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Root canal and pain go hand in hand in many people’s minds. Generally our fears and anxiety stem from others telling us their experiences and not from our own. A root canal (also referred to as RCT or root canal therapy) is a dental procedure where the damaged nerve (also called the pulp) of a tooth is removed. Following removal of the nerve, the canals of the tooth are cleaned and sterilized. Following this cleaning process the canals are filled and sealed permanently to avoid future dental infection. If treatment is not undertaken, the dental infection will affect the tooth along with surrounding oral structures (like gums and bone tissues) and a dental abscess can form in the area as the infection looks to escape.

The reason for the removal of the tooth’s nerve is because these nerves (along with associated blood vessels) is responsible with providing hydration and nutrients to our teeth. They also give us the ability to sense hot and cold.

Surveys year after year find that root canal therapy is considered the most feared of all dental procedures. These surveys also found people’s views on root canal therapy is based on what others have told them and not their own individual experiences. This leads to people believing mostly inaccurate stories about root canals. It is the fear of the unknown as I like to call it.

Is Root Canal Painful Or Can It Be Painless?

A root canal is necessary when the nerve of a tooth develops inflammation or becomes infected. This inflammation or dental infection can develop in a number of different ways:

Tooth decay that pushes into the area of the nerve or pulp chamber.

Fracture or chip in the tooth that gives bacteria a pathway to spread into the tooth’s nerve canal.

Trauma. Traumatic injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to a dental abscess.

A tooth causing pain of this type is irreversible. To save the tooth a root canal must be performed.

Signs and symptoms that a root canal is probably necessary can include pain, extended sensitivity to temperature (either hot or cold or both), tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes, bone and surrounding gingival tissues. In some cases, no outward dental symptoms are present at all

A root canal usually requires one or more visits to the dentist and can be performed by either a general dentist or a specialist called an endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. Your dentist will generally make the call on who should perform the root canal. You will be referred to endodontist if any of the following are needed:

-Degree Of Difficulty. Some teeth have anatomy that is slightly abnormal which makes the canals of the tooth harder to access.

-Re treatment of a previous root canal.

-Patient’s preference.

You and your dentist will discuss who is best suited to complete this root canal for you and make the best, informed decision for your dental treatment.

Root Canal Procedure

Is Root Canal Painful marielaina Perrone DDS Las vegasTake an X-ray if one has not already been taken. This will give your dentist a chance to evaluate the anatomy and shape of the tooth’s canals. It can also show the presence of a dental infection.

Anesthetic. Your dentist will use a local anesthetic to numb the surrounding areas to give you pain relief and also allow the procedure to be completed pain free. Some patients do not require any anesthetic but it will make it more comfortable.

Cleaning Of Tooth Canals. Tiny instruments are used to slowly clean out and debride bacteria, decayed nerve tissues, and bacteria from inside the tooth’s canals. Sterile water, peroxide, or sodium hypochlorite are used periodically to flush away the debris and kill any bacteria present.

Filling of Canals. Each canal is filled to the end of the tooth with a rubbery compound called gutta percha and permanently sealed. The process essentially is like a cork to prevent bacteria and fluid from re-entering the tooth, and keep it sterile. Many dentists prefer to wait a week or so before sealing the tooth. This will give the inflammation that has developed a chance to decrease back to normal levels. Others prefer to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed to keep out contaminants like saliva and food until the next appointment.

Following treatment, your tooth may feel sensitive for a few days to a week. This is especially true if there was pain or dental infection before the procedure. This discomfort can be relieved with over the counter or prescription pain medications or an antibiotic may be necessary if an infection was present. Follow directions given to you very carefully and feel free to ask your dentist questions if an issue comes up.

Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your dentist immediately.

Restoration of Tooth. Generally but not always a tooth that needs a root canal often is one that already has a large dental restoration or extensive tooth decay. Even when tooth decay was not a factor, the tooth treated with a root canal is weaker than a “live” tooth. Therefore, a crown, crown and post, or other extensive dental restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it back to full function again. After a completed dental restoration, you will not be able to notice any difference in its function or form or feel. You and your dentist will discuss this need further and make an informed decision together the best course of action for your dental care.

Is A Root Canal Painful Conclusion

A dental root canal is extremely successful with a more than a 95% rate of success. Many teeth with a completed root canal can last a lifetime with no issues.

Most root canals are completed to relieve the pain of toothaches caused by pulpal inflammation or dental infection. With modern advancements in techniques, dental materials, and anesthetics, most patients state that they do not feel any pain once the procedure is underway. Root canal procedures have an undue reputation of being painful. Usually most patients report that the procedure itself is no more painful than having a routine dental restoration placed. The misconception has developed because the majority of the pain stems from the dental infection and pulpal inflammation that has developed. This can be tricky to get good anesthesia but a good dentist will be able to make you comfortable during the procedure.

