Root Canal Therapy

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection.  In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed.  Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:

  • An abscess (or pimple) on the gums.
  • Sensitivity to hot and cold.
  • Severe toothache pain.
  • Sometimes no symptoms are present.
  • Swellingand/or tenderness.

 

Reasons for root canal therapy:

  • Decay has reached the tooth pulp (the living tissue inside the tooth).
  • Infection or abscess have developed inside the tooth or at the root tip.
  • Injury or trauma to the tooth.

 

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.  An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria.  If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials.  A filling will be placed to cover the opening on top of the tooth.  In addition, all teeth that have root canal treatment should have a crown (cap) placed.  This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.

You will be given care instructions after each appointment.  Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

 

Dentures and Partial Dentures

A denture is a removable dental appliance replacement for missing teeth and surrounding tissue.  They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures - complete and partial dentures.  Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain.  A Partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

A Complete denture may be either “conventional” or “immediate.”  A conventional type is made after the teeth have been removed and the gum tissue has healed, usually taking 4 to 6 weeks.  During this time the patient will go without teeth.  Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process.  Once the tissues shrink and heal, adjustments will have to be made.

Dentures are very durable appliances and will last many years, but may have to be remade, repaired, or readjusted due to normal wear.

Reasons for dentures:

  • Complete Denture - Loss of all teeth in an arch.
  • Partial Denture - Loss of several teeth in an arch.
  • Enhancing smile and facial tissues.
  • Improving chewing, speech, and digestion.

 

What does getting dentures involve?

The process of getting dentures requires several appointments, usually over several weeks.  Highly accurate impressions (molds) and measurements are taken and used to create your custom denture.  Several “try-in” appointments may be necessary to ensure proper shape, color, and fit.  At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will subside as your muscles and tissues get used to the new dentures.

You will be given care instructions for your new dentures.  Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures. 

 

Composite Fillings

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc.  The decayed or affected portion of the tooth will be removed and then filled with a composite filling. There are many types of filling materials available, each with their own advantages and disadvantages.   Composite fillings are the most widely used restoration today.  Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced.  They are very durable, and will last many years, giving you a long lasting, beautiful smile.

How are composite fillings placed?

Composite fillings are usually placed in one appointment.  While the tooth is numb, your dentist will remove decay as necessary.  The space will then be thoroughly cleaned and carefully prepared before the new filling is placed.  If the decay was near the nerve of the tooth, a special medication will be applied for added protection.  The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling. 

You will be given care instructions at the conclusion of your treatment.  Good oral hygiene  

 

Porcelain Crown

A crown is normally recommended to restore a tooth to its normal shape and size. A crown can make your tooth stronger and improve its appearance. A crown can cover and support a tooth with a large filling when there isn't enough tooth structure left.   It is a good way to cover teeth that are discolored or badly shaped. It's also used to cover a dental implant. Crowns are made by a lab technician and thus will usually require two visits to complete the work.  

 

Porcelain Veneers

Many practices only perform a few veneers a year and therefore lack the artistic eye and skills that come from performing them almost weekly. Dr. Paglia's sense of proportion and aesthetics is highly developed and refined and the results speak for themselves.

Veneers are thin pieces of  tooth shaped porcelain that are custom made (for shape and color) by a lab working from a model provided by your dentist. They are bonded onto the front of teeth to create a beautiful and attractive smile

Veneers can help to create a whiter, brighter and straighter smile. As with most dental restorations, veneers are not permanent and may someday need replacement.  They are very durable and will last many years, giving you a beautiful long lasting smile.

Reasons for porcelain veneers:

  • -To create a white, beautiful smile.
  • -Crooked teeth.
  • -Misshapen teeth.
  • -Severely discolored or stained teeth.
  • -Close Space or relieve crowding.
  •  -Worn down or chipped teeth.

 

Teeth Whitening (at our office) 

If you are a candidate for bleaching we may suggest a procedure that can be done in our office. This procedure is called chair side bleaching and takes about 30 minutes to one hour    though though may require more than one office visit. So what does it entail?

With chair side bleaching we administer a protective covering to your gums then apply to the teeth a strong bleaching agent, which is reapplied every 15 minutes.  It is common to have some sensitivity to cold or biting even for up to a week after bleaching. Sensitivity is usually mild and should not stop a patient from gaining the benefits of whitening.  

 

Teeth Whitening (at home)

There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter.

Bleaching solutions-These products contain peroxide(s), which actually bleach the tooth enamel. These products typically rely on percent carbamide peroxide as the bleaching agent; carbamide peroxide comes in several different concentrations (10%, 16%, and 22%).

Peroxide-containing whiteners typically come in a gel and are placed in a mouth guard. Usage regimens vary. Some products are used for about twice a day for 2 weeks, and others are intended for overnight use for 1-2 weeks. If you obtain the bleaching solution from your dentist, he or she can make a custom-fitted mouth guard for you that will fit your teeth precisely. Currently, only dentist-dispensed home-use 10% car amide peroxide tray-applied gels carry the ADA Seal.

You also may want to speak with your dentist should any side effects become bothersome. For example, teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. Some people also experience soft tissue irritation—either from a tray that doesn't fit properly or from solution that may come in contact with the tissues. If you have concerns about such side effects, you should discuss them with your dentist.

Toothpastes-All toothpastes help remove surface stain through the action of mild abrasives. "Whitening" toothpastes in the ADA Seal of Acceptance program have special chemical or polishing agents that provide additional stain removal effectiveness. Unlike bleaches, these ADA Accepted products do not alter the intrinsic color of teeth.  

 

Fixed Bridges

A dental bridge is a non-removable restoration used to replace missing teeth.    The most popular type is usually made of porcelain fused to metal.  Porcelain fixed bridges are most popular because they resemble your natural teeth.  This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.

Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.  Fixed bridges are made by a lab technician and thus will usually require two to three visits to complete the work.

Reasons for a fixed bridge:

  • -Fill space of missing teeth.
  • -Prevent remaining teeth from drifting out of position.
  • -Restore chewing and speaking ability.
  • -Restore your smile.
  •  -Upgrade from a removable partial denture to a permanent dental appliance.