Posts for: July, 2018
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
Many people consider a root canal treatment to be potentially an unpleasant experience. You might even feel a few butterflies fluttering in your stomach if we were to recommend one for you.
But there’s nothing actually to dread about this common and very effective treatment. The procedure doesn’t cause pain; in fact, it most likely relieves tooth pain. What’s more, it could save a tooth that would be otherwise lost.
The name comes from narrow passageways extending from the tip of the root to the innermost tooth pulp. The pulp contains nerves and other structures once vital to early tooth development. And although they’re not as important in a fully mature tooth, those nerves still function. In other words, they can still feel stimulation or pain.
That shouldn’t be a problem with a healthy tooth. But if tooth decay invades the inner pulp, those nerves now under attack will begin firing. You’ll know something’s wrong. As bad as it feels, though, the toothache isn’t your worst problem: if the decay isn’t stopped, it can spread through the root canals to the bone that could eventually lead to losing the tooth.
A root canal treatment removes the decayed pulp tissue and protects the tooth from re-infection. We first deaden the tooth and surrounding tissues with a local anesthesia and set up a rubber dam around the tooth to protect it from contamination from the surrounding environment. We then drill a small access hole through the enamel and dentin to reach the pulp chamber and root canals.
Using special instruments, we remove all the diseased tissue from the pulp and flush out the empty chamber and root canals with antibacterial solutions. After re-shaping the root canals, we fill them and the pulp chamber with gutta-percha, a rubber-like biocompatible material that conforms well to the root canal walls. We seal the gutta-percha with adhesive cement and then fill the access hole. Later, we’ll give the tooth further protection with a custom crown.
After the procedure, you may experience short-term minor discomfort usually manageable with over-the-counter pain relievers like ibuprofen. The good news, though, is that the excruciating nerve pain from within the tooth will be gone—and your tooth will have a new lease on life.
If you would like more information on saving a problem tooth with 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.”
It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.
Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.
Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.
Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.
For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.
If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.
As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.
If you would like more information on caring for primary teeth, 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 for Children’s Teeth.”