Thursday, August 16, 2012

Root Canals FAQs

Why You Shouldn't Fear Root Canals

What is a root canal? Root canal therapy, or endodontic therapy, is the treatment of the pulp of your tooth to eliminate any infection and protect the rest of your tooth from any future infections. The pulp of your tooth contains tiny canals that are inhabited by nerve tissue, blood vessels and other cellular entities. A root canal is when these entities that are inhabiting the canals are removed and the canals are filled with cement. After root canal therapy your tooth is technically dead and won't be able to feel anymore. 
Root Canal Procedure. From right to left, pictures show:
unhealthy or injured tooth, drilling and cleaning, filing, and the filling with cement. 

Why do I need one? A root canal is done in order to save a tooth that would otherwise be lost due to an injury or an infection. An infection in the nerve of your tooth could be caused by an untreated cavity that has continued to decay through to the nerve. Fractured or cracked teeth will sometimes require a root canal if there has been damage done to the nerve. Even after many years, a tooth that was previously broken or had some type of trauma done to it may be unforgiving and eventually require a root canal.  

Does it hurt? Nope! With today's technology and knowledge the procedure should not hurt at all. Your doctor will be sure to sufficiently numb the area, and if you feel anything at all during the procedure, if anything you would only feel a tiny little pinch, your doctor can put more novocaine in the area and relieve any discomfort. If you were having pain in the tooth prior to the root canal then the pain will be gone when it is finished! After the procedure your gums may feel a little sore, but you will be totally fine to go back to work that same day and the day after. Your dentist won't even need to prescribe pain medication since a higher dose of ibuprofen is all that is necessary to eliminate any discomfort after the procedure. 

Do I really need a crown put on the root canalled tooth? Yes!!! I know that crowns can be expensive, but if you neglect to do this final step 2-4 weeks after your root canal then you are risking major damage to the remainder of your tooth and possibly losing it altogether. A tooth that has had a root canal will break or chip extremely easily without the protection of a crown. If the tooth is fractured beyond repair then it would be necessary to extract it, totally wasting the whole root canal. 

Do I absolutely have to have one if my dentist recommends it? Most likely you do, if you have doubts about your specific dentist's recommendation then you should always seek a second opinion. You can also schedule a consultation with an endodontist, a root canal specialist, to make absolutely certain that you require one. If they say yes then you definitely need to go forward with that root canal!  

What if I just don't get one...? Keep in mind that a root canal is a last ditch effort to save a tooth that is dead or dying before it falls out. Ignoring your dentist's recommendation to get a root canal is a very bad idea. The tooth will eventually die, become thin and crack or break, and/or fall out. Once a tooth is gone and it isn't replaced your other teeth will shift and your jaw will experience bone loss. A root canal will stop any associated pain in your tooth. If you have left a tooth that was in pain alone and the pain magically disappeared then there's a good chance that your tooth has already died. 

What are the alternatives to root canal therapy? If you just can't afford a root canal and crown then you can always have the tooth extracted. If you just hate the idea of it and want to try other options then some dentists will perform a procedure known as direct pulp capping. Know that most alternatives to root canals don't usually have a very high success rate, so talk to your dentist.  

I'm terrified by the very thought of a root canal and I never want one! If the idea of having a root canal is so horrifying to you that you just can't stomach it and you absolutely need a root canal to save a tooth, and extracting the tooth isn't an option, then consider sedation dentistry. There are many ways that you can receive the root canal with absolutely no anxiety during the procedure. A sedation dentist will put you under anesthesia during the procedure and by the time you wake up the whole thing will be over. My office provides nitrous oxide and valium for patients with anxiety. 

A Family Dental Care Center: Dr. Seth Rosen
2030 West Main St.
Norristown, PA 19403

Thursday, August 9, 2012

No Dental Insurance and an Aching Tooth?

How to Get Around Not Having Dental Insurance Without Going Broke

If you have dental insurance through your employer then you are part of the lucky few. Private dental insurance is expensive and probably not worth the monthly fee just for routine cleanings. Millions of Americans don't have dental insurance and many find themselves in a situation where they wish they did. While routine cleanings and even getting the occasional cavity filled are relatively affordable, many procedures are not. Emergencies wait for no one and toothaches don't care whether you have the money to fix them or not. Leaving an aching tooth to fend for itself in hopes that it will heal on it's own is a terrible idea. This can cause the problem to continue getting worse, causing more and more problems until you lose the tooth or are forced to spend an exorbitant amount of money fixing the problem in an effort to save your smile. 

