With smart phone in hand, you can instantaneously find out just about anything. Unfortunately, online search results aren’t always accurate. Case in point: there’s an idea floating on the World Wide Web that root canal treatments cause cancer.
Sounds ludicrous? Yes, but like other strange ideas this one has historical roots (pardon the pun). In the early 20th Century, a dentist named Weston Price propagated the idea that leaving a “dead” organ in the body caused health problems. By his view, a root canal-treated tooth fell into this category and could potentially cause, among other things, cancer.
But concern over root canal treatment safety is on shaky ground: dentistry examined Dr. Price’s ideas over sixty years ago and found them wanting. But first, let’s look at what a root canal treatment can actually do for your health.
Tooth decay is an infection that first attacks the outer tooth enamel and then continues to advance until it infects the inner pulp. It can then travel through the root canals to the roots and bone. Without intervention, the infection will result in tooth loss.
We use a root canal treatment to save the tooth from this fate. During the procedure we remove and disinfect all of the diseased or dead tissue within the pulp and root canals. We then fill the empty chamber and canals with a special filling and seal the tooth to prevent any further infection. And while technically the procedure renders a tooth unable to respond to thermal sensitivity or tooth decay, the tooth is still alive as it is attached to the periodontal ligament and its blood supply and nerve tissue. The tooth can still “feel” if you bite on something too hard and it doesn’t affect the tooth’s function or health, or a patient’s overall health for that matter.
As to Dr. Price’s theory, extensive studies beginning in the 1950s have examined the potential health risk of root canal treatments. The latest, a 2013 patient survey study published in a journal of the American Medical Association, not only found no evidence linking root canal treatment to cancer, but a lower risk of oral cancer in 45% of patients who had undergone multiple root canal treatments.
While root canal treatments do have potential side effects, none are remotely as serious as this online “factoid” about cancer. It’s far more likely to benefit your health by saving your tooth.
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 “Root Canal Safety.”
Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.
There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.
The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.
There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.
Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.
A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.
Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.
As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.
If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”
Porcelain veneers are positive proof that unattractive teeth don't always require an intensive restoration to regain their beauty. These thin layers of translucent porcelain — custom-designed and color-matched to blend with your other teeth — are permanently bonded to the visible side of your front teeth.
Although they can't remedy every tooth defect, they're well suited for mild to moderate disfigurements like chipping, staining or gaps. There are now two types of porcelain veneers: the traditional veneer and the “no-prep” veneer.
The standard veneers require some tooth structure removal, referred to as “tooth preparation.” This is because although they're a millimeter or less in thickness, they can still appear bulky if bonded to an unprepared tooth. To accommodate their width, it's necessary to remove some of the tooth enamel. This permanently alters the tooth so that it will need some form of restoration from that time on.
In recent years, however, other veneer options have emerged that reduces — or even eliminates — this tooth alteration. No-prep veneers are so thin they can be applied to a tooth with virtually no preparation. A more common option, minimal-prep, requires only a minor reshaping with an abrasive tool to ensure the fitted veneer looks as natural as possible. Because of their thinness, these veneers also don't have to fit under the gum line like standard veneers.
To obtain no- or minimal-prep veneers, your tooth enamel needs to be in good, healthy shape. They're also best suited for people with small or worn teeth, narrow smiles (the side teeth can't be seen from the front), or slightly stained or misshapen teeth.
Because there's little invasiveness, these low preparation veneers won't typically create tooth sensitivity and they can often be applied without any form of anesthesia. And because tooth structure isn't removed, they can be “uninstalled” to return to your natural look. Of course, that's not always an easy process since the bonding between veneer and the enamel is quite strong, although today's lasers can be used to detach the veneer quite easily.
If you'd like to consider these minimally invasive veneers, talk with your dentist. If you're a good candidate, you may be able to gain a new smile without much change to your natural teeth.
If you would like more information on how veneers can change your smile, 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 “No-Prep Porcelain Veneers.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
Most first-time root canal treatments achieve their purpose in saving an internally decayed tooth and extending its life to match those of the patient’s non-decayed teeth. Occasionally, though, a root canal-treated tooth may become re-infected by decay.
There are a number of reasons for this: the permanent crown meant to add further protection against decay may have been delayed, giving bacteria an opening to re-infect the tooth; it’s also possible the original seal for the pulp chamber and root canals after filling wasn’t sufficient to prevent bacterial contamination.
There‘s also another reason that’s very difficult to foresee — the presence of narrow, curved root canals in the tooth that can pose complications during the procedure. Some of these known as accessory or lateral canals branch off the main canals to create a complex network that’s difficult to detect during the initial procedure. If they’re not cleaned out and filled during the procedure any tissue trapped in them can remain infected and ultimately die. If these canals also open into the periodontal membrane at the attachment between the teeth and bone, the infection can spread there and become a periodontal (gum) infection that can trigger future tooth loss.
Fortunately, a reoccurrence of infection isn’t necessarily a death sentence for a tooth. A second root canal treatment can correct any problems encountered after the first treatment, especially complications from accessory canals. It may, though, require the advanced skills of an endodontist, a dental specialist in root canal problems. Endodontists use microscopic equipment to detect these smaller accessory canals, and then employ specialized techniques to fill and seal them.
If you encounter pain or other signs of re-infection for a tooth previously treated with a root canal procedure, contact us as soon as possible. The sooner we can examine and diagnose the problem, the better your tooth’s chances of survival by undergoing a second root canal treatment.
If you would like more information on tooth preservation through 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 “Accessory Canals.”
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