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Smoking not only damages your general health but also causes problems in your mouth.
1. Smoking can lead to cancer of the mouth which is often fatal. The most common sites are the tongue and the floor of the mouth.
2. Smoking can also lead to gum disease and smoking leads to increased calculus (tartar) on the teeth, which harbours plaque. Swollen and inflamed gums are followed by serious destruction of the tissues around the teeth, which can result in tooth loss.
3. Smoking can delay healing of any injured tissues in the mouth such as ulcers.
4. Smoking produces unsightly stains on the teeth, some of which are extremely difficult to remove - even with special equipment.
5. Smoking during pregnancy can lead to health problems for the baby
Dental amalgam is an alloy of a number of metals, mainly silver, tin and mercury.
Advances in testing equipment have enabled us to detect very small amounts of mercury released from fillings, especially when fillings are polished or removed.
Medical research organisations say that there is no scientific evidence that these tiny amounts of mercury released from dental fillings are a danger to health, apart from those rare cases where some individuals are unusually sensitive to this material. A number of overseas studies indicate there is no increased health risk or shortening of life between groups of people with amalgam fillings and those with none.
Yes. A normal balanced diet contains amounts of mercury and we also come into contact with it in our environment and in a number of other products. You get much more mercury from these sources than from your amalgam fillings.
This is extremely rare. Only 46 cases have been
reported throughout the world since 1905. If you are worried, ask your doctor to
refer you to a specialist for tests to check if you are allergic. If so, your
dentist can use another type of filling for you.
Alternatives exist but some can be rather expensive.
No. A few European parliaments have tried to
phase it out, largely for environmental reasons, but their health authorities
have not "banned" it. The World Health
Organisation says that it is safe to use.
Unless you are one of those rare individuals who is particularly sensitive to dental amalgam, you will not improve your dental health by having these fillings replaced. Australia’s specialist doctors and Health authorities have warned the public that there is no justification for believing that this will cure a range of serious illnesses.
It is always sound practice to avoid any
unnecessary dental treatment during pregnancy, including any dental fillings.
Your dentist may be able to put off your treatment to a more suitable time.
If you already have amalgam fillings, there is no evidence that they can harm
either you or your baby, if you are pregnant.
Modern dentistry has largely eliminated amalgam as the treatment of choice for new fillings. The tooth-coloured materials usually used for children's fillings need much smaller cavities. Some health authorities have suggested that amalgam fillings should be avoided in favour of these newer fillings.
Root canal therapy refers
to the treatment of the inner aspects of a tooth, specifically that area inside
a tooth originally occupied by the tooth's "pulp tissue".
Most people would probably refer to a tooth's pulp tissue as its "nerve". While
a tooth's pulp tissue does contain nerve fibers it is also composed of veins,
arteries, lymph vessels, and connective tissue.
The long term goal of root
canal treatment is to create an end result where it is unlikely that a bacterial
infection will become associated with a tooth whose nerve is no longer healthy.
Related to this long term goal, root canal treatment is also used as a means to
clear up tooth infections (tooth abscesses) and also as a way to treat unhealthy
tooth nerves which are causing a person pain
As a process, root canal treatment first involves cleaning out the inside of a tooth (the area originally occupied by the tooth's nerve tissue). Once this space has been cleaned it is filled in and sealed up.
The cleaning aspect of root canal treatment accomplishes two things, both of which are related to discouraging bacteria which might be able to cause an infection.
The cleaning removes
bacteria which are currently present inside the tooth.
The cleaning process removes nerve tissue (and any other organic debris) from
the tooth. Tissue which could be used as a food source by bacteria.
After the inner aspects of a tooth have been thoroughly cleansed the empty space which exists where the nerve tissue used to be is filled in and sealed off with materials bacteria cannot use as food. The net result of root canal treatment is that the tooth's inner aspect has been cleansed of bacteria and also any nerve tissue bacteria might use as food, and additionally, because the inner hollow aspects of the tooth have been filled in and sealed off, there is physically no place inside the tooth where bacteria can accumulate or persist.
We'd be the first to
acknowledge that root canal treatment has a reputation for being painful, but
we'd be the last to agree that this reputation is deserved.
It seems most likely that a majority of the derogatory remarks you hear in
regards to root canal treatment must be including in them references to that
period of pain and discomfort the person experienced leading up to their need
for treatment.
For the average person and the average case, root canal treatment is a non-event
and not any worse than having a filling placed.
The most common root
canal filling material being used by dentists now days is a rubbery compound
called gutta percha. Gutta percha comes in preformed cones which are similar in
size and shape to the files which have been used to clean out the inside of a
tooth. Cones of gutta percha are coated with a root canal sealer (a paste) and
then positioned into the tooth's root canals. Usually it takes the placement of
several cones until the interior of the tooth has been adequately filled.
Sometimes a dentist will warm the gutta percha cones (either before or after
they are placed into the tooth) so they become softened. This allows the gutta
percha to more closely adapt to the precise shape of the interior of the tooth.
