Endodontic Treatment: Root Canal 101

Dr. Benjamin Coon, D.D.S.

People fear, dread, and postpone getting them. They are fodder for countless jokes. What are they? 

Root canals.

But like a lot of things in life, the anticipation of a root canal is far worse than the actual process of getting one. And consider this: years ago, if you had a tooth with a diseased nerve, you would likely lose that tooth entirely. Now, not only can teeth be saved through endodontics, or root canal therapy, but medical advances have made this treatment relatively simple, with little or no discomfort. Most root canals involve one to three visits to your general dentist or endodontist.

A root canal treats the dental pulp, or the soft tissue that contains nerves, blood vessels, and connective tissue in healthy teeth. Dental pulp lies within the tooth and extends from the crown to the tip of the root, in the bone of the jaw. When the pulp is diseased or injured, the pulp tissue dies. The most common cause of pulp death is a cracked tooth or a deep cavity. If vulnerable dental pulp is left without treatment, pus builds up at the root tip in the jawbone in the 'root canal', forming a pocket called an abscess. An abscess can cause damage to the bone around the teeth; and not only that, an abscess usually hurts.

A molar, showing the 'root canals'

As for the actual procedure of an endodontic root canal treatment, the dentist removes the diseased or dead pulp from a tooth, the 'root canal' itself is cleaned, and then the tooth is sealed off to protect it. Finally, your dentist places a crown over the tooth to help make it stronger, and the procedure is complete.

Here's the step-by-step process of how a tooth is saved through root canal treatment:

• An opening is made through the crown of the tooth into the pulp chamber.
• The pulp is removed, and the 'root canals' are cleaned, enlarged and shaped.
• Medications may be put in the pulp chamber and 'root canals' to help get rid of germs and prevent infection.
• A temporary filling will be placed in the crown opening to protect the tooth between dental visits. Your dentist may leave the tooth open for a few days to drain. You might also be given medicine to control any infection that may have spread beyond the tooth.
• The temporary filling is removed and the pulp chamber and 'root canals' are cleaned, filled and sealed.
• A gold or porcelain crown is placed over the tooth as the final step.    

Your restored tooth will likely last a lifetime, with continued preventive care and good oral hygiene.  

Dr. Benjamin Coon, D.D.S.

Glenwood Meadows Dental

40 Market Street, Suite A

Glenwood Springs, CO  81601

970-947-1717

www.gmeadowsdental.com

Dental Emergencies and Accidents: the Doctor is in!

Dr. Benjamin Coon, D.D.S.

As a dentist, it is ideal to meet my patients for the first time during a routine visit for an exam or teeth-cleaning. Very often, however, the first patient-dentist contact takes place because of a dental emergency. That's okay too: like most dentists, I reserve some time in each day's schedule for emergency patients. Emergency visits are usually preceded by a phone call from the patient or family member, and this communication is extremely helpful, so I can receive as much advance detail on the emergency condition as possible.

Often, patients aren't sure if the dental problem they're experiencing is an emergency. I offer this advice: If it hurts, it's an emergency. Remember, pain is a signal that something is wrong; a problem that will not disappear even if the pain subsides. This is because even injuries that seem small can affect the living tissues inside the teeth. Any obvious damage to a tooth should be treated as soon as possible. Chips or fractures can affect the living tissue inside the tooth, causing more problems in the future. In rare instances, infection can occur and be serious enough to be life-threatening. An immediate visit to your dentist nearly always prevents the damage from getting worse.

Quick treatment is also essential for a lost filling or crown. Even if you don't have any pain symptoms, if you have lost a restorative device the tooth has lost its support and it could easily become damaged. Pieces of tooth often break off or crumble later, making even more extensive treatment necessary. If you see your dentist right away, there's a good chance he or she will be able to repair the damage more easily--and affordably. 

There are a number of simple precautions you can take to avoid accident and injury to your teeth. One way to reduce the chances of damage to your teeth, lips, cheek and tongue is to wear a mouthguard when participating in sports or recreational activities that may pose a risk. Avoid chewing ice, popcorn kernels and hard candy, all of which can crack a tooth. And although it may seem obvious, it's important to cut things using scissors, rather than your teeth!

Accidents do happen, and knowing what to do when one occurs can mean the difference between saving and losing a tooth. These are some common dental injuries, with advice on how to deal with them:

• Knocked-out tooth: Do not scrub it or remove any attached tissue fragments. Put the tooth in a cup of milk and get to the dentist as quickly as possible. Remember to bring the tooth with you!

• Bitten lip or tongue:  Clean the area gently with a cloth and apply cold compresses to reduce any swelling. If the bleeding doesn’t stop, go to a hospital emergency room immediately.

• Broken tooth:  Rinse your mouth with warm water to clean the area. Use cold compresses on the area to keep any swelling down. Call your dentist immediately.