As noted above, the pain from root canals in modern dentistry is mainly from the dental infection that presents to the dentist and the actual procedure should be pain and worry free. The best defense against developing a toothache and the need for a root canal is to see your dentist regularly, maintain proper oral hygiene, and call your dentist at the earliest signs if you have any pains or discomfort.



Dental implants vs bridge is a question many patients are faced with when attempting to replace a lost tooth or multiple teeth. The traditional dental bridge was the main dental procedure used by dentists for a very long time to replace missing teeth. As dental implants have become popular due to long term success rates the traditional dental bridge has become in many people’s mind the lessor alternative. Dental implants vs bridge is an interesting scenario as they both achieve the same thing but in different ways. The dental implants vs bridge debate is one that many of us will face in our lives. Below are some facts about both to help with your decision.

Dental Implants Vs Bridge Procedure

Steps For A Dental Bridge

During the first visit to your dentist for the fabrication of a dental bridge, the teeth surrounding the missing tooth are prepared to accept a dental crown. The preparation involves removing the outer layer of teeth to allow for a dental crown to be placed over top them. Next, dental impressions of the teeth are taken, which give the dental lab technician a precise dental model from which the dental bridge, pontic (fake tooth between the dental crowns), and dental crowns will be fabricated. Your dentist will create a temporary dental bridge for you to wear to protect the exposed teeth and gums while the dental bridge is being made. This generally takes about 2 weeks.

At the second visit, your temporary bridge will be removed, the temporary cement will be cleaned off the teeth, and the new porcelain or metal bridge will be checked and adjusted, as necessary, to achieve an ideal fit. Depending on how extensive the dental bridge is multiple visits may be needed to check the fit of the metal framework and ensure the bite is correct. This is dependent on each individual’s case as metal can distort as well as teeth moving ever so slightly during time in between visits. If the fit is acceptable to the dentist, the dental bridge will then be cemented permanently in place. In the discussion of dental implants vs bridge, a traditional bridge is placed in only one way (cemented) while a dental implant can be placed in 2 different ways (screw retained or cemented).

Steps For A Dental Implant

Initial Consultation. At this initial appointment, your dentist will complete a thorough dental examination, including all necessary x rays, and then take dental impressions of your teeth. After your dentist gathers all the necessary preliminary information, your dentist will talk with you about the recommended treatment plan. You may also discuss at this time whether or not there is a need for a bone graft. At this visit, you can ask about the dental implants vs bridge discussion. Your dentist will happily review the positives and negatives with you.

Bone Grafting And Teeth Removal. If the tooth needs to be extracted, your dentist will evaluate the bone density and quality and decide if a bone graft is necessary. The bone graft will add 4-6 months generally to the time line. This extra time gives your bone time to heal properly and add the new bone structure.

Dental Implant Placement. Once healing has taken place you will be ready for the dental implant placement. The procedure generally takes about 1-2 hours and completed under anesthesia. Once the dental implant is placed, you will need approximately 6 months for healing to take place and the dental implant to integrate into the bone (this process is called osseointegration).

Healing Cap And Temporary Dental Crown. With the dental implant fully integrated in the bone, your dentist will attach what is called a healing collar to the top of the dental implant. This healing collar will allow the gum tissue to form around the implant in a natural looking way. The healing collar is simply a round piece of metal that keeps the gum tissue away from top of implant. The healing cap stays on for about 7-14 days. In some cases a temporary dental crown is fabricated as well at this visit.

Abutment Placement. The healing cap will be removed and a dental implant abutment will be replace it. This abutment will be where the new dental crown will attach (either thru a screw or cement). Once the abutment is in place, your dentist will take a dental impression and send it off to the dental laboratory for fabrication of your new dental crown.

Permanent Dental Crown Placement. The dental implant and dental crown should be a permanent fixture without the possibility of tooth decay forming over time like a traditional dental crown or dental bridge.

Dental Implants Vs Bridge Maintenance

This is where a dental implant will shine in the debate of dental implants vs bridge. A single dental implant will be cleaned just like your natural teeth. This means you can floss around the tooth just like a natural tooth. A dental bridge since it is one longer piece encompassing multiple teeth you will not be able to use regular floss. You will need to use what is called a floss threader. This will allow you to get under each part of the dental bridge and effectively clean around the areas of the dental bridge. This can be an issue for some patients with dexterity issues.