As an alternative to the use of preformed cones, sometimes a dentist will place
the gutta percha via the use of gutta percha "gun". This apparatus is somewhat
similar to a hot glue gun. It prewarms a tube of gutta percha so the material is
very soft. The gutta percha is then squeezed out into the tooth.
After your dentist has finished the filling and sealing aspect of the root canal
process they will place a filling in the access hole they created at the
beginning of your treatment.
The total amount of appointment time which will be required for your root canal treatment can hinge on a number of factors. Some of these are:
>> Different teeth have
differing numbers of root canals, each of which will need to be located,
cleaned, and sealed. As an example, front teeth often just have a single root
canal while molars typically have three or more canals.
>> Should your root canal treatment will be completed in just one sitting or
will the process be broken up into two appointments? It is common place that a
dentist will feel it is best to clean out a tooth during an initial visit and
then have you return for a second appointment when they will seal up the
interior or your tooth. Equally common place, a dentist may feel that it is
preferable to perform both tasks during the same appointment.
You will have to ask your
dentist what is indicated in your situation. As a ball park estimate however, it
seems likely that any single appointment will probably last between 30 and 60
minutes.
After numbing your tooth but before
beginning the actual process of performing the root canal treatment, your
dentist will stretch a sheet of rubber around your tooth. Dentists call this
sheet of rubber a "rubber dam". It is held in place by a small clamp which
grasps onto the tooth.
The purpose of a rubber dam is as follows. Since one of the fundamental goals of
root canal therapy is to clean bacteria out of a tooth, and since saliva does
have bacteria in it, the placement of a rubber dam allows the dentist to keep
your tooth dry so it doesn't get re-contaminated with bacteria while the root
canal treatment is being performed.
So the process of performing root canal treatment can begin, and dentist must first gain access to that area inside the tooth which needs to be cleaned. This is accomplished by using a dental drill and making an access hole which leads to the pulp chamber of the tooth. On back teeth this hole is made on the chewing surface of the tooth. On front teeth the access hole is made on the tooth's backside.
The next step of the root canal treatment process is for to clean out the interior of the tooth. As we discussed previously, this cleaning process will remove any bacteria harbored inside the tooth and also remove any nerve tissue which is present.
The bulk of the cleaning process is
accomplished by way of the dentist using "root canal files". These objects look
like straight pins but on closer inspection you will find that their surface is
rough, not smooth. These instruments literally are files and are used as such.
the dentist will work a series of root canal files, each of increasing diameter,
up and down in your tooth while simultaneously using a twisting motion. This
action will scrape and scrub the sides of the tooth's root canals, thus cleaning
them out. Additionally, as part of the cleaning process your dentist will wash
your tooth out periodically so to help flush away any debris which is present.
The goal is for your dentist to clean the entire length of the tooth's root
canal(s), but not beyond. So to determine the length of a root canal your
dentist may place a root canal file in your tooth and then take an x-ray, so to
see if it extends the full length of the tooth or not. Alternatively, your
dentist may have an electronic device which can be used to make this
determination.
Traditionally root canal files are manipulated by a dentist by using their
fingers. There are, however, special dental drills which can hold and twist
these files, and your dentist may choose to use one. As a variation on this same
theme, there is yet another type of dental handpiece which produces a cleaning
motion by way of holding a root canal file and vibrating it vigorously.
Once the tooth has been thoroughly cleaned your dentist can fill in and seal up its interior by way of placing root canal filling material. Sometimes a dentist will want to place the filling material the same day that they have cleaned the tooth out. Other times a dentist might feel that it is best to wait about a week before completing the root canal process. In the latter case your dentist will place a temporary filling in your tooth so to keep contaminates out during the time period between your appointments.
The most common root canal filling
material being used by dentists now days is a rubbery compound called gutta
percha. Gutta percha comes in preformed cones which are similar in size and
shape to the files which have been used to clean out the inside of a tooth.
Cones of gutta percha are coated with a root canal sealer (a paste) and then
positioned into the tooth's root canals. Usually it takes the placement of
several cones until the interior of the tooth has been adequately filled.
Sometimes a dentist will warm the gutta percha cones (either before or after
they are placed into the tooth) so they become softened. This allows the gutta
percha to more closely adapt to the precise shape of the interior of the tooth.
As an alternative to the use of preformed cones, sometimes a dentist will place
the gutta percha via the use of gutta percha "gun". This apparatus is somewhat
similar to a hot glue gun. It prewarms a tube of gutta percha so the material is
very soft. The gutta percha is then squeezed out into the tooth.
After the dentist has finished the filling and sealing aspect of the root canal
process they will place a filling in the access hole they created at the
beginning of treatment.
Don't look for trouble. It is usually best to exercise caution with a tooth which is undergoing root canal treatment or has just had treatment completed. Until your dentist tells you otherwise you should avoid chewing on the tooth. Here are some reasons why:
After your tooth's root
canal treatment has been completed your dentist will need to discuss with you
what additional dental work will be required so to make the tooth fully
functional again.
