There’s one sure thing about tooth decay: you can’t ignore it. In fact, the best outcomes result from finding it early and treating it before it enters the pulp in the center of the tooth, often a filling or similar treatment.
If it does advance to the pulp, you may need a root canal treatment to save the tooth. This is a moderately invasive procedure where we access the pulp and root canals, tiny passageways leading to the root and supporting bone. We then remove all the diseased tissue and fill the empty pulp chamber and root canals with a special filling. Later we’ll crown the tooth for added protection against future infection or fracture of the tooth.
But there’s also another less-invasive method than a root canal called pulp capping. It’s only appropriate to use, however, if the pulp has become exposed or almost exposed by decay, but hasn’t yet shown signs of disease.
Pulp capping can be either direct or indirect. We use direct pulp capping if the healthy pulp has been exposed by the disease process. We first isolate the tooth from the rest of the mouth to prevent contamination and then proceed to remove all of the tooth’s decayed dentin structure. We then apply a biocompatible material directly over the pulp to protect it from further decay and to facilitate healing. We then restore the tooth, usually with a filling, to its proper function and life-like appearance.
When the pulp is threatened by decay but not yet exposed, we may then use the indirect method. In this approach we first remove most of the decayed dentin, but leave a small amount next to the pulp to keep it covered. We then treat this remaining dentin with a material to help it heal and re-mineralize, followed by a temporary filling of the tooth. A few months later we’ll remove this filling and inspect the treated dentin. If it has regenerated sufficiently, we remove any remaining decay and permanently restore the tooth.
As we said, pulp capping is only used with patients with deep decay whose pulp tissue is healthy. But when we can use it we can avoid some of the permanent alterations that often come with a root canal treatment and still save the tooth.
If you would like more information on treatments for tooth decay, 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 “Pulp Capping: A Procedure that May Save a Decayed Tooth.”
Root canal treatments have suffered a bad rap over the years—and undeservedly. While we applaud root canal therapy for the millions of decayed teeth the procedure has saved, the worn-out cliché that it's painful still lingers on.
So, let's set the record straight: a root canal treatment doesn't cause pain, it most often relieves it. Let's look a little closer at what actually happens before, during and after this tooth-saving treatment.
Before: a tooth in crisis. Tooth decay can damage more than a tooth's outer enamel. This aggressive bacterial infection can work its way into a tooth's interior, destroying the nerves and blood vessels in the pulp, before moving on to the roots and supporting bone through the root canals. Untreated, this devastating process can lead to tooth loss. A root canal treatment, however, can stop the invading decay and save the tooth.
During: stopping the disease. The dentist first numbs the tooth and surrounding gum tissues with local anesthetic—the only thing you might normally feel during treatment is a slight pressure. They then drill into the tooth to access the inner pulp and root canals and remove all diseased tissue. Once the interior spaces of the tooth have been disinfected, the dentist then fills the empty pulp chamber and root canals with a pliable filling called gutta percha to prevent future infection.
After: preventing re-infection. With the filling complete, the dentist then seals the access hole. There may be some minor soreness for a few days, similar to the aftermath of a routine filling, which can usually be managed with over-the-counter pain relievers like ibuprofen. Sometime later, the dentist will normally finish the treatment with a new crown on the tooth. This accomplishes two things: It helps strengthen the tooth against stress fracturing and it provides another layer of protection against future decay.
Root canal treatments have an exceptional track record for giving diseased teeth a second chance. There's nothing to fear—and everything to gain for your troubled 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 Treatment: What You Need to Know.”
There's no doubt treating dental problems can improve your health. But because the mouth is among the most sensitive areas of the body, many dental procedures can be potentially uncomfortable after treatment.
We rely on pain medication to alleviate any dental work discomfort, especially during recuperation. Our arsenal of pain-relieving drugs includes strong opioid narcotics like morphine or oxycodone which have effectively relieved dental pain for decades. But although they work wonders, they're also highly addictive.
We've all been confronted in the last few years with startling headlines about the opioid addiction epidemic sweeping across the country. Annual deaths resulting from opioid addiction number in the tens of thousands, ahead of motor vehicle accident fatalities. Although illegal drugs like heroin account for some, the source for most addiction cases—an estimated 2 million in 2015 alone—is opioid prescriptions.
Dentists and other healthcare providers are seeking ways to address this problem. One way is to re-examine the use of opioids for pain management and to find alternative means that might reduce the number of narcotic prescriptions.
This has led to new approaches in dentistry regarding pain relief. In a trend that's been underway for several years, we've found managing post-discomfort for many procedures can be done effectively with non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, acetaminophen or ibuprofen. They don't share the addictive quality of narcotics and are regarded as safer when taken as directed.
There's also been a recent modification with using NSAIDs. Dentists have found that alternating the use of ibuprofen and acetaminophen often amplifies the pain relief found using only one at a time. By doing so, we may further reduce the need for narcotics for more procedures.
The trend now in dentistry is to look first to NSAIDs to manage pain and discomfort after dental work. Narcotics may still be used, but only in a secondary role when absolutely needed. With less narcotic prescriptions thanks to these new pain management protocols, we can reduce the risk of a dangerous addiction.
TMJ disorder is an oral health problem characterized by jaw pain and difficulty opening and closing your mouth. At Great Meadows Dental Group in Bedford, MA, your dentists, Dr. Papapetros, Dr. Ristuccia and Dr. Rigopoulos, successfully treat jaw problems so patients experience increased comfort and better oral function.
How does TMJ disorder happen?
The temporomandibular joints are hinges located on opposite sides of the head. They operate the jaws, causing fluid up and down and side to side movement. Unfortunately, arthritis, poor dental bite, injury, stress and habitual teeth clenching may interfere with the smooth operation of these facial joints.
As such, people have headaches, ear pain, toothaches, poor movement of the jaws, tinnitus and odd popping and clicking noises emanating from their jaws. About 12 percent of the American adult population suffers from some degree of TMJ dysfunction and that stress may exacerbate the issue.
Getting the help you need
At Great Meadows Dental Group in Bedford, MA, your dentists take TMJ disorder seriously. They understand that these odd symptoms are not imagined, but very real, and accordingly, they listen carefully to their patients' concerns and symptoms. Also, they do complete oral examinations and digital imaging to fully understand the source of pain.
After your TMJ exam, your dentist may recommend treatments that vary from simple to complex, depending on your particular case. Your plan may include:
- Eating a softer diet
- Relaxation techniques to reduce stress
- Jaw stretching exercises
- Application of heat to the sides of the face
- Massaging the jaw joints
- Over the counter analgesic medications, such as ibuprofen
- Muscle relaxant medications
- Cortisone injections to reduce inflammation
- Correction of dental bite with porcelain crowns or orthodontia (braces or aligners)
- Wearing a custom-made, acrylic bite guard at night to reduce teeth clenching and grinding
Only the severest of cases require oral surgery on the jaw joints.
Feel your best
TMJ disorders can be both painful and extremely frustrating. To understand why you have these symptoms and how to manage them, please contact your dentist at Great Meadows Dental Group in Bedford, MA. Dr. Papapetros, Dr. Ristuccia and Dr. Rigopoulos have the expertise and chairside manner you need for the best treatment outcomes. Call the office for an appointment at (781) 275-7707.
Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.
Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!
Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?
The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.
Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.
Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.
Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
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