Dental Questions: Why do teeth need root canals?

When most patients think of endodontics (root canal procedures), they usually assume it is being provided to treat an infection.  While the most common reason for a tooth to need a root canal is infection, there are a whole host of procedures and conditions that benefit from endodontic therapy. Take a look at this list of typical reasons that teeth need root canals!

Infection- Indeed, the most common reason most patients need root canals is from bacteria growing around the roots of the teeth. In the classic model of tooth infection, tooth decay spreads to the dental pulp, causing the tissue to become necrotic. This dying tissue becomes a food source for the bacteria, allowing them to flourish. A root canal treats these infections by removing the remaining tooth pulp, sterilizing the interior of the tooth and cutting off the bacterial food supply. 

Fractured Teeth- Fractured teeth are often impossible to see and difficult to diagnose. Many times it takes the imaging technology found at an endodontist's office to reveal the location and extent of the crack. Most fractured teeth are impossible to restore and require extraction. However, some smaller cracks can be rectified through a combination of a root canal and crown. 

Post Placement- If the top of a tooth is broken off at or near the gum line, placing a crown on the remaining structure is impossible. In certain occasions, a root canal procedure can be performed along with a post placement to save the tooth. A dental post is a metal or composite rod that extends from the root of the tooth to above the gum line, creating a new substructure for a crown to be fashioned. 

Trauma- Many times, dental trauma will cause the internal tooth pulp to recede or become necrotic. A clear sign of this is a tooth becoming darker or red-toned following injury. In order to preserve the tooth and minimize risk of infection, a root canal is often performed. After the root canal is finished, internal bleaching can be used to lighten the tooth back to a natural tone. 

We hope you found this article helpful! If you have any more questions about root canals, dental trauma or dental crowns, please give our office a call!

New treatments for burning mouth syndrome

Have you ever heard of Burning Mouth Syndrome? About bout five of every 100,000 people report this painful condition yearly, with women more likely to be affected than men in a ratio of 33 to 1. In about half of all cases, there is no known cause or source. Fortunately, new research suggests that the drug clonazepam may provide relief for this elusive condition. 

Burning mouth syndrome is a usually reported by patients as a feeling of burning or pain over the tongue, gums or palate. The sensation is often difficult to pinpoint and usual pain medications like aspirin or ibuprofen don't help. Many individuals will report suffering for extended periods of time- from weeks to months. In these instances, burning mouth syndrome is a form of chronic or "internalized" pain. This type of pain has little to do with actual injury to the mouth and more to do with how the brain interprets sensation.

Clonazepam is traditionally prescribed as a sedative and is often used to treat chronic pain conditions like back pain, fibromyalgia and arthritic knee pain. Only now has it's efficacy in treating burning mouth syndrome been recorded in scientific research. On average, patients taking clonazepam reported noticeable improvements in their burning mouth syndrome when compared to placebo groups. 

As with any oral condition, a thorough examination with a dentist is required to diagnose and burning mouth syndrome. Facial pain has many sources- from tight jaw muscles to tooth infections- and we want to be absolutely sure we are treating the true cause! If you would like to know more about burning mouth syndrome or other facial pain conditions, please contact our office. 

Dental Questions: What is a root canal?

Before and after X-rays of a completed root canal (rightmost tooth). Notice how the roots have whiter centers once the procedure was finished. 

In today's article, we are going to shed some light on a common (and commonly misunderstood) dental procedure: the root canal. Many patients fear and dread these treatments when in actuality they are painless and routine. We hope you find this information helpful!

Root canals fall under the dental field of endodontics. These procedures may be carried out by a general dentist or at a specialist's office. Then end goal of any root canal treatment is to remove the nerve tissue from the inner tooth, desensitize it and eliminate any bacteria or infection. This process allows us to save and treat many teeth that would otherwise need to be extracted. 

The first step in root canal treatment is to get the tooth in question completely numb. These procedures can be time consuming, so complete anesthesia is absolutely crucial. Contrary to popular belief, modern root canal therapy is virtually painless, with the many patient leaving the office with much less pain than they were in before!

