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Root canal therapy is an important tool in a dentist’s arsenal to save and maintain our teeth. For many it is a scary procedure we try to avoid, but with a little knowledge, it can take some of the fear away and put your mind at ease. A root canal should not be avoided due to fear, understanding what to expect and why may help you get the treatment you need when you need it.

Root Canal Therapy Frequently Asked Questions

What Is Root Canal Therapy?

Root Canal Therapy (also referred to as root canal treatment or endodontic treatment)  is a dental procedure in which the diseased, decayed tooth, or damaged nerve of a tooth is removed and the inside areas (the nerve and canals within the roots) are cleaned, filled and sealed permanently to avoid infection. Without treatment, the surrounding tissues of the tooth (including the gums and bone) will become infected and a dental abscess can form.

A tooth’s nerve and blood vessel provide nutrients and hydration to a tooth as well as sense of temperature. It provides the sensation of hot or cold. The absence of a nerve will affect the strength of a tooth and make it become more brittle and susceptible to fracture if not protected by a crown.

How Do I Know If Root Canal Therapy Is Needed?

Common symptoms related to an infected tooth include tooth sensitivity (to hot or cold temperatures or even both), sensitivity to touch, toothache/sharp pain when chewing, swelling in the area of the tooth, or a bad taste in the mouth. These symptoms need to be evaluated by a dentist immediately to prevent further pain or damage.

What If I Ignore My Symptoms? Will They Just Go Away?

If the symptoms are ignored and treatment is not begun, the inflammation can progress to infection. Infection will continue to invade the tissues and tooth causing the tooth to become more painful and may become a health threat. Once the tooth “dies”, there are only two choices: extract the damaged tooth or perform root canal therapy.

How Is My Tooth Restored After Root Canal Therapy?

Depending on the extent of the damage to the tooth, your dentist can recommend a dental composite restoration to close the tooth or in most cases recommend a dental crown to protect the tooth against future damage. Over time, the tooth with the root canal therapy will dehydrate. This will make the tooth brittle and more susceptible to fracture/breaking. Most often, a crown is placed after root canal treatment is completed to protect the tooth and restore full function.

Is Root Canal Therapy Painful?

Typically, root canal therapy should cause no more discomfort than a simple dental filling). The pain most people associate with root canal therapy is due to the infection that develops. Root canal therapy actually relieves the pain by removing the dental infection and pressure.

What Are The Advantages Of Root Canal Therapy?

Saving the natural tooth with root canal treatment has many advantages:

-Efficient Chewing.

-Maintains Normal Biting Force And Sensation.

-Natural Looking Appearance.

-Protects other teeth from excessive wear or strain.

Root Canal Therapy helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last as long as other natural teeth and often for a lifetime.

Are There any Risks Or Complications?

Over 90 % of root canal therapy procedures are successful. However, there is a chance of a failed root canal. Sometimes the root canal therapy needs to be redone due to diseased canal offshoots that went unnoticed, the fracture of a filing instrument, or a fracture or perforation in the root. The signs of a root canal therapy failure are marked by a return of pain, pressure, and sensitivity.

Is There An Alternative To Root Canal Therapy?

There are other options. One includes extracting the infected tooth. Then the question becomes how to replace the tooth. A few options are possible and these include a dental bridge and a dental implant. The success rate of root canal therapy is over 90% so it is an excellent option to save your own natural tooth if at all possible.

What Can You Expect After Root Canal Therapy?

Most patients feel some sensitivity for a few days afterward. For many it is easily relieved with an over the counter pain medication (aleve or ibuprofen).

Can Root Canal Therapy Be Avoided?

Some tips include maintaining good dental hygiene, see your dentist and hygienist regularly, eat a well balanced diet, and wear a custom made sports mouthguards to decrease dental trauma. Root canals, unfortunately, are not entirely unavoidable, and may happen even with good hygiene and care.

Root Canal Therapy Conclusion

Many are fearful of the root canal therapy procedure but in reality it is not the horror that many believe it to be. Root canal therapy is an easy way to save your teeth in the event of dental trauma, decay, or dental infection. Knowing what to expect can go a long way to alleviating any fears you may have. It is important to save your natural teeth whenever possible.

A discolored tooth can be a real worry for many parents. A tooth discoloration in children (and even adults) generally occurs from some sort of tooth trauma. It is believed that about 1/3rd of all children will suffer some sort of tooth trauma by age of 7. The discolored tooth may be a cause of embarrassment for a child, and the cosmetics of it may bother the parents. The issue that is most important is that a discolored tooth can lead to pain and infection.

Why Does A Tooth Change Color?

When an accident occurs involving a tooth, blood can leak out of blood vessels. The by products of this blood leakage (mainly iron) can make their way into the small tubules inside the tooth. These by products can cause a tooth to appear grey, brown, or even black. The color change usually does not happen right away. It can take about 2-3 weeks before the color change appears. The other color changes could be from deep tooth decay, or a pink/red looking tooth is usually caused by resorption.