• Possible broken jaw: Apply cold compresses to control swelling. Go to your dentist or a hospital emergency department immediately.

• Objects caught between teeth: Try to gently remove the object with dental floss; avoid cutting the gums. Never use a sharp instrument to remove any object that is stuck between your teeth. If you can’t dislodge the object using dental floss, contact your dentist.

• Toothache: Rinse your mouth with warm water to clean it out. Gently use dental floss to ensure that there is no food or other debris caught between the teeth. One old home remedy for toothaches called for putting aspirin against the gums near the aching tooth; we recommend against this because it may burn the gum tissue. If the pain persists, contact your dentist.

Today, dentists have many options for dealing with dental emergencies. There are advances in pain management and ways to restore teeth. Teeth can be repaired with synthetic materials that are strong and look as good as your natural teeth. Your dentist has the training and skills to identify what the problem is and how serious it is. He or she can almost always reduce or eliminate your pain within a few minutes.

If you’re concerned about visiting the dentist because you have limited or no dental insurance, ask if the practice offers an outside monthly payment plan; most do. If the answer is yes, you can submit an application online and get an immediate credit decision—and the emergency care you need.

Dr. Benjamin Coon, D.D.S.

Glenwood Meadows Dental

40 Market Street, Suite A

Glenwood Springs, CO  81601

970-947-1717

www.gmeadowsdental.com

Baby Teeth: Early Care Important

Dr. Benjamin Coon, D.D.S.

Primary teeth, or "baby teeth" typically begin to appear when a baby is between six months and one year old. Primary teeth help children chew and speak. They also hold space in the jaws for permanent teeth that are growing under the gums. The American Dental Association (ADA) now recommends that a dentist examine a child within six months after the first tooth comes in and no later than the first birthday. Parents should consider a dental visit at an early age is a "well baby checkup" for the teeth.

Recent statistics from the American Academy of Pediatric Dentistry cite that nearly 50 percent of children will be affected by tooth decay before age five, and of the four million children born each year in the U.S., more than half will have cavities by the time they reach second grade. A child's primary teeth are as important as the permanent adult teeth, and there are recommended techniques to care for them to ensure lifelong dental health.

Besides checking for tooth decay and other problems, with an early visit your dentist can show you how to clean your child's teeth and gums properly, and how to evaluate any adverse habits such as thumbsucking. Your dentist can recommend the healthiest type of pacifier, too.

Begin cleaning your baby's mouth during the first few days after birth. Infants should finish their bedtime and naptime bottle before going to sleep. After every feeding, wipe the baby's gums with a clean gauze pad. This removes plaque, a sticky film of bacteria, and residual food that can harm erupting teeth. Starting early with this dental hygiene practice helps your baby become accustomed to a regular routine for lifelong dental care.

When teeth first come in, babies may have sore and tender gums. Gently rubbing your child's gums with a clean finger, a small, cool spoon or a wet gauze pad can be soothing. You can also give the baby a clean teething ring to chew on. If your child is still cranky or in pain after these techniques, consult your dentist or physician.

The central incisors, or the "front teeth", are the first to come in. Usually the bottom teeth appear first. The next teeth are the lateral incisors, next to the central incisors. Over the next two years, the canine teeth (cuspids), first molars, and second molars appear. Most children have a full set of 20 primary teeth by the time they are three years old.

As soon as teeth appear in the mouth, tooth decay can begin to occur. When your child's teeth begin to erupt, brush them gently with a child's size toothbrush and water. Brush the teeth of children over age two with a pea-sized amount of fluoride toothpaste. Be sure they spit out the toothpaste and rinse with water. Most dentists and physicians do not recommend using fluoride toothpaste before the age of two. As brushing transitions from the parent to the child's independent activity, it's important to maintain a persistent and observant role, to be certain these good health habits continue.

A scientific paper in the journal Pediatric Dentistry revealed that children who wait to have their first dental visit until age two or three are more likely to require restorative and emergency visits. Establishing good oral health and preventive care early can save money and preserve oral health for a lifetime.

Dr. Benjamin Coon, D.D.S.

Glenwood Meadows Dental

40 Market Street, Suite A

Glenwood Springs, CO  81601

970-947-1717

www.gmeadowsdental.com

Toothpaste 101

 

Dr. Benjamin Coon, D.D.S.

To keep your mouth healthy between dental appointments, at-home dental hygiene habits are critical. Brushing and flossing are the foundations of dental hygiene. To integrate these good habits at home among all family members, quality toothpaste is an essential element. Selecting the right toothpaste for you and members of your family is important.

Toothpaste doesn't just polish teeth; it also removes the bacteria that cause dental plaque and bad breath. As dental plaque bacteria meet with food, they create an acid that attacks teeth and eventually causes tooth decay. A build-up of dental plaque bacteria can cause several other dental problems including gum disease. These microorganisms also produce volatile sulfur molecules which are a source of bad breath.

