Monthly Archives: September 2012

How is a Root Canal Done?

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Root canals are not the scourge of dentistry like they used to be. By using good local anesthesia techniques, a root canal can be performed with little to no discomfort. A root canal is done by first placing an opening into the pulp chamber.

Tooth Needing Root Canal Treatment

This is a hollow area in the center of the tooth where the dental pulp (a collection of nerves and blood vessels) resides. Once access to the pulp chamber has been obtained, the dentist will clean out any debris, whether it is live nerve tissue or dead, necrotic material. At this point, the actual root canal(s) are located. These are tiny channels that go through the root and exit at the end to communicate with the bone. Sometimes these canals can be very torturous to negotiate and many times requires a dentist with many years of experience to successfully complete the process. The canals are meticulously cleaned by a series of “files”, pin-like instruments. With each successive file, it will clean the walls of the canal, then the debris is flushed out with a sodium hypochlorite irrigating solution.

Root canal x-rays before and after

The canals are then dried and filled with a sealer and an inert material called gutta percha. The root canal has now been completed, hopefully without pain, and is ready for restoration.

 

Tooth Knocked Out On The Ball Field

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Knocked Out Tooth Splinted

Knocked Out Tooth Splinted The Day Of The Accident

Tooth Knocked Out After

Knocked Out Tooth After Healing Period Is Restored By Dr. Gangwisch With Cosmetic Bonding

In my dental career, I have had the opportunity to assist two people who have had a tooth knocked out at a sporting event. The second one was during a baseball game that I was coaching. My left fielder ran at fullspeed right into the outfield fence. He was down on the ground while the ball was in play, then while I was running out to check on him (it was a high school field, so I had to run quite a ways to get to him), he got up and came to me with something in his hand. It was his front tooth. It turns out that of the ten foot sections of the cyclone fence, he would decide to choose the few inches of pole to collide with. Needless to say, when it came to tooth versus pole – the pole won. There were no facilities at this field (it was serviced by a Port-A-John), I had him roll the tooth around in his mouth to clean it. Then, after asking his parent’s permission, I reinserted it back into the socket. He handled it very well for a 14 year old because I could tell he saw stars when I put it in. After the game, I took him over to my office, opened up the tooth and placed medicine inside and then splinted it to the surrounding teeth with braces. Later I did a root canal on the tooth and removed the braces then and rebuilt the chipped tooth. Now his smile looks as good as new.

 

Oral Cancer

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You wake up one morning and pull back your lip and see a growth. The first thought that goes through your mind is that dreaded “C” word – cancer. The good news is that 99% of these growths are benign. That’s not to say that one should ignore something that shouldn’t be there. When I see a lesion in someone’s mouth, the first question I ask is, “How long has it been there”. Many times, if it is fairly new, it may regress with time. I document it with a picture, then have the patient return in a couple of weeks. If the lesion is still there then it’s off to the oral surgeon for a biopsy. Not only is it better for peace of mind but also, if it turns out to be something serious, early detection will greatly increase the chance of survival. A biopsy is a very easy procedure that is done under local anesthetic and a couple of stitches.

Verrucous Carcinoma

If you ever have something growing where it’s not supposed to or a sore that doesn’t heal within a couple of weeks, then it is best to see your dentist as soon as reasonably possible. In the meantime, it is best not to lose any sleep over it since chances are greatly in your favor that it will not be anything serious.

Root Canal – When

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The words “root canal” can strike fear into the hearts of mortal men. With modern techniques, most root canals can be performed with little or no pain. The first concern is proper diagnosis. No one wants to undergo root canal treatment – painless or not – only to find out that it was unnecessary. Some types of tooth pain can be reversible without resorting to a root canal. Removing decay and placing a sedative filling will sometimes do the trick. If there is pain along the “gum line”, the dentist can apply a desensitizer to the root to see if the condition improves. When one goes to the dentist with a toothache, it is not unusual for the culprit to be another tooth. This is called referred pain and it’s very important that the dentist performs a number of tests to determine the exact source. It is extremely important that the patient doesn’t take any kind of analgesic, such as ibuprofen or Tylenol, before an appointment. This can mask the symptoms and skew the diagnostic tests that the dentist performs. Another possibility is that the pain could be coming from something other than a tooth. During spring and fall, it is very common here in Atlanta for patients to appear in my office with “toothaches” only to find out that it was sinusitis. Taking adequate time during the diagnostic phase can save much time, money, and discomfort by getting it right the first time.