Posts for: April, 2020

By Edward Joseph, D.D.S.
April 26, 2020
Category: Dental Procedures
WatchOutforRe-InfectionAfteraRootCanalTreatment

So, you've undergone a root canal treatment to save a decayed tooth. The tooth has a new lease on life — and the pain is gone too. But there's a reality you need to keep in mind — your tooth could become re-infected, putting you back in the same painful circumstance.

Root canal treatments are often necessary when decay works its way deep within a tooth, into the pulp. The excruciating pain a person feels is the infection attacking the bundle of nerves within the pulp tissue. If the infection isn't addressed promptly, it will continue to work its way to the root, eventually damaging the tooth beyond repair.

During a root canal treatment, we drill into the tooth to access the pulp chamber. After clearing it completely of its infected tissue, we then fill the chamber and root canals with a special filling and then seal off the access. A short time later we'll bond a crown over the tooth to protect it and to make it more attractive.

Most of the time, this preserves the tooth for many years. Occasionally, though, re-infection can occur. There are a number of reasons why: the first infection may have been more extensive than thought; the root canal network was more complex and some tinier canals weren't able to be identified; or the protective crown may once again get tooth decay contaminating the root canal.

If infection does reoccur it doesn't mean the tooth is lost. It's possible a second root canal treatment can successfully correct any problems, especially those that may not have been detected the first time. More complex cases might also require the services of an endodontist, a specialist in root canals. They're skilled in advanced techniques and have specialized equipment to handle even the most complicated root canal networks.

In the meantime, if you notice signs of re-infection like pain or swelling around a treated tooth, contact us promptly for an appointment. You should also contact us if the tooth is injured in an accident. The sooner we can treat your tooth, the more likely the second time will be more successful.

If you would like more information on preserving a tooth 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 “Root Canal Treatment: How long will it Last?


By Edward Joseph, D.D.S.
April 21, 2020
Category: Oral Health
Tags: oral health   gum disease  
BoostYourOverallHealthbyReducingGumInflammation

The human body’s immune system has amazing defensive capabilities. Without it a common cold or small wound could turn deadly.

One of the more important processes of the immune system is inflammation, the body’s ability to isolate diseased or injured tissue from unaffected tissue. Ironically, though, this vital component of the healing process could actually cause harm if it becomes chronic.

This often happens with periodontal (gum) disease, an infection of the gums caused by bacterial plaque built up on teeth due to inadequate hygiene, which in turn triggers inflammation. The infection is often fueled by plaque, however, and can become difficult for the body to overcome on its own. A kind of trench warfare sets in between the body and the infection, resulting in continuing inflammation that can damage gum tissues. Untreated, the damage may eventually lead to tooth and bone loss.

In treating gum disease, our main goal is to stop the infection (and hence the inflammation) by aggressively removing plaque and calculus (tartar). Without plaque the infection diminishes, the inflammation subsides and the gums can begin to heal. This reduces the danger to teeth and bone and hopefully averts their loss.

But there’s another benefit of this treatment that could impact other inflammatory conditions in the body. Because all the body’s organic systems are interrelated, what occurs in one part affects another especially if it involves inflammation.

It’s now theorized that reducing gum inflammation could lessen inflammation in other parts of the body. Likewise, treating other conditions like high blood pressure and other risk factors for inflammatory diseases could lower your risk of gum disease and boost the effectiveness of treatment.

The real key is to improve and maintain your overall health, including your teeth and gums. Practice daily brushing and flossing to remove plaque, and visit your dentist regularly for more thorough cleanings. And see your dentist at the first sign of possible gum problems like bleeding, redness or swelling. You’ll not only be helping your mouth you could also be helping the rest of your body enjoy better health.

If you would like more information on the relationship between gum disease and other systemic conditions, 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 “The Link between Heart & Gum Diseases.”


By Edward Joseph, D.D.S.
April 16, 2020
Category: Uncategorized
Tags: oral health  
InTheseUncertainTimesWeStillCareAboutYourDentalHealth

During this year's National Public Health Week in April, health issues like vaping and the opioid crisis are taking a back seat to what is front and center on everyone's mind: the novel coronavirus (COVID-19). This highly contagious viral infection is upending business as usual for most of the world in a way unlike anything we've experienced. Nothing is “normal” right now, including dental care.