Dental Implants Vs Bridge Cost

The dental implant will require more time (at least 6-7 months in best case) to allow for each step to be completed and healed properly. The dental implant tends to cost more overall especially if bone grafting is involved. In my opinion, dental implants vs bridge cost will be up to the patient. Time in some cases is just as important as the financial factor.

Dental Implants Vs Bridge Pros And Cons

Dental Implants Vs Bridge Las Vegas Marielaina Perrone DDSDental Implant Positives

-Surrounding Teeth Unaffected. With a dental implant, there is no need to shave down possibly healthy tooth structure in adjacent teeth as there would be in a traditional dental bridge.

-Success Rate And Durability. Dental implants should with proper care last a lifetime and have a better than 98% success rate.

-Bone Loss Prevention. With a dental implant in place, your bone structure will remain as is and not resorb or break down. This is what happens when a tooth is missing in an area of the mouth

Dental Implant Negatives

-Surgery Required. A big negative in the dental implants vs bridge debate. This is especially true of those with dental phobia.

-Healing Time Needed. As mentioned above a minimum of 6-7 months are needed in the best case scenario to complete a dental implant procedure from start to finish.

-Financial Expense. There is generally a slightly higher fee for a single dental implant vs bridge and could go even higher if other procedures are needed like a bone graft.

Dental Bridge Positives

-Permanent. The dental bridge will be cemented in place and will never be removed to clean unless your dentist finds an issue.

-Simpler and Quicker Dental Procedure. Generally takes only 2 dental visits and can usually be completed in about 2 weeks time. This can be a huge positive for many in the dental implants vs bridge discussion.

Dental Bridge Negatives

Dental Hygiene More Difficult. With a dental bridge, you must brush and floss under and around the false tooth. Using floss threader as mentioned above may be difficult for some. Dental hygiene maintenance is a must if there is any chance of long term success for a dental bridge.

-Lifespan Shorter. A dental bridge generally lasts about 7-10 years. Some dental bridges can last longer and some can fail sooner. This is due to the wear and tear on adjacent teeth (these teeth remain susceptible to periodontal disease and tooth decay. Either tooth decay or periodontal disease can weaken support for the dental bridge.

-Surrounding Teeth Affected. A dental bridge requires support from the surrounding teeth that are used to hold the artificial tooth in place. If these teeth are not strong enough to have dental crowns, a dental bridge might not even be possible.

Dental Implants Vs Bridge Conclusion

Choosing dental implants vs bridge can be a difficult decision. Your dentist will help guide you through the process and help you make an educated dental implants vs bridge decision that is best for your smile. It is important to maintain regular dental visits no matter which side you choose in the dental implants vs bridge decision.



Dental Infections (also referred to as an abscess) generally develops as a result of untreated tooth decay and poor oral hygiene. However, a dental infection can also develop from other reasons previous dental work or traumatic injury. When a dental infection begins to develop, a pocket of pus forms in the mouth as a result of an overwhelming growth of bacteria. Symptoms of a dental infection often includes swelling, pain (often radiating away from area), and sensitivity in the area. It is vital to seek professional treatment as without proper and timely treatment, the dental infection may spread to other areas of the jaw or even the brain.

Tooth decay and cavities are very common. About 90% of adults ages 20–64 have had prior tooth decay. Also, almost 30% of people in the same age group have untreated tooth decay. Treating tooth decay early is important to prevent further complications such as dental infections which can often lead to tooth loss.

Anyone who experiences dental infections should see a dentist immediately to prevent the dental infections from spreading.

One of the initial options for a dentist is to recommend an antibiotic to kill dental infections. Some antibiotics will work better than others. This is due to the type of bacteria causing the actual infection., There may also be some over-the-counter pain medications to help relieve the dental infection symptoms temporarily.

Antibiotic Use For Dental Infections

Dentists generally only recommend antibiotics for dental infections. However, not all infected teeth will require antibiotics during treatment. In some instances, a dentist may be able to drain the infected area of pus, remove the infected tooth, or complete a root canal procedure to fix the issue. Antibiotics should not be used unless absolutely necessary to complete dental infections treatment.

Antibiotic Types And Dosages For Dental Infections

The type and dosage of antibiotic your dentist will recommend will vary depending on the type of bacteria that causes dental infections. Different antibiotics work in different ways to eliminate different strains of bacteria. There are over 150 different strains of bacteria that are present in the oral cavity. Many of these bacteria have the potential to grow and cause a dental infection. Treatment can change depending on the bacteria causing the dental infection, although, dentists simply recommend an antibiotic that works against many types. This gives them the best chance to handle the infection effectively and quickly.

