

Any time a person eats something that bacteria can break down and use to produce acid, the environment in the mouth becomes acidic.  The mouth will usually stay like this for 20-30 minutes until the environment becomes neutral again.  While the mouth is acidic, the outer layer of enamel is damaged on a microscopic level.  When the mouth returns to a neutral environment, the outer layer is repaired by substances that are present in saliva.  This process of damage and repair is normal and occurs in everybody's mouth.

Cavities occur when the breakdown of teeth is out of balance with the repair of teeth.  There are many factors involved in this process, but essentially it means that the mouth is spending too much time as an acidic environment.  This can result from eating or drinking sugar-containing foods too frequently, and not cleaning the teeth adequately.

 There are things you can do to tip the balance of the mouth's environment toward the neutral side and away from the acidic side.  Limiting the frequency of sugar intake is very important.  If a person only eats three regular meals a day and drinks water, his or her mouth will be acidic for a much smaller time than a person who snacks constantly and drinks soda throughout the day.

 Keeping the teeth clean is the other important part - brushing and flossing reduce the number of bacteria in the mouth that can produce acid, and toothpaste contains a mineral (fluoride) that helps the tooth repair process and strengthens teeth so acid causes less damage.

 If you can tip the balance of your mouth's environment the right direction, cavities can't develop.  The basic principles are the same, but every patient's situation is unique.  Talk to your dentist about what you can do to push things in your favor.