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Five words no one welcomes: “You need a root canal.” But if you are delaying treatment because you are worried about pain and an uncomfortable day in the dentist’s chair, please think again! Modern root canal procedures are designed to repair your damaged tooth gently and efficiently, and leave you with a restored natural tooth that can last a lifetime.

• Why might you need a root canal?

First, a little tooth biology. Each tooth has a crown (the part we see above the gums) and one or more roots (the part of our tooth below the gum line that is attached to bone in our jaw). The tooth has three basic layers: the hard enamel and cementum that cover the outer crown and root, the softer dentin beneath that layer, and, on the inside, the pulp. Pulp is made of living tissue, and contains the blood vessels and nerves that nourish the tooth and keep it vital.

Even with the protection the enamel and dentin provide, sometimes the pulp can be infected or damaged. If you have suffered an injury to your mouth or jaw, or an infection has developed from an opening in the tooth caused by a deep cavity or crack, you may need a root canal to prevent further infection, pain, and even tooth loss. Call our New York, NY office immediately if you feel pain with chewing or pressure, prolonged sensitivity to heat or cold, swollen, and tender gums around a tooth, or tooth discoloration.

• The Root Canal Procedure

If a root canal is necessary, the procedure is very straightforward. After the area around the tooth is numbed, we will make an opening in the crown to allow access to the pulp inside. Very small instruments will be used to clean the inner tooth and removed bacteria and dead or dying tissue. The area will be thoroughly disinfected, and the inside of the tooth shaped and then filled and sealed. A temporary filling or crown might be placed on the tooth to prevent bacteria and food from entering the site if a permanent crown needs to be created. The entire process usually takes from one to three visits.

If we suggest a root canal, it is because this is the best way to save your tooth. Please feel free to talk to us about your particular needs and concerns. Which tooth is affected, how many roots are involved, what type of filling or crown might be best—we will work with you to provide all the information you need and all the options you have available.

Common Concerns

• Are you concerned about pain?

The most painful part of a root canal is often the severe discomfort your tooth causes before treatment. And infections and damaged nerves can affect not only the injured tooth, but the gums, tissue and even bone surrounding it. With our modern dental techniques, a root canal procedure is often no more uncomfortable than a regular filling. The local anesthetic we use will prevent you from feeling any pain during the procedure, and, while the area around your tooth might be a bit sensitive following treatment, the pain caused by the infection or injury should be gone.

• Are you anxious about the procedure?

If dental treatment causes you anxiety, please let us know. There are several sedation options we can pursue to make this procedure less worrisome. Our goal is to make your treatment as gentle and comfortable as possible.

No one welcomes the news that a root canal is necessary, but with today’s procedures, this treatment can be just what you need to relieve your pain and keep your natural tooth where it belongs for many years to come. And that is welcome news, indeed!

If you play a contact sport, you know about mouthguards. You know about the cushioning protection they provide for your teeth. And not just your teeth—mouthguards also help protect your lips, tongue, and jaw, helping you avoid or minimize many of the injuries caused by collisions.

But you don’t have to be part of the defensive line or face off on center ice to wear a mouthguard. It pays to be proactive with your oral health in any activity where impact is a possibility. Whether you play a team sport, practice gymnastics, ride a bike, ski, skateboard, or participate in other athletic pastimes, there’s almost always the risk of impact—with a ball, with the mat, with the sidewalk, with another person.

So, how do mouthguards protect your teeth and mouth? It’s a combination of materials and design. Mouthguards are made of a strong, cushioning material such as plastic or silicone, which helps absorb and distribute the force of impact, usually in the form of a horseshoe-shaped piece that fits over your upper teeth. The specific design can be tailored to the sport or activity you’ll be using it for.

And now that you’re wearing braces? Working toward an attractive, healthy smile doesn’t mean you can’t be active or find a mouthguard that will work for you. In fact, when you wear braces, mouthguards do double duty—they protect your mouth and teeth, and they protect your braces, too!

Even minor impacts can damage wires and brackets, and damaged braces means more time at the orthodontist and lost treatment time. More important, your guard not only helps protect your brackets and wires from impact injury, it protects your delicate mouth tissue from trauma caused by impact with your brackets and wires.

Because you probably have braces on both upper and lower teeth, the usual mouthguard design might not work for you. To make sure you’re completely protected, you may need a guard that covers both upper and lower arches.

There are over-the-counter mouth guards designed for braces, and even for covering both your upper and lower teeth. These might be one-size-fits-all or fit-it-yourself guards, or models which should be used only after a fitting at our New York, NY dental. While some of these guards are better than others, the best option for your teeth—and your braces—might be a custom mouthguard.

What are the benefits of a custom guard for orthodontic patients? They:

• Provide a perfect fit around teeth and braces
• Protect better because they fit better
• Are designed for easy breathing and speaking
• Are less bulky
• Are more durable
• Fit more comfortably
• Can accommodate orthodontic adjustments
• Can be tailored to your specific sport or activity.

