Posts for: January, 2019

By Brock Orthodontics
January 29, 2019
Category: Uncategorized
Tags: root canal  
ARootCanalTreatmentcanSaveYourToothandRelievePain

One of the most effective techniques for saving decayed or injured teeth is the root canal treatment. Yet when many people hear they need it, they become nervous at the prospect.

Much of this stems from a common misunderstanding that undergoing a root canal is painful. It’s not — today’s anesthetics are quite effective in numbing pain during a procedure, and mild pain relievers like ibuprofen are usually sufficient to manage any discomfort afterwards.

In fact, a root canal treatment relieves pain caused by decay within a tooth. As decay progresses, it can enter the interior known as the pulp, which contains bundles of nerves and blood vessels. It attacks these nerves causing pain and infection. If the infection progresses through passageways known as root canals that are in the roots of the tooth, the pain can intensify. More important, the tooth is in danger of loss as the root and connective tissues that hold the tooth in place are injured from the spreading infection.

During a root canal treatment, we access the pulp by drilling a small access hole, usually in the biting surface or in the rear of a front tooth. Once we enter the pulp chamber we remove all the contaminated tissue. Once thoroughly cleansed, we fill the empty chamber and canals with a special filling (usually gutta percha) to prevent future infection. The access hole is then sealed and at a subsequent visit we strongly recommend placing a permanent crown to provide further protection from damage to the tooth.

Root canal treatments are quite common. All general dentists have been trained in endodontic treatment and can perform most types of procedures. More difficult cases (like a complex root canal network that may be hard to access) may require the services of an endodontist, a specialist in root canals. Endodontists use advanced techniques and specialized microscopic equipment to treat complicated situations.

It’s actually good news if we recommend you undergo a root canal treatment — it means your tooth has a good chance of survival once it’s disinfected and the decay is removed. But don’t delay: the sooner we can treat your tooth, the better your chances of a healthy outcome.

If you would like more information on root canal treatment, 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 “Common Concerns about Root Canal Treatment.”


YoumayNeedOrthodonticTreatmentBeforeObtainingImplants

You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.

While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.

When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.

If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.

Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.

Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.

If you would like more information on your dental restoration options, 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 “Straightening a Smile before Replacing Lost Teeth.”


By Brock Orthodontics
January 09, 2019
Category: Oral Health
Tags: medicine  
NSAIDsCouldbeJustasEffectiveasNarcoticsManagingDentalPain

Like other healthcare providers, dentists have relied for decades on the strong pain relief of opioid (narcotic) drugs for patients after dental work. As late as 2012, doctors and dentists wrote over 250 million prescriptions for these drugs. Since then, though, those numbers have shrunk drastically.

That’s because while effective, drugs like morphine, oxycodone or fentanyl are highly addictive. While those trapped in a narcotic addiction can obtain drugs like heroine illicitly, a high number come from prescriptions that have been issued too liberally. This and other factors have helped contribute to a nationwide epidemic of opioid addiction involving an estimated 2 million Americans and thousands of deaths each year.

Because three-quarters of opioid abusers began their addiction with prescription pain medication, there’s been a great deal of re-thinking about how we manage post-procedural pain, especially in dentistry. As a result, we’re seeing a shift to a different strategy: using a combination of non-steroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen and acetaminophen, instead of a prescribed narcotic.

These over-the-counter drugs are safer and less costly; more importantly, though, they don’t have the high addictive quality of an opioid drug. A 2013 study published in the Journal of the American Dental Association (JADA) showed that when two NSAIDs were used together, the pain relief was greater than either drug used individually, and better than some opioid medications.

That’s not to say dentists no longer prescribe opioids for pain management following dental work. But the growing consensus among dental providers is to rely on the double NSAID approach as their first-line therapy. If a patient has other medical conditions or the NSAIDs prove ineffective, then the dentist can prescribe an opioid instead.

There’s often hesitancy among dental patients on going this new route rather than the tried and true opioid prescription. That’s why it’s important to discuss the matter with your dentist before any procedure to see which way is best for you. Just like you, your dentist wants your treatment experience to be as pain-free as possible, in the safest manner possible.

If you would like more information on how dentists are safely managing pain in dental care, please contact us or schedule an appointment for a consultation.