Root Canals: What Exactly Are They, And Why Do I Need One?

Root Canals: What Exactly Are They, And Why Do I Need One?

The words root canal might possibly be the two most feared words in dentistry by patients. Root canals have had a negative connotation in patient’s minds for years, and the way they were done in the past, we aren’t surprised at all. In any movie or television show you see, if the words root canal are uttered, there is always a reference to how painful they are, or what a nuisance they are to have done. And any time you talk to someone that has had one done, they never have a positive story to tell about the experience.

It is true, root canals in the past haven’t been a pleasant experience for patients to go through. First, if you need a root canal, you are most likely in pain before the root canal is even performed. Secondly, root canals are a very meticulous procedure for a dentist to perform, so sometimes it can be a pretty lengthy procedure.

The good news in all this talk of root canals, is that most of the time, root canals can be totally avoided. Most of the time, a root canal is needed when a tooth has decay present, and that decay has been present for so long that the decay has eaten away at the enamel and dentin of the tooth and has reached the pulp chamber, or nerve, of the tooth. When decay reaches the pulp chamber it starts to infect the pulp, when that happens, an abscess starts to form under the tooth and creates a lot of pressure pushing on the tooth. That pressure equates to pain in the tooth, and can become very uncomfortable.

If the decay is caught before it reaches the nerve, a simple filling can be done. Resulting in a lot less sensitivity, a lot less cost, and the procedure itself is a lot less invasive, and a root canal can be avoided altogether. There are factors, other than decay reaching the neve, that lead to root canals as well. The most common being trauma.

If a tooth is traumatized (i.e. hit with a ball playing a sport, as the result of a car accident, etc.) the nerve inside the tooth could die, and the tooth might start to turn gray. If this happens, the graying can be reversible. What the dentist would need to do in this case, is perform the root canal to remove the necrotic root, and place a bleaching pellet inside the tooth. This pellet will whiten the tooth from the inside out. This tends to take a few visits to complete, with the dentist changing the bleaching pellet each time you come in, and then placing a filling over the access hole once it is done.

Sometimes, patients are apprehensive about getting a root canal done, simply because they don’t know exactly what it is. We wanted to dispel any apprehension by letting all of you know what exactly a root canal entails. A root canal starts out very similar to having a filling done, and you will be extremely numb, so you won’t feel a thing. The doctor will remove the decayed part of the tooth.

They then clean the nerve out of the pulp chamber, effectively relieving the pressure that was built up from the abscess. In the past, dentists used hand files to do this, and that is where most of the apprehension came from with patients. Performing a root canal with hand files takes a long time, and the hand files aren’t the most pleasant to look at. Thankfully, here in our office, we have new technology in the form of the Wave One Reciprocating Endodontic System. What that does is that it automates the file process, and cuts the length of the filing process pretty much in half. It also is a lot more pleasant to deal with than the hand files that we used a few years ago, and that most dentists still use today.

Once the nerve has been removed and the canals have been cleaned, the dentist then fills the canals with a substance called gutta percha. Gutta percha is a rigid natural latex derived from trees. Gutta percha is used to fill the canals because of its biocompatibility, ductility, and malleability, making it the ideal substance for dentists to use. Filling the canals after the root canal is performed is important to prevent them from getting re-infected with bacteria.

The dentist will then fill in the hole that was used to access the canals and build the tooth back up with filling material. This buildup prepares the tooth to be structurally sound enough to place a crown on the tooth. While the tooth is structurally sound with just the buildup done, it is still considered to be in a very fragile state until a crown is placed. The crown provides 360-degree coverage and protection for the very fragile tooth underneath, and is an essential part of the root canal process.

The alternative to having a root canal done, is usually just to have the tooth taken out. While extraction might look like an easier option at the time of treatment. If you choose this route, things get a lot more complicated in the long run. First of all, you will most likely be in more discomfort immediately following an extraction than you will be following a root canal procedure, as there is more trauma to the surrounding jaw and gum tissue during an extraction than a root canal. Then there is always the risk of a dry socket following an extraction, which can be extremely uncomfortable.

Secondly, if you do not replace the tooth that is taken out, you might not be aware of this, but it greatly affects the surrounding teeth and gums. When you chew, the forces of chewing on the teeth that you have stimulates the bone around each tooth, enabling growth and health of the jawbone. When a tooth is missing, there is nothing left to stimulate the bone, so the jawbone begins to break down, or resorb. This lead to issues resorptionsuch as:

  • Changes in your facial profile and distortion of facial features.
  • Surrounding teeth shifting and “tipping” in toward where the tooth is missing – changing your bite and putting extra forces on those teeth and the TMJ, temporomandibular joint.
  • Super-eruption of the opposing teeth – since the opposing tooth has nothing to bite against, it will become loose over time, and eventually will be lost as well.
  • Shifting and misalignment of other teeth – When there is a space created that wasn’t present before, the surrounding teeth will start to shift over time into that space, misaligning all of the other teeth in the mouth, that can normally only be corrected with orthodontics.