Custom mouthguards are more expensive, because they are individually crafted for your teeth and braces, but in terms of effectiveness, they are the best guards out there—because they are individually crafted for your teeth and braces. If cost is an issue, Dr. David Shipper and Dr. Howard Vogel can let you know whether an over-the-counter option might work for you.

An active life should mean proactive dental care. Wearing a mouthguard when you’re wearing braces protects both your body and your orthodontics. Whichever guard option you choose, it’s a good idea to check out the fit with Dr. David Shipper and Dr. Howard Vogel to make sure you’re getting all the protection you need for both when your mouthguard is doing double duty.

Temporomandibular dysfunction (TMD) refers to a diverse range of disorders that relate to muscular function in the jaw and face — the temporomandibular joint (TMJ). That could mean difficulty opening your mouth, pain in the jaw or face, or any sort of problem with the jaw joint.

TMD can be difficult to diagnose because of the varied causes. Whatever the case, an accurate diagnosis from Dr. David Shipper and Dr. Howard Vogel helps make treatment as successful as possible.

Most often, jaw problems will resolve themselves within several weeks or months. Surgeries like arthrocentesis, arthroscopy, and open-joint surgery should be a last resort. More conservative and reversible treatments should come first and are in fact the most critical step in the treatment of TMD.

Less invasive treatments like acupuncture and splints can be helpful, but that will depend on your particular case. It’s worth your while to speak with Dr. David Shipper and Dr. Howard Vogel at our New York, NY office to learn about solutions that could work for you.

A combination of treatments will most often produce the greatest relief for TMJ patients. It’s a good idea to avoid activities that overuse the jaws, such as chewing gum or clenching your jaws.

You can be proactive in finding relief for TMD by trying the following remedies at home:

• Eat soft food: When you eat soft and/or blended food, your jaw gets an opportunity to rest. Avoid chewy and crunchy food, and food that requires you to open your mouth wide, like apples or corn on the cob.
• Apply moist heat: A hot water bottle wrapped in a moist towel can help reduce symptoms.
• Apply ice: Applying an ice pack wrapped in a cloth or towel for no longer than 15 minutes may also reduce pain and promote healing.
• Do jaw exercises: A physical therapist can help identify the exercises that will work for you. Jaw exercises have been shown to be an effective treatment method that can be performed at home.
• Relaxation: Actively try to relax the muscles of the face and lips, and let your teeth come apart. Many find meditation, yoga, and slow, deep breathing to be helpful for reducing stress and tension.
• Avoid wide yawns: Keep your fist under your jaw when you feel a yawn coming on, to keep your jaw from opening too widely.

Dr. David Shipper and Dr. Howard Vogel and our team want you to have the healthiest possible smile in the healthiest possible body. Oral cancer can affect the mouth, tongue, throat and jaw. Early detection is vital for the best possible outcome when treating this disease. That is why we check for symptoms of oral cancer at every dental examination.

What can you do to reduce the chance of oral cancer?  Reduce your risk factors. You can help prevent oral cancer by adopting these healthy habits:

• Don’t smoke. Don’t chew tobacco. Don’t use a pipe. If you use any tobacco products, quit. Tobacco use is the single largest risk factor for head and neck cancers. Talk to us—we have suggestions for helping you break the habit.
• Drink alcohol in moderation. Heavy drinkers have a higher rate of oral cancer. More than one to two drinks per day can be considered heavy drinking, depending on factors such as weight, age, and even gender. Check with your doctor to find your personal definition of moderation.
• Eat a healthy diet. Cancer-fighting fruits and vegetables are a great addition to any menu.
• Protect yourself from the sun. Help prevent sun-related lip cancers by always wearing a UVA/UVB blocking sun screen or lip balm whenever you are working or playing outside—and reapply frequently.
• Some forms of the HPV virus have been linked to oral cancer, and those affected are generally younger and less likely to be smokers. Research indicates that the HPV vaccine, known for preventing several types of cancer, might also help prevent HPV-related oral cancers.
• Schedule regular dental exams. We are trained to recognize oral cancer and precancerous conditions that you might miss.

Of course, cancer can occur even with the healthiest habits. Do come see us if you detect any of these symptoms:

• A sore or ulcer that doesn’t heal, or persistent tenderness and pain in the mouth
• Lingering sore throat, hoarseness, or vocal changes
• Pain in the neck or ear that doesn’t go away
• A lump, a rough or thickened area, or eroded tissue in the skin lining the mouth
• Red or white patches in the lining of the mouth or on the tongue
• Difficulties chewing, swallowing, speaking, or moving the tongue or jaw
• Numbness in the tongue or mouth
• Changes in the way your natural teeth or your dentures fit together.

Not every symptom is caused by cancer, but it is important to rule out the possibility. We are trained to recognize early signs of oral cancer, and can recommend further tests if needed. Call our New York, NY office immediately if you have any concerns. Early detection and treatment lead to the most successful outcomes.