Root canal therapy is the unsung "hero" of dentistry. Although often falsely maligned as an unpleasant experience, millions of decayed teeth have been saved thanks to this routine treatment.

But although root canal therapy can save your tooth, we can't guarantee it won't be affected by another infection. There are other factors to consider how long a treated tooth will remain healthy.

Root canal therapy stops and limits the damage from tooth decay that has infected the inner pulp and root canals. A dentist or endodontist (a root canal specialist) drills into the tooth to gain access to the pulp. They remove the diseased pulp tissue and then fill the empty pulp chamber and root canals with a specialized filling called gutta percha. The tooth is then sealed and later crowned to protect it against future fracture or infection.

The probability of that occurring may depend on when a dentist performs the root canal in the disease progression—and the earlier the better. If decay has already infected the underlying bone, the tooth's long-term prognosis even with root canal therapy could be dim. That's why you should see a dentist as soon as possible for any tooth pain, even if it goes away.

The type of tooth could impact long-term health. Teeth with single roots are usually easier to treat. But those with multiple roots and an intricate root canal network can be more difficult to treat, and require specialized equipment and techniques.

Age can also impact root canal therapy longevity. The older a root canal-treated tooth is, the more brittle and susceptible to fracture it can become, which can pose complications. That's why we typically place crowns on treated teeth to protect them from both future infection and undue stress created while biting and chewing.

To help mitigate these possible factors, you should see your dentist regularly for checkups and at the first sign of pain or other abnormalities for the earliest treatment possible. And for more complex tooth issues, your dentist may refer you to an endodontist to perform your root canal. With early intervention and attentive care, your root canaled tooth could enjoy many years of life.

If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment: How Long Will It Last?”

When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.

“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”

The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”

A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.

It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.

So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

If you have chronic jaw pain, you may be one of an estimated 10 million Americans suffering from temporomandibular joint disorders (TMD). If so, it's quite possible you're also coping with other health conditions.

TMD is an umbrella term for disorders affecting the temporomandibular (jaw) joints, muscles and adjoining tissues. The most common symptoms are limited jaw function and severe pain. Determining the causes for these disorders can be difficult, but trauma, bite or dental problems, stress and teeth clenching habits seem to be the top factors. Women of childbearing age are most susceptible to these disorders.

In recent years we've also learned that many people with TMD also experience other conditions. In a recent survey of TMD patients, two-thirds reported having three or more other health conditions, the most frequent being fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis or chronic headaches. Researchers are actively exploring if any systemic connections exist between TMD and these other conditions, and how these connections might affect treatment changes and advances for all of them including TMD.

In the meantime, there remain two basic approaches for treating TMD symptoms. The most aggressive and invasive approach is to surgically correct perceived defects in the jaw structure. Unfortunately, the results from this approach have been mixed in their effectiveness, with some patients even reporting worse symptoms afterward.

The more conservative approach is to treat TMD orthopedically, like other joint problems. These less invasive techniques include the use of moist heat or ice to reduce swelling, physical therapy and medication to relieve pain or reduce muscle spasming. Patients are also encouraged to adopt softer diets with foods that are easier to chew. And dentists can also provide custom-fitted bite guards to help ease the stress on the joints and muscles as well as reduce any teeth grinding habits.

As we learn more about TMD and its relationship to other health conditions, we hope to improve diagnosis and treatment. Until then, most dentists and physicians recommend TMD patients try the more conservative treatments first, and only consider surgery if this proves unsatisfactory. It may take some trial and error, but there are ways now to ease the discomfort of TMD.

If you would like more information on the causes and treatments of TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”

If you know anyone with a dental implant, you may know it can be a long process in getting one. Several weeks or months can pass between removing the old tooth and placing the implant, and then several more weeks before affixing the permanent crown.

But with recent advances in implant technology, some patients don't have to wait as long for a new implant and crown. In fact, one procedure commonly known as "tooth in one day," allows patients to walk in with a problem tooth and out the same day with a new "one."

Not every implant patient, however, can undergo this accelerated procedure. If you're considering implants, the state of your bone health will determine whether or not you can.

Implants need a certain amount of available bone for proper placement. But bone loss, a common consequence of missing teeth or dental disease, can reduce bone volume to less than what's needed to place an implant. The patient may first need to undergo grafting to regenerate the bone or choose another restorative option.

If your supporting bone is sound, your dentist might then proceed with the implant. But you will still have to wait a while for your new crown. The implant needs to integrate with the bone to improve its hold. This integration process can take anywhere from a minimum of six weeks to more commonly twelve weeks. After the attachment is mature, the dentist may need to undo the gum covering before taking impressions for the formation of the new crown.

But it is possible to have a tooth or teeth in a day. For a single tooth, your dentist may be able to immediately attach a crown right after implant surgery if the implant is very stable. Even so, this crown will need to be temporary, slightly shorter than a permanent crown so that it won't make contact with other teeth and put too much pressure on the new implant. After further healing from bone integration, impressions will be taken so that you'll receive your permanent crown shortly.

Immediate crown placement can allow you to have the cosmetic and limited functional benefit of a new tooth right from the start. If multiple implants are placed in one arch in a day, it's possible to have immediate teeth if enough implants are attached together with a temporary restoration.

This is different from a single implant replacing a single tooth and does create confusion for patients when they read about teeth in a day. Regardless, no final tooth crown can be placed at the time of an implant—only a temporary restoration.

If you would like more information on your options for dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Same-Day Tooth Replacement with Dental Implants.”

Teeth whitening or bleaching is one of the most affordable and least invasive ways of improving your smile. Although the effect fades with time, whitening can make dull and dingy teeth more attractive in short order.

Teeth whitening is also unique among cosmetic dental procedures in that you can do it yourself at home. While professional bleaching solutions are stronger and capable of greater brightness and longevity, you can still achieve good results with a DIY kit.

If you decide to whiten at home, though, there are a few things to keep mind for a desirable and safe outcome. Here are 3 tips for successful DIY teeth whitening.

Follow the directions. It's not a good idea, both for a successful and safe outcome, to stray away from a kit manufacturer's recommended directions. FDA-approved home kits usually contain 10% or less of carbamide peroxide (one of the more common bleaching agents). That may not seem very strong but it's adequate within the recommended time it remains on your teeth to achieve an effective whitening effect. Exceeding those directions could permanently damage your tooth enamel.

Make sure a home kit will work on your staining. Home whitening kits only affect outer staining on tooth enamel. But dental discoloration can also arise from inside a tooth, often because of trauma, tetracycline use, or as a side effect of a root canal treatment. This kind of internal staining requires a special procedure usually performed by an endodontist to reduce it. So, see your dentist first to make sure your teeth are healthy enough for whitening and that a home kit will work for you.

Get your dentist's advice on home kits. There are a number of whitening applications on the market you can choose, so ask your dentist for recommendations. They can also give you some helpful tips on the whitening process to ensure you'll be safe and successful in your efforts.

Here's a couple of other things to remember to enhance your teeth whitening experience: whether you whiten your teeth at home or with the dentist, be sure you continue to care for your teeth with daily brushing and flossing. And, if you limit your consumption of foods and beverages known to stain teeth, you'll help extend the duration of your brighter smile.

If you would like more information on teeth whitening procedures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Whitening Safety Tips.”