As with other aspects of daily life, you can expect disruptions in dental care because of COVID-19, especially involving routine visits. But with that said, we're working hard to ensure your teeth and gums aren't overlooked during this global crisis. We are here for you, so please call us for any questions you may have, and especially if you are experiencing dental pain.

If you do need to visit the dentist for treatment, you might be concerned about potentially exposing yourself or others to COVID-19. Like every business that interacts with the public and especially all healthcare providers, dental offices are implementing extra precautions during this time to protect both patients and staff against infection.

This isn't something new: The dental profession as a whole has strict protocols for preventing infection that have been in place for several years. Infection control is a top priority for dentists at all times, not just during outbreaks like COVID-19. Here are some of the things we do—and are expanding because of the novel coronavirus—to keep you safe during dental appointments.

Barrier protection. Dental providers routinely use disposable items like gloves, face masks or eyewear to prevent disease spread during procedures that involve close contact with patients. For extra precautions with COVID-19, we're adding more of this type of barrier protection.

Sterilization and waste disposal. Instruments and equipment that we use repeatedly are thoroughly sterilized to remove all microorganisms, including coronavirus, from their surfaces. For disposable items used during treatment, we keep these separate from common waste and dispose of them according to strict protocols for handling bio-medical waste.

Disinfection. Even though the main pathway for spreading COVID-19 is through respiratory droplets in the air, we're continually disinfecting office and treatment surfaces that the virus might potentially contaminate. In doing so, we're using substances recommended by the U.S. Centers for Disease Control (CDC). By the way, you can find a list of such products at //www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf.

These are uncertain times for all of us. But while we're cooperating with social distancing and other measures to slow the spread of COVID-19, we're still here partnering with you to keep your family's teeth and gums healthy.

If you would like more information about special dental precautions during this time, don't hesitate to contact us. To learn more, read the Dear Doctor magazine article “Infection Control in the Dental Office.”


By Edward Joseph, D.D.S.
April 11, 2020
Category: Dental Procedures
Tags: jaw pain   tmj disorders  
ThinkTwiceBeforeConsideringBotoxforChronicJawPainRelief

Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.

Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.

The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.

These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.

In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.

Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.

The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.

The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.

If you would like more information on treating jaw disorders, 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 “Botox Treatment for TMJ Pain.”


AvoidBecomingaDentalInjuryStatistic-GetaCustomMouthguardforYourYoungAthlete

Other than tooth decay, children don't encounter dental disease to the extent adults do. But injuries are another story: More than 5 million teeth are knocked loose each year, and a high percentage involve children. Roughly a third of these and similar children's injuries are sports-related.

April is National Facial Protection Month: Several oral and facial health organizations, including the American Association of Orthodontists, have joined together to raise awareness about the risks of injury to the face and mouth, especially among children. Many of these injuries have long-term consequences with lifetime treatment costs in the thousands of dollars.

But as the name implies, this awareness month is also about protection—what you can do to help your child avoid a costly and devastating dental injury. Top of the list: Have your child wear an athletic mouthguard during all contact sports activities (including practices).

The National Federation of State High School Associations mandates mouthguard wear for football, lacrosse, and ice and field hockey. But those aren't the only sporting activities where a mouthguard should be standard equipment: In fact, basketball has more orofacial injuries each year than any other sport. Generally, mouthguards should be worn for any sports activity that involves potential contact with other players or objects.

There is a variety of mouthguard choices, but most fall into two basic categories, “boil and bite” and custom-made. The former, readily available in retail sports stores, get their name from the procedure employed when first purchased to adjust their fit to an individual player. Out of the package, they should be soaked in hot or boiling water until softened, and then placed in the wearer's mouth to bite down on. After they cool, they'll retain that bite pattern.

Boil and bite guards are relatively inexpensive, but the fit isn't as precise as a mouthguard that is custom-made by a dentist. This can lead to comfort issues—and players are less likely to wear an uncomfortable mouthguard.

Custom mouthguards, on the other hand, have a more accurate fit, allowing them to be thinner and more comfortable. They also provide the highest level of protection against blows to the face and mouth. These are more costly than boil and bite guards, and younger athletes may need a replacement every few years to accommodate jaw growth development. But compared to the physical, emotional and financial cost of a dental injury, custom mouthguards are worth the investment.

A mouth or face injury can happen in an instant and result in damage that can have lingering effects for years. For the best protection, see that your star athlete has and wears a custom mouthguard.

If you would like more information about mouthguard protection, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
Burbank, CA 91505
(818) 842-7628

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