Toothpaste's ingredients help control mouth bacteria and fight dental problems. Most toothpastes contain detergents that create a foaming action to better remove food particles and dental plaque. Abrasives add a little extra cleaning power to help remove stains but can damage tooth enamel when used too vigorously. Breath fresheners are also commonly added to make your mouth feel clean, and added flavors keep your toothpaste from tasting bland. But the most important ingredient is fluoride, which helps prevent cavities and promote tooth health.

There are many types of toothpastes on the market. Each is designed to fit individual needs:

• Whitening Toothpaste: Teeth whitening toothpastes don't actually whiten teeth; they use scrubbing materials or chemicals to remove tooth stains.
• Tartar Control Toothpaste:  Likewise, tartar control toothpastes don't remove dental tartar, but they do help prevent dental tartar from accumulating. Dental tartar can only be removed by a dentist, so it's beneficial to start using tartar-control toothpaste after a dental checkup.
• Desensitizing Toothpaste: Tooth sensitivity often results from weakened enamel or the exposure of roots due to receding gums. Desensitizing toothpastes work by creating a barrier and blocking irritants from reaching the nerves.
• Fluoride Toothpaste:  Fluoride is important to your dental health and can be added to any type of toothpaste. Not only does fluoride strengthen teeth against dental cavities but it remineralizes teeth worn by acid and fights sensitivity. Fluoride toothpaste is an excellent choice for those who need a little extra help protecting themselves from cavities, particularly children and seniors. Fluoride toothpastes are also recommended for those without the benefit of community water fluoridation.
• Gum Health Toothpaste: Dental plaque found under the gum line can lead to gum disease. Although gum health toothpastes are not a professional gum disease treatment, they can control dental plaque and help prevent the possibility of gum disease in the future.
• Fresh Breath Toothpaste: Like many mouthwashes, fresh breath toothpastes are designed to mask bad breath but do not actually treat halitosis.
• Natural Toothpaste: For those who are uncomfortable brushing with chemicals, natural toothpastes may be an option. These contain all-natural ingredients but have varied results. Some natural toothpastes may not contain fluoride, so check the label before buying the product.
• Children's Toothpaste: These toothpastes have been developed to meet the special needs of children. As children are extremely susceptible to dental cavities, their toothpastes often contain fluoride. Younger children should only use a small amount of toothpaste to avoid ingestion and prevent dental fluorosis, and should be always supervised during brushing.
• Baking Soda Toothpaste: Baking soda has traditional significance because it was once used to clean teeth. Some prefer it because they enjoy the fresh feeling they get after brushing with it.
• Gels: Some gels contain mouthwash which may be why some prefer the consistency or taste of a gel over a toothpaste. While gels may make your mouth feel fresher, there's no proof that they clean teeth better than toothpastes. Also, many gels do not contain fluoride.

Picking the perfect toothpaste out of the hundreds available can be daunting. Look for the American Dental Association (ADA) seal of approval. This symbol shows that the manufacturer has participated in a voluntary testing program conducted by the ADA to gauge the product’s safety and effectiveness.

In addition to selecting the right toothpaste, it is also important to brush properly. Here are five important brushing tips:

•  Brush for at least two minutes
• Use a pea-sized amount of paste
• Find a toothpaste for your needs; usually a soft bristle brush is ideal for both children and adults
• Tilt your toothbrush at a 45-degree angle towards the gums and use short, circular strokes. Small children without well-developed fine motor skills will need assistance with this.
• Brush at least twice a day.

Toothpaste is a significant part of your oral hygiene routine, but remember it's just one part of your oral health care regimen. Brushing must be combined with other aspects of dental care including flossing, a good diet and regular dental visits.

Dr. Benjamin Coon, D.D.S.
Glenwood Meadows Dental
40 Market Street, Suite A
Glenwood Springs, CO  81601
970-947-1717
www.gmeadowsdental.com

Dental Anxiety and Fears: Handle with Care

Dr. Benjamin Coon, D.D.S.

Statistics show that at least one in ten Americans suffer from dental anxiety. Dental anxiety, or dental phobia, is more serious than just getting sweaty palms at the thought of going to the dentist: it's a paralyzing fear of dentists or dental treatment. If this sounds like you, keep in mind that you don't have to avoid getting the dental care you need. There are many dentists who have the tools, techniques, communication and compassion to help make regular dental visits more comfortable and relaxing for you.

Dental fear may stem from prior painful or negative experiences, feeling helpless or out of control in a dental office situation, feeling embarrassed about neglecting your teeth, or the fear of being ridiculed about neglecting your teeth. The health consequences of dental anxiety are very real and can be quite serious. In fact, if you put off dental visits, your teeth and gums can become chronically infected. This can affect your ability to chew and digest properly, affect speech patterns, and even lead to heart disease. Fortunately, there are strategies to overcome your dental angst.