Lastly, it is usually more expensive to replace a tooth that has been extracted than it is to get a root canal done. There are a few options to replace a missing tooth, such as an implant, a bridge, and a partial denture, all of which have their own pros and cons associated with them.

So if you have been told that you need a root canal, and are holding off on getting the procedure done because of stories that you have heard from others or the media, give us a call to schedule an appointment so we can bring you in and walk you through the steps so you can see how simple and easy the procedure is. If you have cavities that you have put off getting filled for any reason, call the office and get in before a filling cannot save the tooth anymore. Or if you opted to have a tooth taken out instead of a root canal and have not had the tooth replaced yet, give us a call so we can discuss which option would be best for you.

The whole key, for everyone in general, is to catch issues when they are small and inexpensive. So really, the best way to avoid big expensive procedures is to come in for preventative maintenance as often as possible, and have great home care when you are away from the office, which our hygienists can help you with as well!

“Regular” Cleaning vs. Deep Cleaning

Our hygienist Jamie describes the differences between a “regular” cleaning and a deep cleaning. She also exposes a big secret about dentist offices across the country.

Transcription of video:

One of the biggest questions we get here in our office is, “What is the difference between a “regular” cleaning and a deep cleaning? And we wanted to make this video to help you understand the difference.

First, a “regular” cleaning, known in dental offices as a prophy, is a preventative cleaning done for the purpose of maintaining healthy gums. Healthy gums are firm, pale pink, and there is no bleeding when you brush your teeth. A regular cleaning can only be done when the gums re healthy and there is no presence of gingivitis or periodontal disease.

A deep cleaning, or what is known as scaling and  root planing in most dental offices, is done when a significant amount of bacteria and tartar has built up underneath the gums. A lot of times you cannot see the bacteria or tartar with the naked eye, but it does cause the gums to become puffy, inflamed, and start to bleed.

Last time you were in a dental office, you might have noticed the dentist or hygienist calling out numbers before they started the cleaning. What these numbers are, are measurements of your gums, and it helps the dentist and hygienist to determine the health of the gums. The lower the number the better, and if you hear all threes or under, you are in great shape. When you start to hear fours, fives, and sixes, that means that the bacteria has gotten under the gums and started to create pockets between the teeth and gums, and a deep cleaning needs to be done.

Those are the biggest differences between a regular cleaning and a deep cleaning, and if you have any questions about where you stand, we would be happy to answer them at your next appointment.

What Is Fluoride and What Can It Do For Patients?

Watch our hygienist Nancy describe what fluoride actually is, and the many different applications it has for you at home, and here in our office.

Transcription of video:

Fluoride is a natural mineral that has two properties that help our teeth. It helps fight cavities, and it also helps with tooth sensitivity.

At home, most toothpastes you buy will have fluoride additives already in them, and some mouthwashes as well.

Here in our office we use a fluoride foam, and also a fluoride varnish. The difference between the fluoride here in our office and the fluoride found in over-the-counter toothpaste is that ours comes in a higher dosage.

Both the foam and the varnish are applied after having your teeth cleaned. The foam, which is primarily used for it’s cavity fighting properties, is painted on the teeth, left there for about a minute, and patients are instructed to not eat or drink 30 minutes after the application to help the fluoride to adhere to the teeth.

The fluoride varnish is primarily used for it’s desensitizing properties. The varnish is painted on the teeth in the areas that are sensitive, and left there until you brush your teeth before you go to bed. We have had great results with fluoride varnish helping patients with sensitivity issues.

And that, my friends, are the ways that fluoride benefits both you and me.

What’s The Deal With Flossing? Do I or Don’t I?

What’s The Deal With Flossing? Do I or Don’t I?

So, everyone in dentistry has been in a heated discussion over the past week and a half. The genesis of the discussion was when the Associated Press released an article last week titled ‘Medical Benefits Of Dental Floss Unproven’, and everyone lost their collective minds. Patients ran screaming through the streets as if they had won the lottery, and many dentists curled up in corners of their dental oflossmemeffices, sobbing uncontrollably, while article after article was released on the subject:

‘Forget the floss? Not so fast.’ ‘Flossing dilemma solved.’ ‘So, does Michael Phelps believe in flossing?’ Really? ‘Do we really need to floss? Dentists say yes, science says no.’ ‘Sorry Haters, You Do Have To Floss’ and on and on, so of course, we wanted to weigh in too.