Classes Of Penicillin For Dental Infections

Penicillin type drugs are common forms of antibiotics for dental infections. This includes penicillin and amoxicillin. Some dentists may also recommend amoxicillin with clavulanic acid, as that combination may help eliminate bacteria that are being unsuccessfully treated by previous drugs.

Typical dosages of amoxicillin for a dental infection are either 500 milligrams (mg) every 8 hours or 1,000 mg every 12 hours.

Typical dosages of amoxicillin with clavulanic acid are around 500–2,000 mg every 8 hours or 2,000 mg every 12 hours, depending on the minimum effective dosage.

However, some bacteria have been found to resist these drugs, making them less effective. In fact, many doctors now simply choose a different antibiotic as their 1st line of treatment.

Dentists must also be aware that some people are allergic to these drugs. Anyone who has had an allergic reaction to similar medications should tell their dentist immediately before receiving their treatment recommendation.

-Clindamycin

Clindamycin is highly effective against a wide range of infectious bacteria. Some researchers recommend clindamycin as the drug of choice to treat dental infections, as bacteria may be less likely to resist this drug than penicillin-class drugs.

A typical dosage of clindamycin is either 300 mg or 600 mg every 8 hours, depending on which dosage will be effective for the individual situation.

-Azithromycin

Azithromycin also is able to work against a wide variety of bacteria, working to halt their growth. It may be effective in treating some dental infections, though dentists may only recommend it to people who are allergic to penicillin-class drugs or who do not respond to them or other drugs such as clindamycin.

 The typical dosage of azithromycin is 500 mg every 24 hours for 3 consecutive days.

-Metronidazole

Metronidazole is an antibiotic uses to treat a number of infections by both doctors and dentists. This drug is typically not the 1st choice of treatment.

The dosage for metronidazole is around 500–750 mg every 8 hours.

Time To Begin Feeling Better?

The speed with which each antibiotic takes to work on the dental infection varies depending on many factors. These can include the severity of the infection and how effective the drug is at eliminating the infectious bacteria present.

It is imperative for people to complete a full round of antibiotics, taking all of the prescribed medication exactly how the dentist says to take it. A person may begin to notice their symptoms go away after a couple of doses, completing the full dosage of antibiotics helps prevent the infection from returning or getting stronger.

The majority of acute infections resolve in 3–7 days.

Side effects Of Antibiotics For Dental Infections

While antibiotics are very effective for dental infections they can have some possible side effects. These side effects will vary by antibiotic type and individual. It is important to speak with your dentist regarding possible side effects and what to expect.

Dental Infection Treatments Beyond Antibiotics

Antibiotics may help clear active dental infections, but the tooth will still need work to clear up the root of the dental  infection. Antibiotic treatment is just one part of the treatment.

Typical treatment for dental infection can include one or more of the following procedures:

-draining the abscess

-filling in any cavities

-performing a root canal

-extracting the infected tooth

Natural Remedies For Dental infections

Some over the counter remedies may also help “control” the symptoms of a dental infection. This can include over the counter pain relievers such as ibuprofen (Advil) and acetaminophen (Tylenol) and Sodium naproxen (Alleve).

Other things to try to relive symptoms at home:

-gently rinsing the mouth with warm salt water

-rinsing gently with baking soda and water

-avoiding very hot or very cold foods to prevent temperature sensitivity

-chewing with the opposite side of the mouth

-brushing with a very soft toothbrush around the sensitive area

-avoiding very sharp, hard-to-chew foods that may bump into the sensitive area or become stuck in the teeth

-sleeping with your head elevated to relive pressure

Dental Infections Summary

Antibiotics are not the sole answer to dental infections. They are a part of a larger dental infection treatment. Most if not all dental infections require further dental work by your dentist. This can include a root canal or a tooth extraction.

Prompt dental treatment is important to keep dental infections from spreading and making things more dangerous and painful. Some helpful home remedies mentioned above may help keep inflammation down or ease pain while taking antibiotics and preparing for the recommended dental procedure. maintaining a good oral hygiene regimen, such as brushing and flossing each day and seeing a dentist for regular checkups, may help prevent dental infections and their complications.




Dental anxiety and dental phobia can be a major health issue for a good percentage (%) of the population. It can disrupt our lives and our health in many ways. The sad truth is many parents pass on their fear of the dentist to their children without even realizing it. Overcoming the fear is possible with the right dentist and the right approach.

Why Do Kids Fear The Dentist?

