Root canal, or endodontic (“endo” – inside; “dont” – tooth) treatment, is often wrongly perceived as a highly unpleasant experience and one that causes tremendous pain. However, the truth is that the procedure actually relieves the pain being caused by an infected and inflamed tooth pulp (inside of the tooth). Advances in dentistry have made treatment virtually pain free and it can be completed relatively quickly, usually in a single visit. Left untreated, infection can spread into the bone immediately around the tooth's root, so prompt attention is the best course of action.

If the term “root canal” still sends shivers down your spine, don't despair. Here is some information that should help put your mind at ease.

• Root canal treatment is necessary when deep decay or trauma has caused the inside (pulp) of the tooth to become inflamed or infected. Symptoms of infection can include sharp pain when biting down, lingering pain after consuming very hot or cold foods, a dull ache and feeling of pressure near the infected tooth, and tender gum tissue surrounding the infected tooth.
• After a local anesthetic is administered to numb the infected tooth and its surrounding area, we will make a small opening on the chewing surface of the tooth. This will allow us to remove dead and dying tissue from the pulp and to then clean and disinfect the root canals. Using small instruments, we will shape the canals and seal them with biocompatible filling materials.
• You may feel slight tenderness at the treated site for a few days, but this is quite manageable and can be relieved with over-the-counter (OTC) non-steroidal, anti-inflammatory pain relievers such as aspirin or ibuprofen. You should refrain from chewing on the treated tooth until your follow-up appointment. A crown or other restoration may be needed to protect the tooth and restore it to full function.

If you think you might be a candidate for a root canal treatment, schedule an appointment as soon as possible. If you would like to learn more about the process of root canal treatment, please read the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”

Losing a baby tooth is an important milestone in a child's life. Be sure to take a photo of that toothless smile — it will be something you treasure as your child grows up.

You may be wondering what is really happening when a baby tooth becomes loose and eventually falls or is pulled out. Read on for some answers.

What are baby teeth?
An infant's teeth begin to form before birth, by the fifth to sixth week after conception. When the baby is born, 20 primary (baby) teeth are almost completely formed inside the jaws. These first teeth, also called deciduous teeth, begin to erupt through the gums at about the time the baby begins to eat solid food. The front teeth (incisors) are usually the first to come in, at age six months to a year.

Why are they called deciduous teeth?
Deciduous means “falling off at maturity.” The same term refers to trees that lose their leaves every fall. In many mammals, including humans, it refers to the first teeth, which need to come out to make room for the larger permanent teeth to come in.

What causes the deciduous teeth to become loose?
While your child is using his primary teeth to bite and chew, his adult (permanent) teeth are quietly growing inside his jawbone. Starting with tooth “germs” (the word comes from germination, meaning the start of growth), the top part of each tooth, called the crown, grows first. Then the bottom part, or root, begins to grow and elongate. As the roots develop and the permanent teeth take up more room in the child's jaw, they begin to push against the baby teeth. This causes the roots of the baby teeth to melt away or resorb. Eventually little or nothing is left to hold the baby teeth inside the child's gums, they become wiggly, and finally they can easily be pulled out. This may leave a little bleeding gum tissue that quickly heals.

What should you watch for in the transition from primary to permanent teeth?
As the permanent teeth erupt (push through the gums and become visible), you may notice that they are too crowded, have too much space between them, or are crooked. It's a good idea to have an orthodontic (from ortho, meaning straight and dont, meaning tooth) evaluation at age five to seven. Watch to see that the baby teeth are lost in the right sequence. If one is lost prematurely, for example from decay, make sure that the space that it occupied is maintained to make room for the adult tooth that will replace it. We can help you with this.

Contact us today to schedule an appointment to discuss whether your child's baby teeth are being lost in the right sequence and if the adult teeth are coming in correctly. For more information see the Dear Doctor magazine article “Losing a Baby Tooth.”

A pregnant woman has a lot to think about while preparing to welcome a new member of her family. It's important to think about her oral health as well. She is sharing her body with the developing infant, so problems with her health — including her dental health — can affect the baby. The following facts will help you understand the relationship between oral health and pregnancy.

1. A baby's primary (baby) teeth begin to form during the sixth week of pregnancy. They begin to form their enamel (the hard outer layer of the teeth) and dentin layer (just under the enamel) at about the third or fourth month. The calcium, phosphorous, and protein that are needed for these structures must all be provided by the mother's diet.
2. A good diet for a pregnant mother, in order to provide for both her needs and those of the fetus (the developing baby), includes whole grains, fruits, vegetables — including green leafy vegetables — proteins and dairy products. A doctor may also recommend iron and/or folic acid supplements.
3. If the mother's diet does not provide enough calcium for the baby's bones and teeth, it will come from calcium stored in her bones — not from her teeth. The old idea that a mother's teeth lose calcium during pregnancy has been found to be a myth.
4. Progesterone, a normal female hormone, is elevated during pregnancy. This hormone stimulates production of prostaglandins, substances that cause inflammation in gum tissues if the bacteria that cause periodontal (gum) disease are present. The resulting swelling, redness, and sensitive gum tissues, called pregnancy gingivitis, are common during the second to eighth months of pregnancy.
5. The bacteria involved in periodontal disease can affect whole body conditions such as heart disease and strokes, diabetes, and respiratory diseases. The inflammation resulting from such bacteria can also cause premature delivery (birth before 37 weeks of pregnancy) or low birth weight in the baby.
6. Periodontal disease is also related to pre-eclampsia, or high blood pressure, during pregnancy.
7. Dental x-rays do not expose the mother to very high radiation, but in any case every precaution is taken to minimize exposure to the fetus. These include a leaded apron that shields the baby from exposure.
8. Most drugs commonly used in dentistry, including local anesthetics, can safely be given to pregnant women without affecting the fetus. However, it is important to let your dentist know you are pregnant before embarking on any treatment to make sure anything that is done will be safe for the fetus and its developing teeth.