Once the patient is numb and comfortable, a small opening is made in the top of the tooth to access the innermost layer called the pulp chamber. Here, the nerve endings that cause symptoms such as pain and cold sensitivity are cleaned out from the tooth.  This step is continued down the roots of the teeth, where a series of small files are used to clean and shape the root system. Once the pulp chamber and roots are completely cleaned, the tooth is filled with a thick, rubbery material called gutta percha. This step is crucial as it creates a plug against bacteria and recurrent infection.

After the treatment is complete, the top of the tooth is filled and restored, typically with a tooth-colored material. In many instances, teeth that receive root canals will need crowns for optimal strength. This is something the treating dentist will discuss with you and plan ahead of time. 

As with many dental treatments, this article is a general guideline and doesn't cover all aspects of endodontic therapy. If you have been told you need a root canal or want to know more about this type of procedure, please give our office a call. We will be more than happy to ease your mind and point you in the right direction!

Periodontists we work with

Properly managing your dental care can take a team of dentists, specialists and laboratories. For our patients that need the help of a periodontist, we are proud to work with Dr. Jeremy Wilgus of Camarillo Periodontics. His office combines the technology, expertise and compassion that our patients seek. 

If you have conditions such as deep pockets or periodontitis you may be referred to Dr. Wilgus. He specializes in a number of surgical and non-surgical techniques to improve gum health and repair damage. Beyond these services, his office offers various procedures to adjust and re-contour the gums. For some patients, a full cosmetic reconstruction will include visits to Dr. Wilgus for crown lengthening or grafting to create an ideal gumline. He is also an expert in placing implants in sensitive areas, such as the anterior teeth. If you would like to know more about periodontal services or why a patient might benefit from the services of a periodontist, please call our office! 

Dental Questions: What is Periodontal Disease?

Periodontal disease follows tooth decay as the most prevalent condition effecting the oral cavity. In fact, over half of all Americans have some type of problem with their periodontal tissues. It is important to understand the differences between the two main categories of periodontal disease- gingivitis and periodontitis.

The word "periodontal" identifies the tissues surrounding the teeth: the gums, bone, connective tissue and ligaments. These structures live in a delicate balance with the bacteria that exist naturally in our mouths. Over time, poor oral hygiene can allow the bacteria to colonize and grow around the teeth, leading to inflammation of the gum tissue. This first stage in periodontal disease is known as gingivitis. At this point, you might notice puffy, red gums that bleed during brushing or flossing. 

As the inflammation progresses and the bacterial colonies grow, the jaws start to undergo bony changes. Our bones will begin to grow away from the source of infection, leading to recession, pocket formation and loose teeth. These changes are associated with the more advanced form of periodontal disease known as periodontitis. 

Fortunately, there are a number or dental procedures aimed at stopping or reversing the effects of periodontal disease. It all starts with a dental exam to determine the extent of damage and assign an appropriate cleaning regimen. Patients with healthy tissue might just need a simple preventative cleaning, while others may benefit from a more intense procedure- such as scaling and root planing. If you would like to know more about periodontal disease, what causes it and how we can treat it, please contact our office!

Medicare and Dentistry

For many retired Americans, Medicare provides a health safety net that would otherwise be unobtainable on a fixed income. Although the service aims to provide similar coverage to many employer insurance plans, it is not comprehensive. One of the most notable gaps in coverage is the lack of dental insurance. 

Every week, our office receives at least one request to bill Medicare for dental treatment. Unfortunately, the differences between medical and dental coding and billing make this impossible. Simply put, there is no avenue for a private dental office to bill to Medicare. With this in mind, it is important to budget for dental procedures to supplement your existing health coverage.

Another important distinction to make is the difference between Medicare and Medicaid. While Medicare is a service for the elderly, Medicaid aims to assist low income families and individuals. The California branch of Medicaid is Medi-cal, which contains a dental component known as Denti-cal. At this time, our office does not accept Denti-cal. However, many dental schools and community clinics specialize in utilizing and billing this service. 

If you would like to know more about dental insurance, coverage and other services, please contact our office. We are always happy to help you better understand your insurance plan and if it can be utilized at our office!

Dental Questions: Why do my gums bleed when I floss?

An example of proper flossing technique.

Gums bleeding while flossing is a frequently recorded complaint at every dental office. Many patients are turned off from flossing as it becomes painful, messy and inconvenient. However, it is important to understand that your gums are probably bleeding because you need to floss more often. 