Most kids are fearful of the unknown. Whether it be the dark, what lurks in the closet, or what their parents have taught them to fear. The first visit to the dentist should be done around age 1-3. The first appointment should be simple and fun. It is better to not wait for problems that need further treatment. Most of us would not be afraid of an oral exam, x-rays and a cleaning.  Unfortunately, many parents are unaware of this and wait until the child is older or has a dental issues that need to be addressed immediately. Children are also super perceptive of their surroundings and are easily influenced by their parents. Therefore the fears can be passed on down to the kids. If a parent is afraid and openly shows it, a child will see that and feel the same way. A positive outlook on dental care, a caring dentist, and at home good oral habits and diet ,will lead to a child free of dental issue.

Parental Supervision Is Important

Taking care of oneself can be a positive experience if educated properly on the benefits. Recent research has shown maintaining good dental care can keep our overall bodies healthy. Parents need to play an active role in their child’s dental health. That includes monitoring their child’s brushing in the morning and evenings until the child is comfortable and confident to do it on their own.

Most kids, will choose to do the fun activity over the boring one. If the task is not fun it will be rushed through or avoided all together. This directly applies to how well children brush and take care of their teeth. This is one area where kids definitely need our guidance to maintain a healthy smile.

It is recommended that you brush 2x per day for a minimum of two minutes each time. Two minutes can feel like forever for a child. To get your child to brush and floss for the proper time, try making a game out it. Set a timer for two minutes and challenge your child to brush until the timer goes off, or sing songs while brushing. Cute, fun toothbrushes are in stores everywhere. Choose one that’s small enough for your child to hold comfortably by his or herself, with a small, rounded head and very soft, polished bristles. An electric toothbrush is also recommended for little ones. An electric toothbrush makes it easier to use and makes them feel like big grown ups. Whichever brush they choose it should be replaced every few months, particularly for preschoolers who tend to chew while they brush. For babies, a soft finger toothbrush, or wet wash cloth are easiest to use for you and them. Some children’s toothbrushes also have lights that flash or music that plays which serves as a built-in timer. Set the timer again for two minutes for flossing. There are also fun flossers that make it easier to do the best job possible. Another tip would be to brush with your child — Stand side-by-side in front of the bathroom mirror and brush together. Have fun. Let your child mimic your brushing technique. Another helpful tool is the use of a plaque disclosing solution. This solution will allow you and them to see where the plaque is before brushing and what was missed after brushing. Then you can “help” them remove the last of the plaque. Once the color is gone, the plaque is too! The entire process should take just a few minutes in the morning and a few minutes at bedtime.

Tips To Avoid Dental Anxiety In Children

Introduction To Dentist. Set up a meet and greet appointment with your dentist. Your child can tour the office meet the staff and dentist. Get comfortable in the surroundings so it is not as much of an unknown to them. Another good way to get them familiar is have them go to the dentist with an older sibling or you and watch what happens. This takes away the fear of the unknown.

Use Positive Words And Actions. Talking positively about your dentist and your own dental care will instill comfort in your children. It will allow them to relax further.

Set Up A Rewards System. Encourage brushing and flossing and doing well at dental appointments by offering up a special prize over time. Kids love rewards. Establish a reward your child will earn for having a perfect dental examination, such as that new video game or doll they may have been wanting. Make sure they understand that brushing, flossing, and limiting sweets are all ways to reach their goal. You can even tape a photo of the reward to the bathroom mirror for daily reinforcement. Tell your dentist about the reward system, so he or she can also encourage your child at each checkup. If you are still finding cavities, diet may need to be looked at more closely, and a fluoride rinse may need to be added into the routine. Remember to schedule your child’s dental checkups every six months. Very important to stay on schedule and go when needed. You are laying the foundation for your child’s oral health and general health throughout life.

Praise Your Child. Give them encouragement by telling them they are doing great and keep up the good work. This will encourage them to continue their healthy habits into the adulthood.

Be A Good Teacher. It is important for children to know the Why and How of things. Same goes with dental care. If they are simply forced to do it without reason they will fight you. If they realize it is for their benefit or it is fun they will choose to do it. Be sure to explain the importance of brushing and flossing in simple terms kids can understand. For example: “Flossing is important because it removes cookies and food left between your teeth. Do you want tooth bugs stuck in between your teeth?” At your child’s next dental examination, ask your dentist to reinforce the proper brushing and flossing techniques.

Find A Dentist That Works Well With Children. Not all dentists work well with children. It has become very commonplace to go see a pediatric dentist for the children and a separate one for the parents. This does not have to be the case. There are many family dentists who love seeing children in their practice as well. This makes it easier to schedule appointments as a family and also allows your children to see the positive experiences you are having. With the right dental team, dentistry can be an enjoyable experience.

Dental Anxiety Conclusion

Dentistry can be a challenging experience for children and adults. It does not need to be that way. With proper at home care and routine dental visits it can be a positive experience for the entire family.