Treatment For An Injured Tooth

The damage done inside the tooth is generally irreversible but sometimes it can be repaired especially if it is from decay only. The general rule of thumb is the darker the tooth the higher the likelihood, that the nerve of the tooth has died.

If your child’s tooth has darkened the prudent thing to do is to have your child’s dentist examine it.  If there are other signs that the tooth is dead, has a deep cavity, is resorbing or shows signs of inflammation or an infection. Many of these signs can be seen on the x-ray. The dentist will then diagnose the problem and recommend treatment. Treatments range from a root canal treatment, removing the tooth, or doing a filling or crown. If there is no sign of infection or other symptoms, the dentist may choose to leave the tooth alone. The tooth will eventually fall out on its own and it will maintain space in the meantime for the permanent tooth to erupt. Studies have shown that about 3/4′s of discolored primary teeth normally fall out on their own without any ill effect to the permanent teeth.

Other Color Changes

Other colors can include pink or red. Just like the other colors above, the tooth can turn right away or wait a few weeks.

When a tooth turns red after an accident, it generally means a blood vessel has broken. When this happens, blood leaks inside the nerve of the tooth (pulp). This is referred to as pulpal hyperemia. This can be very difficult to diagnose and over time the tooth may darken as well. The possible long term complication of this is that our body’s defenses may begin to resorb some of the internal layers of the tooth (called internal resorption). As the resorption occurs the pink or red color becomes more noticeable as the tooth structure becomes thinner and thinner. If this occurs, the teeth are either left alone until they fully resorb or they can be removed by your dentist. Resorption can also happen just prior to tooth eruption, the tooth is already on its way to falling out, and the permanent tooth pressure has caused it to resorb from the inside out.

Tooth Discoloration Conclusion

It is the nature of the parent to want to treat their children as quickly as possible. That is precisely what should be done. If you have any concerns about changes in your child’s teeth you should see your dentist immediately to diagnose the problem. Do not leave a potential infection unchecked, ask your dentist what your options are, and make an informed decision in your child’s dental treatment.

Teeth Whitening is a common procedure in general dentistry but especially so in the field of cosmetic dentistry. There are different types of teeth whitening including in

Internal Bleaching Marielaina Perrone DDS

Internal Bleaching Can Make You Smile Again!

office and at home options like the use of teeth whitening strips. But did you know there was a procedure available to perform a deeper teeth whitening from the inside of the tooth out? This procedure is commonly known as internal teeth whitening or internal bleachingInternal bleaching is used to lighten a discolored tooth that has had root canal treatment.

Internal bleaching is a more conservative option compared to restoration with veneers or crowns, but is sometimes used to lighten teeth before the application of these techniques to prevent the discoloration of the natural tooth from showing through. In addition, porcelain veneers or crowns may be required not only to achieve improved color, but also to strengthen a root canal treated tooth.

How is Internal Bleaching Performed?

Internal bleaching is a dentistry technique that is used to lighten the color or whiten the appearance of a tooth or teeth. Internal bleaching is only to be done under the direct supervision of a dentist. This is because the procedure involves inserting a chemical oxidizing agent directly into the tooth.

Internal Bleaching Before Marielaina Perrone DDS

Internal Bleaching Before

The internal bleaching procedure is performed on a non vital tooth that has received root canal treatment. The root canal treatment could have been the result of infection or dental trauma. Whatever the reason, the tooth in question did not require a crown and has maintained its natural tooth structure. When a tooth dies or becomes non vital it loses the blood and nutrient flow to it. This sometimes results in a changing of tooth color to a darker shade than the surrounding teeth.

Following completion of root canal treatment, the dentist will place a chemical oxidizing agent into the chamber of the tooth and leave it there for about 2 weeks time. This process can be done a few times over that 2-3 week period until the tooth achieves the level of whiteness desired by dentist and patient. Once the color is correct, the opening is sealed closed with a white tooth colored composite filling to keep out foreign matter and bacteria that could cause further problems.

Internal Bleaching After Marielaina Perrone DDS

Internal Bleaching After

Internal bleaching may be used by itself for whitening teeth or  in combination with exterior teeth whitening products.  Your dentist will evaluate the current condition of the teeth and determine if it is necessary to make use of two different kinds of teeth whitening procedures at the same time. When it is decided to use both products at the same time, the dentist will choose two products that are compatible to one another so that they do not interact poorly with one another. If chosen incorrectly, the interaction between the two bleaching products could ultimately damage the teeth they are designed to treat.

How well does Internal Bleaching work?

Internal bleaching is very effective for whitening teeth that have been damaged by trauma or infection. The process allows the dentist to focus on one tooth to raise its level of whiteness back to the level of the other teeth to give a more natural appearance overall.

Internal Bleaching Conclusion

Anyone who has had a tooth turn color after receiving root canal treatment can understand the difference between natural, undamaged, tooth structure, and dark, non-vital, tooth discoloration. While internal bleaching is very specific in it’s applications, it is an easy choice for someone with a dark front tooth. Internal bleaching is a great tool for cosmetic dentists to restore one or more teeth back to their natural white condition. It is a fairly simple procedure with great reward. If you have a tooth that does not whiten as all the others do, ask your dentist about internal whitening, and see if this is an option for you.

