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Hearing that you need a root canal can be highly intimidating. What is a root canal? It is the removal of the nerve supply from the tooth. Here, Dr. David Shipper and Dr. Howard Vogel will describe the parts of a tooth and explain the reasons for a root canal and how it is done when you visit us in our New York, NY office.

Your tooth is made up of many layers. The outside layer is called enamel and is made of minerals. The middle layer is dentin, which is also a calcified tissue, but less dense. The center of the tooth is called the pulp, and that hosts the nerves and blood vessels. A root canal is the removal and replacement of this center with a sterile filling.

A root canal is needed when an infection spreads to the center of the tooth. This can be from trauma (recent or previous), a cavity, a severe crack, or other compromise that causes nerve damage. An X-ray and examination are required to see if a root canal is needed. Symptoms may include but are not limited to pain, swelling, change in tooth color, and over-reaction to temperature change or pressure.

When it is time to begin, you’ll receive local anesthesia (via injection) to make you most comfortable. A rubber dam is used to isolate the tooth, while other equipment determines the nerve location and maintains a sterile working environment. All of the infected area is removed including the nerve tissue and blood vessels. Then, medicines are used to sterilize and alleviate any pain. Next is the placement of a filling material in the spot where the nerve used to be.

When your nerve and blood supply are taken away, the tooth is non-vital, or dead, and can become weak and fragile. If your tooth is badly decayed, a large portion of it will have to be removed. It is recommended to place a crown on the tooth to keep the enamel from breaking or falling apart. If you do not get a crown, you could eventually lose the tooth to more decay or infection. The tooth could also break off completely and you would have to have an extraction. The crown fits over the top of the tooth and secures it from breaking down.

A root canal saves the life of a tooth that would otherwise succumb to further infection and eventually extraction. Infection is the cause of most-needed root canals. If you are ever unsure what is happening at your appointment, don’t be afraid to ask questions so you understand the procedure completely.

If you're scheduled to get a dental implant, it's only natural to have questions about it. The pain involved is usually on the mind of most patients. Of course, some discomfort is possible, as with any major dental procedure. Having a well-defined plan ahead of time, which is carried out by Dr. David Shipper and Dr. Howard Vogel, reduces the risk of complications or side effects post-surgery.

During the procedure you won't feel a thing, since it is performed under general or local anesthesia that totally numbs your mouth. It's more likely that you will feel some pain or discomfort after the anesthesia has worn off.

There are usually three things that will affect the length and intensity of any discomfort:

• The complexity of your surgery (for example if you need a bone graft or sinus lift beforehand)
• How well-trained the dental team which works on your case is (it may be multiple people, including a periodontist, oral surgeon, and/or general dentist)
• How quickly your body is able to heal itself post-surgery

The pain experienced from an untreated case will usually far outweigh that experienced from a dental implant. Good oral hygiene after your surgery is important to avoid infection. Salt water rinses are generally recommended 24 hours after your surgery. Brush your teeth gently around the implant.

It's also a good idea not to eat any food that is too hot, cold, or hard. Soft or pureed foods will help you to avoid chewing for the first few days after surgery and will help your mouth to heal faster. You'll typically be prescribed pain medication, but some patients find that ibuprofen or acetaminophen work well enough. Just remember, the most severe discomfort is usually experienced within the six hours after your anesthesia wears off.

Getting a dental implant is a big decision, and we want to make sure you get through it easily. Our New York, NY team is here to help if you have any questions about the procedure or post-surgery care.

As a parent, you want the best for your children, and that includes doing their best in school. You can support them by taking an interest in their activities, being enthusiastic about attendance, and helping them with homework. There may also be one more way you can help your children succeed at school. Surprisingly, research suggests that children with better oral health are likely to do better in school.

What the Research Says

One study in North Carolina looked at risk factors for poor school performance among school-aged children. As expected, the study found poor school performance linked to low socioeconomic status, low levels of parental education, and poor overall health. However, it also found a strong link between poor oral health and poor school performance, with children classified as having poor oral health 40 percent more likely struggle in school.

These findings are generalizable to the rest of the country. For example, attendance is an important factor in academic achievement, but dental conditions are responsible for a loss 51 million school hours among schoolchildren each year. Dental pain and infection are linked to poorer performance.

School-Based Programs to Promote Oral Health

In light of the apparent benefits of good oral health for school performance, some schools are taking steps to promote better oral care and health. In Maine, for instance, schools in need can apply for grants through School Oral Health Program (SOHP). The SOHP consists of four components:

1. Oral health education for all children to support healthy behaviors
2. A weekly fluoride mouth rinse to strengthen teeth
3. Dental screenings to identify children who may need dental care
4. Dental sealants, or plastic coatings, on back teeth to guard against decay

The State of Maine also supports an “Annual Sugar Out Day” to raise awareness of the effects of sugar on dental health and to help students choose low-sugar alternatives.

Oral Health Habits to Adopt

You can help your child improve oral health and do better in school by encouraging good oral hygiene. This includes brushing at least twice a day with a fluoride-containing toothpaste, and reminding your child to drink water after eating. Also, regular trips to our New York, NY office can help prevent serious tooth problems.

Gingivitis, or inflammation of the gums, is an early stage of gum disease. If you have gingivitis, it’s important to visit Dr. David Shipper and Dr. Howard Vogel to get proper treatment, since home care isn’t enough to get rid of the plaque that leads to tartar and eventually to gum disease. Monitor yourself to see if you have these signs of gingivitis, and get help as soon as you can to prevent the progression to periodontitis. Your vigilance could save your teeth.

1. You have one or more risk factors.

Having risk factors for gingivitis doesn’t mean that you have or will get the disease, but it does mean that you should be especially watchful. You’re more likely to get gum disease if you have the following risk factors:

• You are a smoker.
• You are a female going through puberty, pregnancy, or menopause.
• You have diabetes.
• You have a compromised immune system, as is the case if you have HIV/AIDS.
• You have a family history of gum disease.

2. You have inflammation in your gums.

Gingivitis is inflammation of the gums, and that is a tell-tale sign of the condition. Gingivitis or periodontitis can involve a bacterial infection, and inflammation is your body’s response to an injury or infection. The four standard signs of inflammation are pain, redness, swelling, and a higher temperature than normal.

If you have inflammation around your teeth, your gum disease may have progressed to the more serious condition of periodontitis. Dr. David Shipper and Dr. Howard Vogel can evaluate your case using a scope, or small ruler. The ruler is used to measure the pockets around your teeth, with a depth of one to three millimeters being normal.

3. Your teeth seem to be moving around.

Loose teeth are a classic sign of periodontitis. You may also have them if you have gingivitis. They can occur when your gum line recedes, or as the result of having soft bone in your jaw.

You might also notice other signs of your teeth moving around. For example, they may seem to be oddly spaced, or they could be separating from each other. You might also notice that your partial dentures don’t fit properly anymore, even if they’re not that old.

Gingivitis is a very treatable condition, but you need the help of Dr. David Shipper and Dr. Howard Vogel to keep it in check. Contact our New York, NY office to schedule an exam today!