Crescent Dental Blog

Category Archives: Dental Health

Dental Health, Root Canal Treatment

What is a Root Canal

What is a Root Canal?

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. Without treatment, the tissue surrounding the tooth will also become infected and abscesses may form. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed.

“Root canal” is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s nerve lies within the root canal.

A tooth’s nerve is not vitally important to its health and function after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

Why Does Tooth Pulp Need to Be Removed?

When a tooth’s nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:

  • Swelling that may spread to other areas of the face, neck, or head
  • Bone loss around the tip of the root
  • Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.

What Damages a Tooth’s Nerve and Pulp in the First Place?

A tooth’s nerve and pulp can become irritated, inflamed, and infected due to deep decay, repeated dental procedures on a tooth, and/or large fillings, a crack or chip in the tooth, or trauma to the face.

What Are the Signs That a Root Canal Is Needed?

Sometimes no symptoms are present; however, signs you may need a root canal include:

  • Severe toothache pain upon chewing or application of pressure
  • Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
  • Discoloration (a darkening) of the tooth
  • Swelling and tenderness in the nearby gums
  • A persistent or recurring pimple on the gums

What Happens During a Root Canal Treatment at Crescent Dental?

A root canal will require one or more office visits. The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. Your dentist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but your dentist will generally anaesthetise the area to ensure you are relaxed and at ease.

Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth. An access hole will then be drilled into the tooth. The pulp, along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.

Once the tooth is thoroughly cleaned, it is sealed. In some cases your dentist may decide to wait before sealing the tooth – for instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. In most cases however the tooth will be sealed on the same day it is cleaned out.

Next, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth’s root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.

The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown or may need to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your Crescent dentist will discuss the need for any additional dental work with you.

How Painful Is a Root Canal?

Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed.

What Should One Expect After the Root Canal?

For the first few days following the completion of a root canal, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications such as ibuprofen (e.g. Advil). Most patients can return to their normal activities the next day.

Until your root canal procedure is completely finished — that is to say, the permanent filling is in place and/or the crown, it’s wise to minimize chewing on the tooth under repair. This step will help avoid recontamination of the interior of the tooth and also may prevent a fragile tooth from breaking before the tooth can be fully restored.

How Successful Are Root Canals?

Root canal treatment is highly successful; the procedure has more than a 95% success rate. Many teeth fixed with a root canal can last a lifetime. Also, because the final step of the root canal procedure is application of a restoration such as a crown or a filling, it will not be obvious to onlookers that a root canal was performed.

Alternatives to a Root Canal

It goes without saying that saving your natural teeth is the best option, if possible. The only procedural alternative to a root canal is having the tooth extracted and replaced with a bridge, implant or removable partial denture to restore chewing function and prevent adjacent teeth from shifting. However these alternatives are generqlly more expensive than a root canal procedure and require more treatment time and additional procedures to adjacent teeth and supporting tissues.

Root Canal Prevention

Since some of the reasons why the nerve of a tooth and its pulp become inflamed and infected are due to deep decay, repeated dental procedures on a tooth and/or large fillings, following good oral hygiene practices (brushing twice a day, flossing at least once a day, and scheduling regular dental visits) will reduce the need for a root canal procedure. Trauma resulting from a sports-related injury can be reduced by wearing a mouthguard.

Ask your dentist’s advice on root canal procedures; you can call Crescent Dental in Limerick on 061 484 844 to schedule your appointment. You may be eligible for a free check-up; see www.crescentdental.ie

Dental Health, Sports Mouthguards

Why wear a mouth guard?

Why Wear a Mouth Guard?

Each year approximately 10,000 primary school children in Ireland damage one or more of their front permanent teeth. This figure, taken from recent research carried out by HSE West, is consistent with international research and previous epidemiological research on children’s dental health in Ireland. The extent of the damage can range from a small chip fracture to a front tooth, to a fracture of the root of the tooth and in some cases, a tooth knocked out of the mouth completely. The cost of treatment can be substantial for the initial emergency visit and for the follow up long-term care that is eventually required in most cases. Most chip fractures are treated by tooth-coloured fillings initially but eventually a crown or permanent cap is required. In more complicated cases a root treatment, a bridge, an implant or even orthodontic treatment may be required to correct the damage caused by a sports injury. This treatment can take several years to complete and cost several thousand euro. All of this could be prevented in the first place if mouth guards were worn when playing contact sports.

