Posts for: April, 2019

TheresStillHopeforaRe-InfectedToothAfterRootCanalTreatment

Most first-time root canal treatments achieve their purpose in saving an internally decayed tooth and extending its life to match those of the patient’s non-decayed teeth. Occasionally, though, a root canal-treated tooth may become re-infected by decay.

There are a number of reasons for this: the permanent crown meant to add further protection against decay may have been delayed, giving bacteria an opening to re-infect the tooth; it’s also possible the original seal for the pulp chamber and root canals after filling wasn’t sufficient to prevent bacterial contamination.

There‘s also another reason that’s very difficult to foresee — the presence of narrow, curved root canals in the tooth that can pose complications during the procedure. Some of these known as accessory or lateral canals branch off the main canals to create a complex network that’s difficult to detect during the initial procedure. If they’re not cleaned out and filled during the procedure any tissue trapped in them can remain infected and ultimately die. If these canals also open into the periodontal membrane at the attachment between the teeth and bone, the infection can spread there and become a periodontal (gum) infection that can trigger future tooth loss.

Fortunately, a reoccurrence of infection isn’t necessarily a death sentence for a tooth. A second root canal treatment can correct any problems encountered after the first treatment, especially complications from accessory canals. It may, though, require the advanced skills of an endodontist, a dental specialist in root canal problems. Endodontists use microscopic equipment to detect these smaller accessory canals, and then employ specialized techniques to fill and seal them.

If you encounter pain or other signs of re-infection for a tooth previously treated with a root canal procedure, contact us as soon as possible. The sooner we can examine and diagnose the problem, the better your tooth’s chances of survival by undergoing a second root canal treatment.

If you would like more information on tooth preservation through 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 “Accessory Canals.”


By Edward Joseph, D.D.S.
April 22, 2019
Category: Oral Health
Tags: oral health   gum disease  
GumDiseaseCouldbeAffectingMoreThanJustYourMouth

Periodontal (gum) disease can weaken gum attachment and cause bone deterioration that eventually leads to tooth loss. But its detrimental effects can also extend beyond the mouth and worsen other health problems like heart disease or diabetes.

While the relationship between gum disease and other health conditions isn't fully understood, there does seem to be a common denominator: chronic inflammation. Inflammation is a natural defense mechanism the body uses to isolate damaged or diseased tissues from healthier ones. But if the infection and inflammation become locked in constant battle, often the case with gum disease, then the now chronic inflammation can actually damage tissue.

Inflammation is also a key factor in conditions like heart disease and diabetes, as well as rheumatoid arthritis or osteoporosis. Inflammation contributes to plaque buildup in blood vessels that impedes circulation and endangers the heart. Diabetes-related inflammation can contribute to slower wound healing and blindness.

Advanced gum disease can stimulate the body's overall inflammatory response. Furthermore, the breakdown of gum tissues makes it easier for bacteria and other toxins from the mouth to enter the bloodstream and spread throughout the body to trigger further inflammation. These reactions could make it more difficult to control any inflammatory condition like diabetes or heart disease, or increase your risk for developing one.

To minimize this outcome, you should see a dentist as soon as possible if you notice reddened, swollen or bleeding gums. The sooner you begin treatment, the less impact it may have on your overall health. And because gum disease can be hard to notice in its early stages, be sure you visit the dentist regularly for cleanings and checkups.

The most important thing you can do, though, is to try to prevent gum disease from occurring in the first place. You can do this by brushing twice and flossing once every day to keep dental plaque, the main trigger for gum disease, from accumulating on tooth surfaces.

Guarding against gum disease will certainly help you maintain healthy teeth and gums. But it could also help protect you from—or lessen the severity of—other serious health conditions.

If you would like more information on preventing and treating gum disease, 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 “Good Oral Health Leads to Better Health Overall.”


GetaLookatYourFutureMakeoverLookNowwithaTrialSmile

You've reached a decision—that old, unattractive smile has to go. You're ready for a complete makeover—and the field of cosmetic dentistry has the materials, techniques and equipment to make it happen.

But it could be a major undertaking requiring a fair amount of time and money. And once all the procedures are complete, what if you're not happy with the results?

Fortunately, you don't have to wait with nervous apprehension until the end of the dental work to see what your smile will look like. We can give you a realistic preview of your new smile before we even begin—and not on a computer monitor. We can actually create a trial smile applied directly to your actual teeth so you can see your new look up close and personal, and in all three spatial dimensions.

That's not to put down enhanced computer presentations. State-of-the-art imaging software can display an accurate representation of your future smile transposed onto an image of your face. But it's still a two-dimensional image, like any other photograph. It can't present the full range, movement or feel of the real thing.

