The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”
Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.
A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.
However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:
Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.
Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.
A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.
A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.
Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.
And sometimes there is no pain, but an infection may be discovered during a dental exam.
Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.
Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”
“I’ll go to the dentist when the tooth hurts,” (or the variation “when my tooth bothers me”)—how many times have you heard this, or perhaps even said it? Do you know why it’s not a good idea to wait to see your dentist until you have pain?
- Your dental treatment will be more expensive (cost more).
- Your dental treatment will be more involved and complex. Most dental diseases are silent in their early stages. By the time you feel pain, the problem is quite advanced.
- Local anesthetic (commonly called novocaine) may not work as well to control your pain during treatment.
- Most painkillers (both over-the-counter and prescription) do not eliminate severe dental pain.
Toothaches: With toothaches, your pain comes from the tooth’s nerve. The nerve of your tooth is buried deep within the tooth and surrounded by hard material (dentin and enamel). This means that tooth decay has to travel quite a distance to reach the nerve of your tooth to cause pain!
When you’re seeing a dentist on a regular basis, hopefully, your dentist will find the tooth decay long before it gets to this point, and you can do a filling. Once you’re having pain, the most likely situation is that the decay has created a path to allow your mouth’s bacteria access to the tooth’s nerve. This causes the nerve to die and creates an abscess (localized infection). The only ways to treat this abscess and get you out of pain are to have a root canal or to remove the tooth.
Tooth decay can grow from a small, fillable area to a dental abscess in as short a time as one year under the right conditions. Abscesses and infections can cause death if the underlying cause is not treated. They are nothing to fool around with!
Gum Pain: Your gum pain can be caused by a number of conditions ranging from something simple (canker sore. etc.) to something very complex (periodontal disease, cancer etc.). Here, we’ll discuss some of the more common conditions that are not as easy to treat once they’re far along.
A pimple-like area on your gums that grows and shrinks is usually a sign of an infection of either your tooth or your gums. Your infection is trying to find a way to drain, and it will follow the easiest path. Sometimes it will travel into the neck area (making swallowing difficult for you) or up by your eye (making seeing difficult as well as placing it closer to your brain—a place that you do not want infection to travel!)
Loose teeth can also cause gum pain. (Just ask any child who’s in the process of losing his or her baby teeth!) In an adult, loose teeth are caused by periodontal disease, which is a low-level infection of the areas around your teeth. This infection eventually causes the bone around your teeth to move down the root of the tooth. When the bone gets near the end of your root, there is no longer enough support for the tooth. As a result, your tooth moves around and tugs on the gum that is still attached to it, causing pain. Unfortunately, we currently have no way to replace the bone around your teeth, so once it’s gone, it’s gone and the only option is to remove your tooth. (But the bone loss that came before can make it difficult to make you a denture or other replacement for your teeth.)
Early intervention and treatment for a dental problem may cost a few hundred dollars. Waiting until the tooth or area bothers you could cost you a thousand or more dollars (or even your life in the most severe cases). Please don’t wait until it hurts to seek dental care!
Dr. Jennifer Robb is a general dentist located at 1320 Cooper Foster Park Rd., Lorain, OH 44053. Her office can be reached by phone at 440-960-1940 or by using the contact us form on her website at www.drjrobb.com or on facebook at www.facebook.com/DrJenniferRobb (please feel free to join our facebook page)
There are different ways to ease a child's potential nervousness with dental visits, like starting those visits around their first birthday or seeing a pediatric dentist who specializes in children. But even doing those things won't guarantee your child won't develop some form of dental anxiety, which could complicate their dental care.
To help make appointments easier for anxious children, many dentists use conscious sedation as a means of helping them relax. With this technique, the dentist administers a mild sedative to the child to take the edge off their nervousness, while allowing them to remain awake during treatment.
Sedation isn't anesthesia, the means we use to stop pain during treatment (although sedation may be used with anesthesia). Rather, sedation reduces emotional fear and anxiety. And unlike general anesthesia, a sedated child can still breathe without assistance and, depending on the depth of the sedation, respond to physical and verbal stimuli.
In most cases, children are administered sedation medications by mouth, usually as a syrup, although on occasion it might be delivered intravenously with an IV. The dose is usually given some time before their treatment session after the dentist has evaluated them. Dentists mostly use mild sedatives like Midazolam or Hydroxyzine with very little risk of side effects for children.
During the procedure, a designated staff member continually monitors the child's vital signs. Besides heart rate, pulse and respirations, they may also check the child's exhaled carbon dioxide levels to ensure they're breathing normally.
After the treatment session is over, staff will continue to monitor the child until their vital signs return to pre-sedation levels. If the child is of driving age, they'll need someone to drive them home. Children who've been sedated should remain home for the rest of the day, but they can usually return to school the next day depending on what kind of dental work they've undergone.
Dentists follow strict protocols for pediatric sedation adopted by the American Academy of Pediatrics, the American Dental Society, and the American Academy of Pediatric Dentistry. In addition, many states have also established processes for administering sedation therapy. It's a safe and effective method to ease a child's anxiety over their dental visit.
If you would like more information on making dental visits easier for kids, 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 “Sedation Dentistry For Kids.”
My dentist recommended I have a crown. Do I have any other options?
