The word “endodontic” means inside the tooth. An endodontist is a dental specialist who deals with problems arising from the tissues inside the tooth. This tissue is called the dental pulp. A patient is usually referred to an endodontist because the pulp tissue has been damaged by decay, trauma or gum disease. An endodontist receives at least two additional years training after dental school. The endodontist’s primary aim is to save your teeth and minimize dental pain. Saving the tooth can usually be done through non-surgical root canal therapy. Your regular dentist may refer you to an endodontist. Or you may want to seek one yourself if you have persistent, swollen gums or toothaches, or if one of your teeth becomes discolored following trauma. If you wish, our office can refer you to a Board Certified highly qualified specialist to assist you, if your family dentist is unable to.
A root canal is the procedure done to remove dead or damaged pulp tissue from the inside of a tooth. Damage may be caused by severe decay, gum disease or trauma. You may be referred to a specially trained dentist, or endodontist, to do the procedure. Endodontists say that recent advances in technology have made root canal therapy faster and less uncomfortable for the patient, and that even the term “root canal” is a bit outdated. Today they call it endodontic therapy. The procedure works like this: First, the patient is given a local anesthetic like novocaine. The endodontist removes the damage tissue, then cleans the inside of the tooth and fills the space with another material. You may then be referred back to your regular dentist for the final restoration. The tooth may also have a cap, or crown, put on to protect it from fracture. More than 90% of the time this process is able to save a damaged tooth.
In the first half of this century, the most common cure for a persistent toothache was to pull the aching tooth. Now, endodontists and dentists are able to save decaying or damaged teeth in more than 90% of all cases. Many toothaches are caused by damage to the pulp, or soft tissues, inside the tooth. In most cases, the pain can be eliminated by endodontic therapy, what used to be called a root canal. The process is not as lengthy or as uncomfortable as it used to be. During the procedure the endodontist will remove the damaged pulp, then clean the inside of the canal and seal the space. If you’ve been told the damaged tooth has to come out or be extracted, ask about endodontic therapy. It’s also a good idea to seek out another dentist or endodontist for a second opinion before extraction.
The soft inner tissue of a tooth, or pulp, can become damaged in several different ways. If left untreated, deep decay can infect the pulp, causing pain and abscess formation. Sudden trauma to the tooth is a third way the pulp may begin deteriorating. If you are in an accident or hit in the teeth, the inside of your teeth may be affected. Damage may not be visible at first, so it’s a good idea to see a dentist as soon as you can after an injury to your teeth or your mouth. Some warning signs of pulp degeneration include an extremely painful toothache, and extra sensitivity to heat or cold. You may also have some pulp damage if the tooth becomes darker, or discolored.
Q. WHAT IS Q&A AND HOW LONG HAS IT BEEN PUBLISHED?
A. Q&A is a special quarterly magazine supplement for dental patients to read before or after their appointments with the dentist or hygienist to help address questions about dental health and about types of treatment that may be performed or recommended during dental appointments.
Developed with the cooperation of dentists and hygienists from across the nation, Q&A has been published since October 1991. Each issue of Q&A features questions submitted by dental professionals who wish to participate in keeping their patients informed about and involved in their own dental care.
Q. WHAT PURPOSE DOES TOOTHPASTE SERVE?
A. Toothpaste typically contains a detergent compound to penetrate and loosen deposits and stains on tooth surfaces so they can be more easily removed during tooth brushing. Toothpaste also contains cleaning and polishing agents to produce a smooth, shiny tooth surface that can inhibit the accumulation and retention of plaque. In addition, flavoring agents found in toothpaste can make the mouth and breath feel clean, and toothpastes containing fluoride can help strengthen the teeth’s hard outer layer — the enamel — to help prevent cavity formation. Some toothpastes have tartar-control properties to minimize tartar (mineralized plaque) build-up.
Others have special tooth-whitening properties. Some help reduce tooth sensitivity, and still others have anti-microbial properties
to help control the bacteria responsible for gum disease. Inform your dentist or hygienist of the toothpaste you
use so they can evaluate its effectiveness or make recommendations for changes based on your dental health.
Q. WHAT DOES FLOSSING DO THAT TOOTH BRUSHING CAN’T?
When used regularly and correctly, dental floss or tape can effectively remove plaque that accumulates in the very narrow areas between the teeth, that is, the interdental areas, which usually cannot be reached by the bristles of a toothbrush. Some toothbrushes feature specially contoured bristles that can extend into the interdental areas, but flossing these areas and plaque accumulation and can help fight gum disease. Ask your dentist or hygienist about that type of floss or tape best suited for your needs and, if you need assistance, about that correct way to floss.
Q. CAN GUM DISEASE BE TREATED? IF SO, HOW?
A. Gum disease — gingivitis and periodontitis — can be treated effectively, economically, and easily if detected in its early stages by your dentist or hygienist. Treatment involves close cooperation between you and your dentist or hygienist, and its success ultimately depends on your efforts. Your dentist or hygienist will recommend procedures you should follow at home such as regular brushing and flossing and may suggest the use of a mouthrinse and/or oral irrigator to help control plaque, the primary cause of the majority of gum diseases. Regular tooth cleanings at the dental office also can help control gum disease. In addition, depending on the severity of the disease, teeth may need to be treated below the gum line to remove plaque you can’t see and to produce a smooth surface to which plaque can’t stick. Because gum diseases vary by individual, dentists design specific plans for treating each case.
Q. WHAT SHOULD I DO IF MY CHILD ACCIDENTALLY KNOCKS OUT A TOOTH?
A. It is possible, under certain circumstances, to re-implant a permanent tooth that has been completely knocked out of its socket. Ask the dentist for emergency instructions as re-implantation has been found to be most successful if it is done within 30 minutes of the accident.
Q. CAN A CHIPPED TOOTH BE FIXED?
A. Yes. A chipped tooth can be repaired with a filling material that matches the color of the tooth and shaped to resemble the tooth before the chip occurred. This is a relatively new and simple procedure, and before the “composite” material was available, a chipped tooth could only be fixed by placing a cap over the entire tooth. Capping may still be the restoration of choice when a tooth has been severely damaged.
Q. HOW CAN YOUNG CHILDREN BE MOTIVATED TO BRUSH THEIR TEETH?
A. Depending on the child’s age and personality, he or she may be more willing to regularly brush if you make
a game out of brushing, brush with your child on a regular basis if he or she enjoys emulating grown-ups, or allow the child to select the toothbrush and toothpaste, which are available in colorful, entertaining varieties. Some children may respond well if toothpaste isn’t used or if you do the brushing for them while they are seated comfortably on your lap. Until children reach school age and are able to brush their teeth thoroughly on their own, adult participation is encouraged.
Q. DO WISDOM TEETH ALWAYS NEED TO BE REMOVED?
Wisdom teeth show wide variation in their size, development, and position in the jaw bone. They are usually evaluated once the jaw has reached its full development, typically when a person is between 15 to 22 years of age. During the evaluation, the dentist will check to see how many teeth are present in the jaw and whether there is enough space to accommodate the wisdom teeth. Some people never develop or are missing some wisdom teeth while others grow to maturity with the full complement of four. Your dentist may recommend removal of the wisdom teeth if there is insufficient space for them or if they are “impacted.”