Posts for: May, 2018
A root canal treatment is a highly effective way to save a deeply decayed tooth. Sometimes, though, complications make it difficult or even impossible to perform the traditional procedure. In those cases, we may need to use a different option.
Tooth decay becomes an imminent threat to a tooth's survival if it works its way into the pulp, the innermost layer of a tooth. It's only a short advancement from there into the roots by way of the root canals.
In a typical root canal treatment, we access the pulp by drilling a small hole in the biting surface of a back tooth or the back side of a front tooth. We remove all the tissue within the pulp and fill it and the root canals with a special filling to prevent re-infection. After sealing the access hole, we cap the tooth with a crown to further protect it.
Although root canal treatments have a high success rate, re-infection can still occur. Often, a second root canal will save the tooth from the new infection.
In some cases, though, using the traditional procedure might do more harm than good. It's possible we may find extra canals previously undetected branching out from the primary canal at the root end. Canals can calcify and narrow, making them extremely difficult to fill. Subsequent dental work may also prove troublesome: we would have to take the restoration apart, which could further weaken the tooth.
The alternative is a procedure known as an apicoectomy. Instead of accessing the pulp through the crown, we access the root end through the gum tissue. We then focus on removing infected tissue at the tooth's root end, along with a tiny amount of the root tip. We then place a small filling at the end of the root canal (essentially plugging it up) to prevent further infection. We may also perform grafting to encourage bone growth in any voids left by the procedure.
Endodontists, specialists in root canals, have the advanced training and specialized equipment to perform an apicoectomy. With their expertise, they may be able to save your tooth with this specialized procedure when a root canal treatment won't work.
If you would like more information on options for treating decayed teeth, 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
Your child’s dental care wouldn’t be the same without x-ray imaging. It’s one of our best tools for finding and treating tooth decay.
But since x-rays emit radiation, is your child in any danger when they’re exposed?
X-rays, an invisible form of electromagnetic energy, will form images on exposed film after passing through the body. Because it takes longer for x-rays to pass through dense tissue like teeth and bones, the corresponding areas appear lighter on the film than less dense tissue like the gums. We can detect decay because the diseased tooth structure is less dense and thus appears darker against healthier tooth structure.
The downside of x-rays, though, is the radiation they emit could potentially alter cell structure and increase the risk of future cancer, especially with children. That’s why we follow a principle known as ALARA when using x-ray imaging. ALARA is an acronym for “as low as reasonably achievable,” meaning the doses for an x-ray session will be as low as possible while still gaining the most benefit.
Advances in technology, particularly the development of digital processing, has helped reduce the amount of radiation exposure. We’re also careful with what types of x-rays we use. The most common type is the bitewing, a device with the film attached to a long piece of plastic that the child holds in their mouth while biting down.
Depending on the number of our patient’s teeth, we can usually get a comprehensive view with two to four bitewings. A typical bitewing session exposes them to less radiation than what they’re receiving from natural environmental background sources each day.
Keeping the exposure as low and as less frequent as possible greatly reduces health risks while still getting the full benefit of early decay detection. Still, if you have concerns about your child’s x-ray exposure, we’ll be happy to discuss our approach and all the precautions we take using x-ray imaging.
If you would like more information on x-ray diagnostics and your child, 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 “X-Ray Safety for Children.”
You can't go wrong with an early start caring for your child's teeth and gums. In fact, dental care should begin in earnest when their first tooth appears.
You should begin by gently cleaning your infant's gums and new teeth after each feeding with a clean, water-soaked washcloth or gauze pad. Once they start eating solid food, you should transition to a soft-bristled brush with just a smear of fluoridated toothpaste. Around age 2, you can increase that to a pea-sized amount and begin teach them to brush for themselves.
The next important element in your child's dental care is beginning regular dental visits around their first birthday. There are good reasons to begin visits at this time. There primary teeth should now be erupting in earnest and you'll want to begin prevention measures against tooth decay if needed. You'll also want to get them used to going to the dentist early in life: if you wait a year or two later, they may not respond well to the unfamiliar surroundings of a dental office.
There are also a number of things you can do to support hygiene and dental visits. You should not allow your child to sleep with a pacifier covered or a bottle filled with anything but water. Milk, juices and other sugar-containing liquids will raise the risk of tooth decay. And speaking of sugar, limit their consumption to meal times: snacking constantly on sugar can create an environment ripe for decay.
Of course, dental disease isn't the only hazard your child's teeth may face. Accidents can happen and your child's otherwise healthy teeth could be injured. So, make sure they don't play too close to hard furniture or other features around the house they could fall on. If they should begin playing contact sports, invest in a custom mouth guard — avoiding an injury is well worth the cost.
Getting into dental care with your children as soon as possible will set the foundation for good oral health. And the example you set will stick with them as they take on their own dental care when they're older.
If you would like more information on caring for your child's teeth, 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 “Top 10 Oral Health Tips for Children.”