Plaque accumulates in the spaces between teeth because toothbrushes do a poor job of reaching these areas. As plaque settles at/below the gum line, the tissues there become inflamed, thin and ulcerated. As you floss, you are both eliminating the plaque and bacteria from these areas and temporarily aggravating the  gum tissue (hence the bleeding). Over time, the absence of buildup will allow the gums to heal and rethicken, stopping the bleeding. 

A knee-jerk response to bleeding on flossing is to floss less often or less vigorously. While you may be physically cutting the gums with floss, a proper technique will avoid this. Make sure you thread the floss in between the teeth and move it up the side of each tooth at each contact. Try to "cup" the floss around the teeth and allow it to go slightly below the gum line. This will maximize effectiveness and minimize gingival inflammation. If you would like to know more about flossing, oral hygiene or dental cleanings, please contact our office!

Our Wonderful Staff!

Why is our office so great? It has to be the awesome people who come together and make Thousand Oaks Family Dentistry a wonderful place to be. Our busy staff took a little time out of their day to put together these composite photos. Enjoy!

From left to right, top to bottom: Michael, Nancy, Shannon, Kristi Carol and Jonathan and Duke (moral support!)

From left to right, top to bottom: Adrienne, Aleeza, Faith, Jerry, Kari Ann and Lori

We love our staff and are positive you will too! If want to find out more about what makes our office special, please give us a call or email to schedule an appointment. 

Dental Questions: Help- I Broke My Temporary Crown!

Anyone who has had a temporary crown break knows that they tend to come off at the least convenience times. After the initial shock and confusion wears off, you may be wondering what your next step is. Even if the crown falls out in one whole piece, do not try to put it back on the tooth and continue using it.  Although the crown seems small, it poses a serious choking risk particularly when sleeping or chewing. Additionally, don't try to glue the crown back together or recement it. This can result in damaging the underlying tooth structure in a way that ruins the fit of the permanent crown. 

Your best bet for fixing a broken or missing temporary crown is calling our office. If the crown can't be recemented, we will make a new one on the spot. We keep copies of all the temporary impressions we make until the final crown is delivered. This allows us to recreate temporaries on-demand and in short notice. Our office always tries to work these type of appointments in same-day or early the next day! If you have any further questions on the dental crown process, please give us a call or email. 

Different Types of Dental Crowns

As technology progresses, the field of dentistry gains new materials, techniques and services. However, we rarely stumble upon a magic "one size fits all" approach. This is particularly true of the advancements in dental crowns. There are nearly hundreds of different crown materials and manufacturers, each with their own specific use. In this article, we will discuss four general types of dental crowns and why we use them. Enjoy!

Porcelain fused to metal- These crowns combine the esthetic properties of porcelain with the adaptability of metal. A metal framework is cast to a stone model of the prepared tooth. Afterwords, layers of porcelain are baked on, creating the look of a natural enamel. These crowns are typically used in the back of the mouth, as they are durable and resist wear to the opposing teeth. However, the metal substructure can make these crowns too opaque to be used in cosmetic applications.  

Gold- Gold crowns are less frequently used in modern dentistry due to the availability of newer, more esthetic materials. However, gold is one of the most adaptable materials available, allowing for a near seamless junction between tooth and crown. It also requires the least amount of tooth structure to be removed, but this becomes irrelevant in instances of severe decay, chips and fractures. 

Lithium Disilicate "Emax": Emax is an extremely durable and esthetic material. It can be used in nearly all areas of the mouth, although we tend to use it in cosmetic areas. Since these crowns are made from a single type of material, they transmit light very well and perfectly match natural enamel. Emax can even be stained or painted to match imperfections in the surrounding teeth!

Zirconia "BruxZir": Like Emax, BruxZir crowns are made from a single type of material (engineered zirconia). However, they trade cosmetic advantages for extreme fracture resistance and durability. BruxZir crowns are best used in patients with strong jaws or grinding problems, where other materials will not last. In fact, these crowns are hard enough to wear enamel, meaning that they need to be used judiciously and only when necessary. 

An important note is that Thousand Oaks Family Dentistry charges the same crown fee regardless of material used. We want our patients to know that we are focused on the best long term outcomes for their dental care- be it from the newest technology or tried and true methods!