A trial smile can. We shape and sculpt composite resin to resemble the finished dental work and temporarily bond it to your teeth. Once applied, you'll then be able to see what your appearance will look like from different angles and movements. Although we'll have to remove the trial smile before you leave, we can photograph it so you can show it to family and friends for their reaction.

While it's an added expense, a trial smile has two great benefits. First, it helps both of us "test drive" your new look and see how it performs in different ways: as you speak, when you're relaxed and, of course, when you smile. This allows us, if necessary, to fine-tune your planned dental work. Perhaps the biggest benefit, though, is that it can reassure you you've made the right decision to remake your smile. 

With a trail smile, there are no surprises—you'll know what the end result will look like before any work is done. And that can be a great motivator toward obtaining the smile you've dreamed of having.

If you would like more information on restoring your smile, 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 “Testing Your Smile Makeover: The Reassurance of a Trial Smile.”


By Edward Joseph, D.D.S.
April 12, 2019
Category: Dental Procedures
Tags: dental implants   dentures  
DentureswithImplantsCouldHelpYouAvoidBoneLoss

Even with modern prevention and treatment advances, losing teeth in later life is still a sad but common part of human experience. Just as generations have before, many today rely on dentures to regain their lost dental function and smile.

But although effective, dentures have their weaknesses. The most serious: they can't prevent jawbone deterioration, a common problem associated with tooth loss.

Bone health depends on chewing forces applied to the teeth to stimulate replacement growth for older bone cells. When teeth are gone, so is this stimulation. Dentures can't replicate the stimulus and may even accelerate bone loss because they can irritate the bone under the gums as they rest upon them for support.

But there's a recent advance in denture technology that may help slow or even stop potential bone loss. The advance incorporates implants with dentures to create two hybrid alternatives that may be more secure and healthier for the supporting bone.

The first is known as an overdenture, a removable appliance similar to a traditional denture. But instead of deriving its support from the gums alone, the overdenture attaches to three to four implants (or only two, if on the lower jaw) that have been permanently set into the jawbone. This not only increases stability, but the implants made of bone-friendly titanium attract and foster increased bone growth around them. This can help slow or even stop the cycle of bone loss with missing teeth.

The second type is a fixed denture. In this version, four to six implants are implanted around the jaw arch. The denture is then secured in place to these implants with screws. It's a little more secure than the overdenture, but it's also more expensive and requires good quality bone at the implant sites.

If you've already experienced significant bone loss you may first need bone grafting to build up the implant sites for these options, or choose traditional dentures instead. But if you're a good candidate for an implant-supported denture, you may find it provides better support and less risk of continuing bone loss than traditional dentures.

If you would like more information on implant-supported dental restorations, 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 “Overdentures & Fixed Dentures.”


By Edward Joseph, D.D.S.
April 07, 2019
Category: Dental Procedures
Tags: porcelain veneers  
TransformingYourSmilewithVeneersStepbyStep

Dental veneers are a great way to transform a smile without the expense or effort often required of other restorations. These thin layers of dental material adhere to the front of teeth as a "mask" to cover chips, heavy staining or other blemishes.

Still, veneers require attention to detail for a successful outcome. Here's a step-by-step look at changing your dental appearance with veneers.

Step 1: Considering your options. While most veneers are made of dental porcelain, composite resin materials are increasingly popular. Although more prone to chipping or staining, composite veneers don't require a dental lab for fabrication. Another option, depending on your dental situation, are ultra-thin veneers that require little to no tooth preparation. Your dentist will help you decide which options are best for you.

Step 2: "Test driving" your new smile. We can help you "see" your future smile with special software that creates a computer image of your teeth with the planned veneers. We can also use composite material to fabricate a "trial smile" to temporarily place on your teeth that can give you the feel as well as the look of your future smile.

Step 3: Preparing your teeth. Unless you're getting no-prep veneers, we'll need to modify your teeth before attaching veneers. Although only 0.3 to 0.7 millimeters thick, veneers can still appear bulky on unprepared teeth. They'll look more natural if we first remove a small amount of enamel. A word of caution, though: although slight, this enamel removal permanently alters your teeth that will require them to have some form of restoration from then on.

Step 4: Attaching your new veneers. After the planning phase (which includes color matching to blend the veneers with the rest of your teeth), a dental lab creates your veneers if you've opted for porcelain. After they're delivered, we'll clean and etch the teeth with a mild acidic gel to increase the bonding effect. We'll then permanently attach the veneers to your teeth with a very thin but ultra-strong resin luting cement that creates a unified bond between the veneers and teeth.

Following these steps is the surest way to achieve a successful outcome. With due care you're sure to enjoy the effects for a long time to come.

If you would like more information on changing your smile with veneers, 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 “Porcelain Veneers: Your Smile—Better than Ever.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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