What many people don’t realize, is that a tooth has nerves and blood vessels just like the rest of our body. A tooth is “vital” or alive. There are reasons why a tooth can become non vital, or dead. ItCosmetic Dentist Marielaina Perrone DDS is not always easy to tell, and sometimes can be quite painful.

A dead tooth is simply a tooth that no longer has access to nutrients and blood flow. Our teeth are composed of three layers: the enamel, the dentin and the nerve or “pulp”. A healthy tooth has living cells and tissue inside.This living tissue plays a role in the development of the teeth. The nerve is the part of the tooth that can sense temperature, when you drink or eat something really cold or hot. It can also sense how hard you are biting into something, and feel pain.

All the blood vessels and nerve fibers are located in the pulp and this means that when the pulp is dead, then the tooth is dies as well. What can happen if a tooth becomes non vital, and why does it die?

What Causes a Tooth To Die?

The two main causes are:

-Tooth Decay - Tooth decay or a bacterial infection, when left untreated, will begin to invade deeper into the tooth eventually penetrating through enamel and into the second layer, the dentin. When the decay or infection reaches deep inside the tooth, the cells of the pulp try to fight it off by triggering the inflammatory process. This includes action by the white blood cells. Pus develops when some of the white blood cells die during the battle against the infection. If the infection is not treated at this stage, all the white blood cells will die and the blood flow will stop completely.When this occurs, tooth sensitivity is usually the first sign of trouble and this sensitivity will eventually reach the pulp and results in a severe toothache.

-Dental Trauma – This can occur from traumatic injuries, falls, severe grinding and clenching, biting into very hard objects, and sometimes idiopathic internal resorption (a tooth self destructs from the inside out for no apparent reason) . When dental trauma occurs, the blood supply can be severed immediately, resulting in the pulp dying off. Sometimes it is a slow progressive breakdown as teeth wear and crack from bad oral habits. Prevention is the key whenever possible. This is why sports mouth guards are recommended for all contact sports activities. Nightguards are recommended for clenchers and grinders. Extremely hard foods should be avoided such as popcorn kernels, corn nuts, and the mouth should not be used in place of tools such as scissors or a bottle opener.

Signs and Symptoms

It can be very difficult to identify a dead tooth just by looking at it and that is another reason why it’s important to visit a dentist regularly. It is possible to have no symptoms when a tooth becomes non vital. However, a non-vital tooth may exhibit some a tell tale symptom like turning darker. This discoloration is usually the dead pulp becoming visible. Another sign of a non-vital tooth is an unexplained swelling, or a raised white pimple like area. These signs are normally a result of a periodontal abscess, caused by periodontal disease or injury, which can rupture and produce an infection in the gums and mouth. A dead tooth will eventually become loose due to the destruction of surrounding bone by the infection process. It can also produce a foul odor and even more severe pain.

Cosmetic Dentist Marielaina Perrone DDSTreatment Of A Dead Tooth

Many patients will ask, “If the tooth is dead why not just leave it alone?”.Simply put, the dead tissue in the pulp chamber will become a breeding ground for bacteria. If left untreated, an abscess can occur along with pain and discomfort. There are usually two options for treatment of a non vital tooth:

-Extraction – A tooth extraction can be performed if the tooth is not savable, or it can be chosen due to finances becoming an issue. A tooth extraction is usually the least expensive option but it can also can leave other issues on the long term horizon (such as tooth shifting, cosmetic and functional issues). Once extracted, tooth replacement can be done using a dental implant, a fixed bridge, or a removable denture.

-Root Canal Therapy -  This procedure is performed when a patient chooses to save the tooth. Root canal therapy allows the dentist to clean out the dead tissue and infection, ridding of the decayed part of the pulp. This will allow the dentist to rebuild on the sterile tooth to return full form and function. With today’s modern technology, root canal therapy can be a painless and comfortable experience and, if done early, can save a tooth by preventing further infection and subsequent tooth loss. The procedure usually begins with anesthesia to prevent any pain, then a dentist will make an opening for the cleaning instrument to penetrate the affected inner parts of the tooth. The infection is cleaned out and the opening is then closed with a filling. The tooth can then be bleached to turn it whiter or a veneer or a crown can be placed over the tooth to make it look natural.

How To Prevent A Tooth Becoming Non-Vital

Maintaining a proper dental hygiene regimen including brushing and flossing regularly can prevent the buildup of food and bacteria that gets trapped between teeth and gums, which can cause infection and tooth decay leading to dead teeth. Regular visits to the dentist are also very important, since your dentist will be able to identify and diagnose early signs of tooth issues. There are other early signs that you can recognize on your own that include sensitivity to heat or cold, pain when chewing or biting down, slight discolorations, bad breath, gum swelling and facial swelling. Saving a dead tooth depends on early detection and early treatment. Do not ignore the signs and symptoms – get it checked out to decrease your chances of infection and tooth loss.