In many cases a tooth which has required root canal treatment is one which has a
large filling, or else has large portions missing due to extensive decay or
breakage. These teeth, in this state, are not as sturdy as they once were and it
is not uncommon that a dentist will recommend to a patient that a tooth which
has had root canal treatment should be restored using a dental post and crown.
Your dentist will of course need to determine what is appropriate treatment for
your situation
a "post" is a rod which is
positioned and cemented in a tooth's root. Most posts are most made out of
metal.
Some dentists feel that the placement of a post can help to strengthen the root
of a tooth, and therefore place them for that reason. Other dentists primarily
rely on posts as a way of helping to firmly support that portion of the tooth
(and its accompanying filling material) over which a crown will subsequently be
cemented.
To place a post, a dentist
will first use a drill so to remove some of the gutta percha filling material
which was placed during the tooth's root canal treatment. The post is then
cemented into position and, as necessary so to begin the process of restoring
any missing tooth structure, filling material is subsequently placed around the
post's upper portion.
Crowns are dental
restorations which cup over the portion of the tooth which lies above the gum
line. People sometimes refer to dental crowns as "caps". Dental crowns can
either be gold or else have a porcelain surface so they look white like the
tooth's neighboring teeth.
A dentist will use a dental crown as a means of improving the appearance of a
tooth, restoring a broken down tooth to its original shape, and/or strengthening
a tooth. After a tooth has had root canal treatment, any or all of these
qualities may be needed.
Before a dental crown can
be placed the tooth must first be trimmed so it is tapered in shape. This
tapered aspect of the tooth will extend up into the dental crown's center and is
a very important factor in the crown's stability. After the needed shape has
been achieved your dentist will take an impression of the tooth, which in turn
is sent to a dental laboratory which will create the crown. Once the dental lab
has completed your crown your dentist will cement it in place.
The answer to this
question most likely lies in how much expertise your dentist anticipates is
needed for the successful treatment of your tooth. Different teeth offer
different challenges to a dentist. As an example, it is usually easier for a
dentist to perform root canal treatment on front teeth rather than back teeth.
Any tooth, however, has the potential for having its own set of characteristics
which makes it a challenge for a dentist to successfully treat, and in these
cases your dentist may feel that it is best that an endodontist performs your
root canal treatment.
There can be situations where your dentist may feel that the services of an
endodontist are required simply to determine what treatment it is that you need.
The sources of some dental symptoms are not easily identified and may require
the knowledge and experience of an endodontist to locate them.
There is usually a premium
attached to the level of expertise an endodontist can provide. Often an
endodontist's fee will be higher than that of your regular dentist, but when
their level of skill and knowledge is needed it is well worth the expense. In
some parts of the country you may find that an endodontist is not conveniently
at hand and seeking the services of one may require a trip to a neighboring
city.
So let your dentist decide
who should perform your root canal treatment; as in many, and possibly most
situations, your dentist may feel that they are more than capable of providing
the treatment your tooth requires. This type of situation is nice because it
means that your root canal treatment can be performed in an office with which
your are familiar by a dentist you know. The fee your dentist charges for the
root canal treatment will probably be less than if you required the services of
an endodontist. Additionally, since your dentist knows you, you might find that
they are more accommodating with scheduling, billing, and insurance
considerations than an endodontist's office would be
It no doubt is the hope of
your dentist that the root canal treatment they provide for you will allow your
tooth to last a lifetime. This can certainly be the case and hopefully the
outcome you will experience.
Previously we described some of the goals of root canal treatment:
If after root canal treatment has been performed a tooth still harbors bacteria (an infection), then the treatment has not be successful. Signs of failed root canal treatment include tooth pain (ranging from very mild to extreme) and tenderness or swelling in the gums in the area near the tooth (ranging from very slight to pronounced). These signs can either:
In general, the presence of problems indicates that, despite your dentist's best efforts to clean and seal up the tooth, bacteria have found some location in which to live and persist. Bacteria are incredibly small organisms and it doesn't take much space for them to find a home. Some of the reasons why bacteria can find a location in which to live include:
Your dentist will have to evaluate your specific situation and advise you if they think re-treatment of your tooth is likely to resolve your problems. They may offer to perform this re-treatment themselves or they may feel that the expertise of an endodontist is warranted for your case. If re-treatment is not a possibility then the tooth should be extracted.
It is possible that your tooth's root canal treatment has been successful but the tooth itself has experienced problems which have severely compromised it.
Broken or cracked teeth.
Teeth which have had root canal treatment are seldom as structurally strong as they once were. These teeth often require dental posts and crowns so to adequately strengthen and protect them.
Tooth decay and gum disease.
Teeth which have had root canal treatment are not impervious to tooth decay and gum disease, both of which can lead to the loss of the tooth. You must brush and floss your teeth effectively so to prevent the occurrence of these problems
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