Let’s first look at what a crown is. A crown covers all the sides and the chewing surface of your tooth. There is nothing else that covers a tooth in the same way a crown does, so there really is no equivalent treatment, but there are other choices you might make.
A crown is recommended:
• When you have lost a large part of your tooth to decay
• When you have lost a large part of your tooth to an accident
• When you break off a large part of your tooth
• When you have a filling that covers 75% or more of your tooth
• When you’ve had a root canal
In the first four items of the list above, the result is that you have less of your own tooth structure to help hold a filling. For the last item on the list, a root canal removes not only your tooth’s nerve, but its blood vessels as well. The blood vessels are what provides nutrition to your teeth. When there is no nutrition, teeth can break more easily. This process is similar to that of trees in the Fall. When the sap stops flowing to the leaves, the leaves change color and eventually dry out and can be destroyed more easily. Since a crown wraps around the sides and top of your tooth, it can help protect your tooth against breaking or splitting.
Now that you know what a crown is and why it is recommended, let’s look at some of the other choices you could make:
Lab-made fillings: You may see or hear these referred to as inlays or onlays. Unlike the silver or white fillings which are more commonly placed by dentists, the inlays or onlays are made as one piece by the dental lab either from metals like gold or from tooth colored materials like porcelain. They are then cemented to your tooth. Because they are one-piece, they are less likely to break than fillings done in the office, but in some cases they may cost almost as much as a crown. Some offices now have milling machines that can make something similar while you wait; however, only time will tell if these materials last as long as those used by a dental lab.
Large fillings: In some cases, your dentist can place a large silver or white filling in your tooth. If there is not enough of your tooth left to hold a filling, you may need a retention device to give the filling something more to hold onto. While these do work in some cases, there is some evidence that these devices cause microscopic fractures in your tooth that may grow over time. In addition, filling materials do have limits, so your filling may not have the same shape or contours that your real tooth did. And if more of your tooth or any of the filling material breaks or fractures, you may need to have a crown done anyway.
Stainless Steel Crowns: If a lab-made crown is a custom fitted suit, a stainless steel crown is a one size fits most piece of clothing . A lab-made crown is custom fit to your tooth. Stainless steel crowns come in several sizes and are silver colored. Your dentist will pick the size that fits the closest and modify it to fit your tooth. They do not seal as tightly around your tooth as custom-made crowns and are more likely to allow food, liquids and saliva to leak around them. This leakage can cause another cavity, one which may be harder to detect. They may be a good choice if you need a short period of time to save up for a lab-made crown.
Remove the tooth: This is often the least desirable option. Anytime a tooth is removed, the bone that was around the tooth gets smaller and other teeth can shift or move. In addition, replacing the lost tooth will probably be as expensive or more expensive than doing the crown.
Each dental situation is unique and this article is only meant as a guide. If your dentist has recommended a crown to you, it may be best to ask him or her to show you why the crown is being recommended and to ask if there are any other treatment options available to you. If you do not have a dentist or would like to discuss other treatment options, please call my office at 440-960-1940 to make an appointment or you can use the contact form on my website at www.drjrobb.com
*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.
Jennifer G. Robb, DMD is a general dentist who sees both adults and children.
1320 Cooper Foster Park Rd. W
Lorain, OH 44053
Dental cavities are one of the most common chronic diseases in the United States. It is the process where bacteria in your mouth use refined carbohydrates (particularly sucrose) and produce acid (primarily lactic acid). The acid erodes tooth structure creating cavities. If the cavity becomes deep enough to cause inflammation of your dental pulp, the result is pain, possible abscess, and the need for expensive dental treatment to save the tooth or loss of the tooth.
For children, dental cavities are associated with an increased number of missed school days, decreased ability to learn, and diminished oral-health-related quality of life.
Older models of caries management stressed drilling and filling—but we now recognize that placing fillings in teeth does not always stop the overall disease process. So we are now placing an emphasis on preventing cavities from developing in the first place.
How do we prevent cavities from developing?
- Mechanical tooth cleaning with toothbrush and floss.
- Fluoride: Studies have shown that fluoride in toothpastes and drinking water has reduced dental cavities by approximately 50%. Fluoride is also available in chewable tablets (prescription) and rinses (both prescription and over-the-counter). Dental offices can also do topical applications of fluoride (liquids, gels, foams, or varnishes)—these contain a higher concentration of fluoride than what you can buy in the store to use on a daily basis.
Fluoride is not as effective at preventing cavities in the pits and grooves of back teeth as it is on other tooth surfaces. This is why sealants are recommended for back teeth that have many grooves on their chewing surface.
The American Academy of Pediatric Dentistry offers the following tips to reduce cavities:
- Avoid frequent consumption of sugary foods and liquids
- Begin oral hygiene measures, including toothbrushing, starting when the first tooth comes into your child’s mouth
- Establish a “dental home” before your child’s first birthday and have a caries risk assessment as well as getting parental education. (Some general dentists will do this and others will want young children to see a Pediatric Dental Specialist.)
Note: The information in this article is not meant to replace the clinical judgment of your healthcare professionals.
Jennifer G. Robb, DMD is a general dentist who sees both adults and children.
1320 Cooper Foster Park Rd. W
Lorain, OH 44053
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