The term “root canal” strikes fear into many dental patients. But rest assured that this procedure is the best solution to many severe dental problems. It can be pain-free and will actually relieve pain and suffering from infections and dental injuries.

Why would you need root canal treatment? This procedure becomes necessary when the pulp, the nerve tissue on the inside of a tooth's root, becomes inflamed or infected because of deep decay, or when it has suffered a severe injury as a result of an accident or blow to the mouth. The pulp is composed of living tissues including nerves and blood vessels.

Root canal treatment may be necessary if you have a wide variety of signs or symptoms. The pain can feel sharp or intense when biting down, or linger after eating hot or cold foods. Sometimes it can be a dull ache or there may be tenderness and swelling in your gums near the site of the infection.

After trauma, the pulp of a tooth can be exposed or damaged because a tooth has fractured or cracked, necessitating root canal treatment. And the procedure is often needed for permanent teeth that have been dislodged or knocked out.

What exactly is root canal treatment? Root canal treatment is also called endodontic treatment, from the Greek roots “endo” meaning “inside” and “odont” meaning “tooth.” During the procedure, the area is numbed to relieve pain. A small opening is created in the chewing surface of the tooth and very small instruments are used to remove dead and dying tissue from the inside. The pulp is needed during a tooth's growth and development, but a mature tooth can survive without it. The canal is disinfected and then sealed with filling materials. Sometimes root canal specialists use microscopes to work at an intricate level of detail on these tiny areas of the tooth's root.

By having root canal treatment, you prevent inflammation and infection from spreading from the root of a particular tooth to other nearby tissues. Infection can result in resorption, an eating away of the root and its anchoring bone, and you could lose your tooth or teeth. So please don't hesitate when we recommend this treatment. It's not as bad as you think, and you will feel significantly better afterwards.

Contact us today to schedule an appointment to discuss your questions about root canal treatment. You can also learn more by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Trauma & Nerve Damage to Teeth.”

Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”

If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.

Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.

Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.

Advantages of prepless veneers include:

• Tooth preparation or reduction is not needed, leaving the original tooth whole.
• They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
• They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
• They can be used to “lengthen” teeth that have been worn down by grinding.
• Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.

Disadvantages include:

• There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
• Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
• Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
• They do not usually work for lower teeth because of space restrictions.
• They cannot replace lost or damaged enamel.

Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.

Contact us today to schedule an appointment to discuss your questions about prepless veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”

If you wake yourself by snoring or have been told by others that you snore, you should share this fact with us during your next visit. Why? Many people are shocked to learn that their dentist is a vital resource for treating snoring and Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (back of your throat) is blocked or obstructed causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more.

Self Test For Sleep Apnea

While your responses to the following questions are not a diagnosis for OSA, they can be warning signs that you may have OSA or another condition that is impacting your sleep.

1. Are you a loud habitual snorer?
2. Has anyone ever witnessed you holding your breath, gasping for air or even choking while asleep?
3. Do you regularly feel un-refreshed or tired even after waking from eight or more hours of sleep?
4. Do you find yourself easily falling asleep throughout your day at work or at home?
5. Do you suffer from poor concentration or judgment, memory loss, irritability and/or depression from lack of sleep?
6. Are you 15 pounds over the normal weight range for your height and/or does you neck measure more than 17 inches around if you are male and 16 inches if you are female?

If you answered, “yes” to any of the above questions, you should share your responses to all of these questions with both your physician and us so that you can receive a thorough examination to address your sleep concerns. And if you are diagnosed with OSA, we can help with specific oral treatment options that may work best for you.

Learn More

Learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.” Contact us today to discuss your questions or to schedule a consultation.