What is current practice in Ireland?

Up to recently, wearing of mouth guards was optional for children in many sports varying from 5% usage in soccer to a high of 60% in rugby. The recent decision of the GAA to make wearing of mouth guards compulsory for children playing Gaelic from January 2013 is a welcome development. However, with over two thirds of schools and sports clubs reported as not having a policy on mouth guard use, it is obvious that parents will need to become much more vocal in advocating for change on this important oral health issue.

How effective are mouthguards at preventing dental injuries?

Ice hockey is the most dangerous sport in the world when it comes to dental injuries. In Ireland anecdotal evidence would indicate that gaelic football, hurling, rugby, hockey, soccer, basketball and boxing are all high risk for dental injuries. Other pursuits like skate boarding and rollerblading also carry significant risk of facial and dental injury. In Canada the introduction of compulsory wearing of mouth guards in professional ice hockey resulted in a decrease in the annual rate of dental injuries from 8% to 1%. In the USA over a 14 year period there has been a dramatic reduction in the annual incidence of dental injuries following the introduction of face masks and later mouth guards. Similar reductions were achieved in basketball over the same period following the introduction of mouth guards.

Which type of mouth guard is the most effective?

There are three types of mouth guard

1. Stock mouth guard
These are the cheapest. They are made of latex rubber or polyvinyl chloride and come in three sizes. They are of little or no value and may in fact be unsafe as they interfere with breathing and speech and do not redistribute forces on impact.

2. Boil to fit mouth guard
These are the most widely available type of mouth guard and can be bought in most sports stores. This mouth guard comes in a kit of the ‘do it yourself’ variety consisting of a fairly rigid outer shell and a soft but resilient heat or self cured lining. Once the
lining is softened in boiling water, the person bites down to help it take the shape of their mouth. However, by biting down the thickness of the mouth guard is reduced therefore reducing effectiveness. Because of their bulkiness, these mouthguards can be uncomfortable to wear. On the positive side they are relatively inexpensive and do provide a basic level of protection.

3. Custom made mouth guard
These provide the highest level of protection. A randomised controlled trial in Australia concluded that there was a significant protective effect of custom made mouth guards relative to all other types of mouth protectors. This effect was enhanced when custom made mouth guards were worn during both practice and play sessions. A recommendation that all Australian football players should wear custom made mouth guards has been accepted by sporting authorities in Australia. Custom fitted mouth guards are constructed and fitted to the shape of the mouth. The essential difference between this and other varieties is that the guard is constructed on a plaster model replica of the teeth made from an impression of the teeth taken by a dental professional. This results in a mouth guard that is comfortable and fits more snugly on the teeth. Because of the better fit, breathing and swallowing is easier and speech is less affected. Because of the laboratory construction technique a minimum of 4mm thickness is guaranteed enabling the redistribution of forces when there is an impact or trauma to the face.
These mouth guards are more expensive because of the additional steps taken during construction. However, this additional expense is more than compensated for by the additional advantages and effectiveness associated with wearing this type of mouth guard.

It is worth noting that for children under the age of 12 where the dentition is changing rapidly a custom made mouthguard is unlikely to last for more than 12 months and boil to fit gumshields will be a more cost effective option. Our dentists will discuss with you whether your child is suitable for a custom made mouth guard.

How to care for your mouth guard

– Rinse in cold water before use
– After use, dry and store in a plastic container with air vents to allow the air to circulate
– Once in a while, clean with a mild detergent and rinse thoroughly
– Store in a cool place as mouth guards can distort if left in the sun or hot water
– Bring along when visiting the dentist to ensure that it still fits properly

Mouth guards and orthodontic treatment

An Orthodontist will advise on the correct type of mouth guard for people wearing braces while playing contact sports. Separate upper and lower custom made mouth guards may be required. Removable orthodontic appliances should be removed when playing any type of contact sports. Custom made mouth guards should be an essential part of the kit of every child and adult playing contact sports in Ireland. Much unnecessary and avoidable permanent injury to the face and teeth costing families thousands of euros could be prevented if wearing of custom made mouth guards was made compulsory for all contact sports in this country.