In the original AP article, the author, Jeff Donn writes, “The federal government has recommended flossing since 1979, first in a surgeon general’s report and later in the Dietary Guidelines for Americans issued every five years…When the federal government issued its latest dietary guidelines this year, the flossing recommendation had been removed, without notice.”

I don’t know about any of you, but I am not leaving my teeth in the hands of the federal government. And if you stop flossing, your teeth will eventually end up in someone’s hands because they won’t be in your mouth for very much longer. Our opinion matches up with that of Matthew Messina DDS, “The dietary guidelines removing flossing actually kind of makes sense. Floss is not a food or drug. I don’t need federal guidelines to include flossing.”

Thankfully, some members of the dental community, and actual dentists that went through dental school, like Dr. Messina, continued to weigh in on the topic. The American Dental Association released a statement saying, “Interdental cleaners, such as floss are an essential part of taking care of our teeth and gums. Cleaning between teeth removed plaque that can lead to cavities or gum disease from the areas where a toothbrush can’t reach.”

The AP report goes on to say, “In a letter to the AP, the government acknowledged the effectiveness of flossing had never been researched.” We thought it was self-explanatory that toothbrushes by themselves couldn’t clean the surfaces between the teeth, and that you needed floss to get in and clean those surfaces sufficiently, and Ronald Goldstein DDS, author of ‘Change Your Smile’ agreed, “It was so obvious centuries ago that flossing is necessary to help clean the teeth that it didn’t take research to prove it. They’re saying there are not sufficient long-term results with the flossing, there’s no evidence to support it, but logic takes over sometimes from lack of evidential research.”floss

To sum up our stance, plaque and food particles still get in between your teeth, and really the only way to get them out is to floss. So, yes, it is our recommendation that everyone still flosses, even though we know that is NOT what anyone wants to hear. If you still aren’t convinced, give us a call here at the office at 602-993-4200 or bring it up next time you are in for your appointment.

Soak The Doc Campaign

Soak The Doc Campaign

Whew! Monsoon season in Phoenix is a tough time to keep cool. Here we are mired in triple-digit temperatures, and if that isn’t enough, the humidity has finally shown up. To put it nicely, it is miserable outside right now. So much so, in fact, that the dentists here at Legacy Dental Group, Dr. Louis Core and Dr. Julie Brann, have agreed to participate in our ‘Soak The Doc’ campaign.

The ‘Soak The Doc’ Campaign is something new that we are doing this summer. We knew that our docs were laid back and fun, so we asked them to participate, and they took it and ran with it. So what the campaign is, is this:

When you are here for your appointment,

soakthedoc2
A drop in the bucket.

all you have to do is take a selfie. It can be just of yourself, or with  one of our great team members, and then tag our location and post it to one of your social media accounts with the hashtag #branncorewaterwar. Each time a patient posts a photo, we get to add a drop to the bucket, and once the bucket is full, we get to soak the docs! To add a little incentive to the campaign, Dr. Core went out and got a $100 Visa gift card, and once the bucket is full, we will randomly be picking a winner for the gift card.

One problem we are having is exactly how we are going to soak the docs, and this is where you guys come in. How should we soak the docs? Super Soakers? Water balloons? Ice Buckets over the head? Nothing is off limits, and we could use some suggestions. Comment below about how you would like to see us soak the docs, and the best idea will get to watch our docs get soaked in the manner they suggested!

Stay tuned or pictures and videos of the event. I know that all of us here are looking forward to it!

Introducing Dr. Julie Brann

Introducing Dr. Julie Brann

We are so excited to announce the newest member of our dental team, Dr. Julie Brann. Dr. Core has been on an exhaustive search for the past few months to find the exact right person to join our team, and we have finally found her!

Most of your know that our office is open 6 days a week, Monday through Saturday, but what you may not know is that Dr. Core has been working all six days by himself for the past 8 months. None of us know  how he has been able to keep up that pace, but he has been nothing short of amazing during this time. Dr. Brann will be taking over on Fridays and Saturdays for him going forward, and working alongside him during the week and Tuesdays, Wednesdays, and Thursdays.

We first met Dr. Brann while she was in her residency at the St. Vincent DePaul Lutheran Medical Center here in Phoenix in early 2016. We were so impressed with her clinical knowledge and her level of dentistry that she was performing, we know that she was going to be the right fit for us. The only issue was that she was not available to start until July due to her obligations with her residency. So, Dr. Core pushed on, working six days a week, until Dr. Brann was available because he knew she would be a perfect fit for us.