When you don't have dental insurance, here are a few ways you can get the care you need without going broke: 

Financing Credit Cards. If you can't afford to pay a large sum all at once to fix your toothache then financing credit cards, like CareCredit, can help you pay it over the course of a few months. If you choose a 6, 12, or 24 month plan you will qualify for interest free financing. These are great because as long as you keep up with payments and pay within a certain time frame you basically borrow the money for free! 

Colleges of Dentistry. Many dental assisting schools and colleges of dentistry offer services that are much cheaper and teacher-supervised. This is very popular among people trying to keep their dental bills down and so there is usually a pretty long waiting list.  

Mission of Mercy. Mission of Mercy is a nonprofit organization that provides free dental care to those without access or financial means. Events are held usually yearly in certain cities where people can sign up or show up to receive free care.

Discount Dental Plans. Many private practices offer sliding scale fees or discount dental plans for patients without dental insurance. For example, my practice offers a plan called the Family Plan. For $99/year patient's receive two free cleanings, X-rays, and exams and a significant discount on most of our other services. A lot of other private practices offer similar plans and often have them showcased on their website. 

Coupons. Not sure what could be wrong with your aching tooth? Or maybe you broke a tooth and just want to know your options? Check the websites of your local dental offices, many have coupons for free or discounted emergency exams and X-rays. This can save you a couple dollars and give you a peace of mind. 

A Family Dental Care Center: Dr. Seth Rosen, DMD
2030 West Main Street, Norristown, PA 19403

Thursday, August 2, 2012

Will Dental X-rays Give Me Cancer????

Why You Shouldn't Fear Dental X-Rays

In recent years more and more patients have expressed their concern about the safety of dental X-rays. While there has been a lot in the media about them, there is no reason to fear for your lives because of past and future dental X-rays. 

The modern bitewing X-rays that you receive at your dental office give off a very small amount of radiation, about 0.04 mGy (milli-grays). In comparison, a chest X-ray gives off 0.1 mGy and the average American is exposed to 3.1 mGy of radiation every year from background radiation. "Background radiation" is the unavoidable amount of radiation that every person is exposed to simply by living on this world (this radiation comes from various sources such as cosmic rays, rocks, water, and food). 

A chart comparing the radiation exposure of various sources.
Notice that dental X-rays give off the lowest amount of radiation vs. other X-rays. 

So what about all those stories on the news about how dental X-rays were linked to brain tumors? This is certainly a case where the media threw a story completely out of proportion. The coverage on the research that was reported on about the link between brain tumors and dental X-rays was probably meant to scare the general public and create a good story. In reality, the study doesn't really hold up. In a nut shell, researchers interviewed 1,400 people with benign brain tumors and 1,350 without a history of brain tumors about their dental history. More people with brain tumors remembered having more frequent dental X-rays than those without a history of brain tumors. At first glance this seems pretty scary. However, no actual records were pulled and the people were only asked to report what they remembered. This study essentially relied on the memories of certain people to come to a conclusion, something that is very unreliable and would not be taken seriously by the medical community. The findings of the study were probably more coincidental than accurate and proved nothing. To evaluate whether dental X-rays are truly linked to brain tumors, or any cancer, a much more extensive and conclusive study would have to take place. 

It would be unwise to completely deny yourself the technology of dental X-rays. They are fairly safe and often uncover health problems that you would not otherwise be aware of. A small cavity in a tooth that is not causing any pain can be detected through a bitewing X-ray and taken care of quickly. If left untreated, a simple filling that may cost a little over $100 could turn into a very expensive root canal and crown, costing thousands. With that in mind, it's still important to be careful with this technology and limit exposure. Your dentist should always provide a leaded apron for you to wear that minimizes any exposure of radiation to your body. While most dentist's recommend that you receive bitewing's once a year, a person with a consistently healthy mouth may only need to get X-rays every two years. 

A Family Dental Care Center: Dr. Seth Rosen, DMD
2030 West Main Street
Norristown, PA 19465