Contact us today to schedule an appointment to discuss your questions about pregnancy and your oral health. You can also learn more by reading the Dear Doctor magazine article “Pregnancy and Oral Health.”

As the Boy Scouts say, it's best to be prepared. You may never have a traumatic injury to your teeth. But what if you do? Here are four questions and answers about such injuries and their treatment that may be helpful some day.

What are traumatic injuries?
We are talking about physical damage caused by a fall, an accident, or a blow to the face. The word trauma comes from the Greek root meaning “wound.”

A traumatic injury can also cause broken, cracked, or split teeth, or a fracture to the root of the tooth. A tooth may be dislodged from its proper position, pushed sideways, out of or deeper into its socket. It may even be completely knocked out of your mouth.

What should you do if your tooth is knocked out?
With proper treatment, the tooth can be restored to its original place. You must handle the tooth gently and seek professional help as soon as possible. Rinse the tooth in cold water if it is dirty, but do not use any cleaning agent. Avoid touching the root. While hurrying to your dentist, keep the tooth from drying out by keeping it in a container of milk or of your saliva, or by holding it in your mouth between gum and cheek. It is vital to keep the tooth's living tissues moist until it can be professionally assessed and replanted in its socket. If a tooth has been dislodged but not knocked out, it must be repositioned in its socket and may be stabilized with a splint.

Who can treat a tooth that is damaged by a traumatic injury?
A general dentist, an oral surgeon or an endodontist is trained to treat such injuries. An endodontist is trained to treat the root canal(s) inside a tooth. The word comes from “endo” the Greek word for “inside,” and “odont,” the word for “tooth.” After a tooth is replaced in its socket and stabilized, root canal treatment is often needed.

What is root canal treatment?
A tooth is composed mostly of dentin, a living tissue. The top part or crown is covered by hard mineralized enamel. The soft tissue inside the tooth, the pulp, contains blood vessels, nerves and connective tissues. It extends from the crown to the tip of the roots. Treatment of dental pulp injuries is called root canal or endodontic treatment and is usually needed to treat teeth that have been dislodged or fractured.

Contact us today to schedule an appointment to discuss your questions about injuries to teeth and related nerve damage. You can also learn more by reading the Dear Doctor magazine article “Trauma & Nerve Damage to Teeth.”

If an adult has lost his or her teeth (a condition called “edentulism”), full removable dentures (false teeth) can restore the person's appearance and ability to bite, chew, and talk properly. Even with our current extensive knowledge about tooth care and restoration, over 25 percent of Americans have lost all their teeth by the time they are 65.

How much do you know about dentures? Test yourself below.

How does tooth loss affect your bones?
Bone is a living substance that is constantly changing and rebuilding itself, depending on signals it receives from surrounding tissues. The bone that surrounds your teeth is called alveolar bone (from “alveolus,” meaning sac-like). To keep healthy, alveolar bone needs stimulation or function such as chewing and your teeth touching your opposing teeth. If you lose your teeth, bone begins to melt away (resorb).

How can we minimize bone loss during tooth extraction?
We can maintain bone volume by using bone grafting techniques. While this sounds scary, it is a relatively easy procedure. The principle of bone grafting is to build a sort of scaffolding on which your body begins to build and maintain its own bone. Bone loss can be prevented by the placement of a few dental implants.

How are dentures designed and created?
The dentures that look best and work best for you are based on your original teeth. We often utilize photographs of how you looked with your natural teeth, along with your input about possible changes you would like to see. First we take detailed impressions (molds) of the residual ridges in which your teeth once rested. From these we make denture bases of a light cured plastic resin. We attach horseshoe-shaped rims made of wax to the bases, to simulate the position of the teeth as we work out their design and spacing, based on both appearance and function. The prosthetic teeth are then tried out in your mouth, adjustments are made, and the dentures are processed in a dental laboratory. The final product substitutes a pink colored plastic (methyl methacrylate) to represent the gums and white plastic material as the teeth, created to make them look as natural as possible.

What is your part in the denture fitting process?
As a patient with new dentures, you must learn to use your jaw joints, ligaments, nerves, and muscles in new ways to help stabilize your dentures and to relearn to speak, bite, chew, smile, and laugh with these new structures. It takes a little practice, but with your removable dentures you can once again enjoy a complete and normal life.

Contact us today to schedule an appointment to discuss your questions about full removable dentures. You can also learn more by reading the Dear Doctor magazine article “Removable Full Dentures.”