An Advanced Education in General Dentistry Residency is a year-long program that less than 5% of all dentists enter after they graduate dental school. It is reserved for the most talented dentists in their class, and only for dentists that are dedicated to furthering their education and learning the latest techniques in dentistry. As stated above, Dr. Brann completed her residency at the St. Vincent DePaul Lutheran Medical Center after finishing dental school at Tufts University in Boston, MA. Before Tufts, Dr. Brann received her Bachelor of Science degree in Biology at Oakland University in Eastern Michigan where she is originally from.

What we love most about Dr. Brann is her compassion for her patients. She has completed mission trips to Rajahmundry, India in 2011, and Port-Au-Prince, Haiti in 2014 providing dental treatment to underprivileged children and adults who were without access to dental care. She has carried that compassion throughout her residency, and through to her work here at our office.

Dr. Brann has only been a Phoenician for a little over a year, so when she is not here in the office seeing patients, she is out exploring what Phoenix has to offer with her husband Glen. You can also catch her cheering on her beloved Michigan Wolverines, but we will convert her to a Sun Devil fan in no time at all!

7 Dental Procedures You Didn’t Know Medical Insurance Will Pay For

7 Dental Procedures You Didn’t Know Medical Insurance Will Pay For

If you have read some of our past blogs, you will know that most dental insurance companies haven’t raised their dental benefit levels since their inception back in the mid-1960’s. The maximums were $1000 a year back then, and most continue to be $1000 today.

The dental insurance companies keep raising their premiums, and the fees of the dental procedures as cost of living and inflation goes up, but the yearly maximum has stayed stagnant at right around $1000 for the last 50 years.

To get an idea of how things have changed since the beginning of dental benefits and now, the cost of a new house back in 1965 was $13,600, the cost of a new car was $2,650, and the average income was $6,450 a year. Back then, $1000 covered a lot of dentistry, but today, it barely covers procedures needed to treat one tooth.

More and more dental offices these days are turning toward medical insurance to help their patients supplement the dental treatment they need. This was very rare a few years ago, but many offices have learned that almost all of the medical insurance companies will pay out for procedures done in a dental office, as long as the procedures fall under the scope of the dentist’s license.

Since a lot of dental offices don’t bill anything to medical insurance, most patients don’t know that they can use their medical insurance toward their dental treatment. It can get tricky at times because not every procedure can be billed to medical insurance. The following procedures though, can:

Exams and Consultations

Whether it be a new patient exam, a periodic exam that is done in conjunction with a cleaning appointment, an emergency/limited exam, or a consultation, these can all be sent to medical insurance.

X-rays

Any x-rays taken in a dental office can be sent to medical insurance because they are diagnostic in nature.

Cone Beam CT Scans

Cone Beam CT Scans are usually taken in conjunction with the need for an implant or to extract wisdom teeth, these are also diagnostic in nature, so can also be sent to medical insurance.

Oral Surgery

Not all oral surgery is done by an oral surgeon. While oral surgeons have been billing medical insurance for years, some things done in a general dental practice can also be sent to medical insurance. Any type of extraction, including wisdom teeth can be sent to medical insurance, as well as any type of bone graft.

Trauma

Any procedure that is done in a dental office that is a result of any type of accident (car accident, workman’s comp, etc.) can be billed to medical insurance, whether they are dental in nature or not. For example, if you break a couple of teeth in a car accident, one tooth needing a filling and the other a crown, both of these procedures can be sent to medical insurance because they were caused by the trauma from the accident.

Night Guards

Night Guards are very effective for people who clench and grind their teeth at night. These guards protect the teeth, and even the restorations like crowns and fillings against harmful night time grinding and clenching. These guards are considered medical equipment by medical insurance companies, and often times are paid for at 100%, rather than the 80% or 50% that dental insurance usually pays.

OSA (Obstructive Sleep Apnea) Appliances

There have been a lot of advances in dentistry over the past decade, but none more-so than for Obstructive Sleep Apnea. Before these advances, most people needed to be hooked up to a large and invasive CPAP machine. With the advances that have been made, sleep apnea can (most of the time) be managed by wearing an appliance very similar to the night guard mentioned above, and is a lot more comfortable to wear than the facemask to a CPAP machine.

These appliances are also considered medical equipment, much like the night guards are, and are covered at 100% a lot of times as well. Although in most cases a sleep study is required to prove medical necessity, but one can be obtained very easily.

Bring your medical insurance card to your next dental visit to see if you can take advantage of using your medical insurance to supplement your dental treatment. Doing so will open up your dental benefits so that you can apply them to procedures that are more dental in nature like crowns, root canals, and dental implants. Call 602-993-4200 today or visit our website to see how we can help you use your medical insurance at the dental office.