Many people come into the office without any understanding of endodontic (root canal ) therapy.

I am often asked the following questions:

1. Why do I need root canal treatment?
2. Does that mean that I have to get the roots removed?
3. After having a root canal, I had to have the tooth taken out. Is this common? How long do they last?
4. Will the tooth be as good as new?

Endodontic treatment may be need if you have any of the following:

• prolonged sensitivity to heat or cold
• tenderness to touch and chewing
• tooth discoloration
• swelling or  drainage
• tenderness of the lymph nodes

The need for treatment can arise from acute or chronic physical trauma, deep decay, or a loose cracked or broken filling.

Root canal therapy (Endodontics – within the tooth) doesn’t mean that the roots have to be removed.

Every tooth has one or more roots with one or more canals .  Within these canals are nerves and blood vessels which are called the pulp.  When the nerve is exposed to too much trauma, there can be swelling of the blood vessels (inflammation), pain, and sometimes nerve death or abscess.  Root canal therapy removes the pulp from the canals but leaves the roots intact. The canals are cleaned, reshaped, and filled with a special material called gutta percha.  This seal prevents reinfection by bacteria.

Endodontics has changed a lot over the years.

Once taking multiple visits  (I have heard as many as twenty), it was also associated with pain, many failures, and inconsistent results. People also associated root canal treatment with pain because the arrived at the office in pain. However,  endodontics is now relatively pain-free, can often be performed in one visit and has a very high success rate.

Will my tooth be good as new?

Once endodontic therapy is completed, a crown or other permanent restoration needs to be place within 30- 90 days.  Otherwise, the tooth may crack or the root canal seal may fail.  Usually more than a filling is needed for adequate protection.  Once restored, the tooth should remain problem free for many years. You can however still get decay in the tooth or break the tooth just like before the root canal treatment.  In fact, one has to be especially careful to have routine checkups because you will not feel anything if the tooth starts to decay.    Occasionally,  Endodontic surgery may be needed due to  unhealing abscesses, cracked roots, or deposits within the canal that inhibit complete filling of the canal.

Invisalign is constantly trying to improve their product.

Recently they introduced Invisalign Teen.  This product helps dentists treat younger patients by including:

• Blue wear-indicators fade from blue to clear to help your teen gauge wear time
• Designed to compensate for the growth of new teeth and molars
• Six free individual replacement aligners are included in case any get lost or misplaced

In addition, many improvements have been made to their existing product lines.  These include improvements in rotating, erupting, and intruding teeth.  They have also optimized tooth movement so that the whole tooth moves rather than just tips.  More information can be found by clicking the  following:

Invisalign news release

Or by watching this video:

Invisalign Improvements

I had one assistant go home with a bad cold or flu and another leave today because her daughter has the H1N1 virus. I had to close today. Has the flu affected your business or family? Are you planning on getting vaccinated for the regular flu or for H1N1 (swine flu)? Please comment.

I decided to begin with this topic because I have found much confusion both among dentists and the general public. I am going to limit my comments to permanent crowns. However, you can also ask me any questions about temporary crowns.

There are 3  general types of crowns: all metal, porcelain fused to metal, & all ceramic or porcelain. (All other types I consider temporary or long-term temporary.)  These crowns can be full crowns, covering the whole tooth, or partial crowns.  Let us discuss each of these types separately.

All Metal Crowns

which are made of  gold or other alloys have the following advantages

1. Less tooth needs to be removed.
2. Withstand biting and chewing forces best with the least force transmitted to those opposing teeth biting against them.
3. Minimal tooth wear to opposing teeth.

The color is the main drawback and why these are usually suggested only for out of sight teeth.

Porcelain-fused-to-metal crowns

can be made to more closely match the color of your existing teeth. However:

1. The crown’s porcelain may chip or break off.
2. The porcelain is harder against the opposing  acting more like a hammer and also causes more wear.
3. More tooth has to be removed to allow for both the metal and the porcelain.
4. Because of the metal lining, they quite often appear more opaque than the natural tooth.
5. At the edge, especially if your gums recede, the metal can show through the porcelain appearing as a dark line.

These crowns are used for front and back teeth.

All Ceramic or all porcelain crowns

are the most aesthetic and provide the best color match. They are also the best choice for people with metal allergies.  But:

1. They are typically not as strong as porcelain to metal crowns (However, improvements are being made all the time)
2. They wear the teeth more than metal crowns but about the same as porcelain to metal.
3. There are many types and the all have different properties in terms of strength, opacity, wear, and type of preparation.  Your dentist needs to know which will be best in your situation.

These are a great choice for front teeth but certain materials can be used for back teeth and even short span bridges (another discussion).

Please comment on this discussion of crown types.  Ask me any questions. Do you know the type of crown that you have in your mouth?

Depending upon your responses, I may follow this up with a more detailed discussion of all ceramic crowns.

We had an excellent Invisalign Day yesterday.

We started 4 new cases and got commitments for more.  We have decided to extend all discounts for two weeks so that anyone who was unable to attend will still be able to receive these tremendous rates. Call us for more details:

248-669-4141 or email  Gordon@dentabyte.com

I have delayed the first discussion session till after the Invisalign Day tomorrow.

I may have a discussion session related to Invisalign soon. However, I think the first session will be Types of Crowns-PFM, Gold, All Ceramic, etc. I believe I will follow that up with a discussion of types of veneers. So stay tuned.

In the meantime in light of the upcoming Invisalign day,  enjoy the following video:

Welcome to our blog. Since I am new to blogging,  I will begin by asking for suggestions.  Please respond now with a comment with topics of interest to you. I will start discussions based upon the topics suggested.

Thanks,

Gordon P Smith, DDS