At Crescent Dental we offer high quality custom made mouthguards in a variety of colours and styles, including the full range of Piranha Guards. Please see /mouthguards/ for more information or call 061 484 844 to book your appointment.

Childrens Dentistry, Dental Health

How do I help my Children care for their teeth

At Crescent Dental we treat lots of children from around Munster and we always encourage preventive care for our young patients. Teaching your child proper oral care at a young age is an investment in his or her health that will pay lifelong dividends. The best way to start is by setting an example; taking good care of your own teeth sends a message that oral health is something to be valued. And anything that makes taking care of teeth fun, like brushing along with your child or letting them choose their own toothbrush, encourages proper oral care.

To help your children protect their teeth and gums and greatly reduce their risk of getting cavities, teach them to follow these simple steps:

  1. Brush twice a day with a fluoride toothpaste to remove plaque – the sticky film on teeth that’s the main cause of tooth decay
  2. Floss daily to remove plaque from between teeth and under the gumline, before it can harden into tartar. Once tartar has formed, it can only be removed by a professional cleaning
  3. Eat a well-balanced diet that limits starchy or sugary foods, which produce plaque acids that cause tooth decay. When you do eat these foods, try to eat them with your meal instead of as a snack-the extra saliva produced during a meal helps rinse food from the mouth.
  4. Use dental products that contain fluoride, including toothpaste.
  5. Make sure that your child’s drinking water is fluoridated. The mains water supply in Ireland is generally fluoridated (0-8 1 parts per million). However in any cases where your child is not drinking fluoridated water (e.g. bottled water) your dentist or paediatrician may prescribe daily fluoride supplements.
  6. Take your child to the dentist for regular checkups.

What Brushing Techniques Can I Show My Child?

You may want to supervise your children until they get the hang of these simple steps:

  1. Use a pea-sized dab of a good fluoride toothpaste. Take care that your child does not swallow the toothpaste.
  2. Using a soft-bristled toothbrush, brush the inside surface of each tooth first, where plaque may accumulate most. Brush gently back and forth.
  3. Clean the outer surfaces of each tooth. Angle the brush along the outer gumline. Gently brush back and forth.
  4. Brush the chewing surface of each tooth. Gently brush back and forth.
  5. Use the tip of the brush to clean behind each front tooth, both top and bottom.
  6. It’s always fun to brush the tongue!

When Should My Child Begin Flossing?

Because flossing removes food particles and plaque between teeth that brushing misses, you should floss for your children beginning at age 4. By the time they reach age 8, most kids can begin flossing for themselves.

How Important is Diet to My Child’s Oral Health?

A balanced diet is necessary for your child to develop strong, decay-resistant teeth. In addition to a full range of vitamins and minerals, a child’s diet should include plenty of calcium, phosphorous, and proper levels of fluoride.

If fluoride is your child’s greatest protection against tooth decay, then frequent snacking may be the biggest enemy. The sugars and starches found in many foods and snacks like cookies, candies, dried fruit, soft drinks, pretzels and potato chips combine with plaque on teeth to create acids. These acids attack the tooth enamel and may lead to cavities.

Each “plaque attack” can last up to 20 minutes after a meal or snack has been finished. Even a little nibble can create plaque acids. So it’s best to limit snacking between meals.

What Should I Do if My Child Chips, Breaks or Knocks Out a Tooth?

With any injury to your child’s mouth, you should contact your dentist immediately. The dentist will want to examine the affected area and determine appropriate treatment.

If your child is in pain from a broken, cracked or chipped tooth, you should visit the dentist immediately. If possible, keep any part of the tooth that has broken off and take this with you to the dentist.

If a tooth is completely knocked out of the mouth by an injury, take the tooth to your dentist as soon as possible. Handle the tooth as little as possible — do not wipe or otherwise clean the tooth. Store the tooth in water or milk until you get to a dentist. It may be possible for the tooth to be placed back into your child’s mouth, a procedure called reimplantation.

Moe information on children’s oral health is available here

Ask your dentist’s advice on looking after your children’s teeth; you can call Crescent Dental on 061 484 844 to schedule an appointment; see www.crescentdental.ie