Please level with your dentist about your unease, and ask for time to discuss your anxiety outside the "chair". Dentists are trained to address and work through fearfulness and patient apprehension. Through empathetic listening, thorough explanation and education, and a predetermined agreement or a "sign" for when to stop or take a break, a caring dentist can mitigate these common patient concerns:

• Injection, pain or noise anxiety

• A fear of gagging or choking

• Concern that the dentist will not stop when asked, or allow for frequent breaks

• A feeling of loss of control in the dental chair

• A concern about being tipped back in the dental chair

•  A lack of knowledge about treatment options and what to expect as they are carried out

• A concern about a medical emergency during treatment, and

• Other health issues that impact dental treatment.

There are other strategies that help combat dental anxiety. Many patients find that sedation dentistry, yoga breathing and relaxation techniques, listening to music on an mp3 player or watching TV during a visit, or undergoing therapy and hypnotherapy sessions has helped them overcome their fears. Dental anxiety is not insurmountable. A skilled and caring dentist can ensure a comfortable treatment and help instill confidence in even the most tentative patients.

Dr. Benjamin Coon, D.D.S.
Glenwood Meadows Dental
40 Market Street, Suite A
Glenwood Springs, CO 81601
gmeadowsdental.com

Dental Health Benefits of Xylitol Sweetened Chewing Gum

Dr. Benjamin Coon, D.D.S.

Xylitol is a naturally occurring carbohydrate. It is found in fibrous vegetables and fruit, like raspberries and cauliflower. It also occurs naturally in our bodies; an average size adult manufactures up to 15 grams of xylitol daily during normal metabolism. Pure xylitol is a white crystalline substance that looks, pours and tastes like sugar.

It is an excellent alternative to sugar as a sweetener. Xylitol is slowly absorbed and partially utilized by our bodies, so the functional calories are 2.4 calories per gram;  about 40% less than other carbohydrates. In addition, the body does not require insulin to metabolize xylitol, which makes it an excellent sweetener for diabetic diets. But one of the best benefits of xylitol is that it is a cavity fighter, and it's widely available in several different sugar free chewing gum brands.

Over 25 years of clinical trials confirm that xylitol use reduces tooth decay rates both in high-risk groups (high caries, or tooth decay prevalence, poor nutrition, and poor oral hygiene) and in low-risk groups (low caries incidence using all current prevention recommendations). Sugar free chewing gums and candies made with xylitol as the principal sweetener have already received official endorsements from six national dental associations. 

Tooth decay happens when bacteria in your mouth consume the sugars we eat. When you eat food containing ordinary sugar (sucrose), it gives bacteria on your teeth energy, allowing them to multiply and start making acids that can eat away the enamel on the teeth. This "acid attack" causes tooth decay and cavities to begin to form.

Xylitol is a natural sweetener derived from plants. It does not break down like sugar and can help keep a neutral pH level in the mouth. Xylitol also prevents bacteria from sticking to the teeth. This is how it protects the teeth from tooth decay. With xylitol, the acid attack that would otherwise last for over half an hour is stopped. Most people are not aware of this benefit because such a claim makes xylitol into a drug, crossing a boundary not allowed by the Food and Drug Administration.

Because the bacteria in the mouth that are causing cavities are unable to digest xylitol, their growth is greatly reduced. The number of acid-producing bacteria may fall as much as 90%. No acid is formed because the pH of saliva and plaque does not fall. After taking xylitol, the bacteria do not stick well on the surface of the teeth and as a result, the amount of plaque decreases.

Research has also shown that the use of xylitol helps repair damage to the enamel. Saliva in itself protects the mouth and teeth. Stimulated saliva in particular contains all the components needed to repair early cavities. If sugar is only eaten a couple of times a day, the saliva can do the job alone. But most people take sugar so often that the mouth's own defensive tools are not enough.

Saliva that has xylitol is more alkaline than saliva stimulated by other sugar products. After taking xylitol products, the concentration of basic amino acids and ammonia in saliva and plaque may rise, and plaque pH rises as well. When pH is above 7, calcium and phosphate salts in saliva start to move into those parts of enamel that are weak. Therefore, soft, calcium-deficient enamel sites begin to harden again.

Have a look at the sugar free gum products on the market. With the exception of Trident Layers, all of Trident's gums contain xylitol, including Trident Extra Care, regular Trident and Trident Splash. There are several other varieties available. For children ages four and up, and all adults, chewing gum with xylitol is a great thing to do to maintain dental health.

Dr. Benjamin Coon, D.D.S.

Glenwood Meadows Dental

40 Market Street, Suite A

Glenwood Springs, CO  81601

970-947-1717

www.gmeadowsdental.com