Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
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We now have amazing therapies to replace lost teeth with life-like replicas that look and perform like real teeth. But for oral health in general it’s still better to save a natural tooth if we can.
That’s the main purpose of a root canal treatment — to rescue a tooth whose pulp (an area of tissue and nerve bundles inside the tooth) has died from trauma or ravaged by a bacterial infection that continues to progress up into the bone via the root canals. By accessing the pulp through a small opening in the top of the tooth we remove the dead and infected pulp tissue, thoroughly disinfect the empty pulp chamber and root canals, and then fill them with a special filling. We then seal the opening (and later install a permanent crown) to prevent future fracture of the tooth and re-infection.
So, how can you know your tooth is in danger? Your first indication may be an intense tooth pain that comes on quickly. This pain is emanating from the nerves in the pulp as the tissue begins to die. Once the nerves have died, they will no longer transmit pain signals: hence the pain will subside rather quickly in about two or three days.
So it is important to understand that the absence of pain doesn’t mean the infection has subsided — quite the contrary, it’s still present and active, making its way along the root canals of the tooth. At this point you may begin to notice a secondary pain when you bite down on the tooth. This is originating from other nerves located around the periodontal ligament (the main tissue that helps hold teeth in place with the bone) as the tissues become inflamed from the infection. You may also develop an abscess, an area in the gum tissue where infectious pus may collect. Depending on its location, the abscess can be acutely painful or “silent,” meaning you may not feel any pain at all. The infection is still there, though, and the tooth is still in danger.
If you encounter any of the pain symptoms just described, you should visit us for an examination as soon as possible. If the cause indicates the need for a root canal treatment time is of the essence — the longer we delay, the greater the risk of ultimate tooth loss.
If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Signs and Symptoms of a Future Root Canal.”
Is it a root canal problem, a gum infection, or both?
Sometimes it's difficult to pinpoint the source of tooth pain; it can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Identifying the origin of a toothache is important, however, so we can choose the right treatment and do all that we can to save the tooth.
When a tooth becomes decayed, bacteria can infect the sensitive, living nerve tissue deep inside the tooth known as the root canal. This condition is called an endodontic (“endo” – inside; “dont” – tooth) problem. The infection inside the tooth can spread to the periodontal ligament (“peri” – around; “dont” – tooth) that encases the tooth and attaches it to the jawbone. Occasionally, infection of endodontic (root canal) origin can spread out from the end of the tooth root all the way up the periodontal ligament, and into the gum.
The reverse can also happen: dental pain can originate from periodontal (gum) tissues that have become diseased. Gum disease is caused by a buildup of bacterial biofilm (plaque) along the gum line. It results in detachment of the gums along the tooth surface. In advanced cases, this bacterial infection can travel into the nerve tissues of the dental pulp through accessory canals or at the end of a tooth.
To figure out where pain is coming from when the source is not obvious, we need to take a detailed history of the symptoms, test how the tooth reacts to temperature and pressure, and evaluate radiographs (x-ray pictures).
Unfortunately, once dental disease becomes a combined periodontal-endodontic problem, the long-term survival of the tooth is jeopardized. The chances for saving the tooth are better if the infection started in the root canal and then spread to the gums, rather than if it started as gum disease that spread into the root canal of the tooth. That's because in the latter case, there is usually a lot of bone loss from the gum disease. Effectively removing plaque from your teeth on a daily basis with routine brushing and flossing is your best defense against developing gum disease in the first place.
If you would like more information about tooth pain, gum disease or root canal problems, please contact us or schedule an appointment for a consultation. You can also learn more about this diagnostic dilemma by reading Dear Doctor magazine's article “Confusing Tooth Pain.”
Don't ignore tooth pain hoping it goes away. No matter how mild or fleeting it may be, it's a sign that something's wrong. Healthy teeth shouldn't cause discomfort because the parts containing the nerves — the interior pulp and the dentin around it — are shielded by dental enamel and gums.
Here are some common reasons that teeth ache:
As you can see, it's risky to discount tooth pain and “wait ‘til it goes away.” Our office can help you determine the origin of your pain and the best course of action to resolve it. When in doubt, it's always better to err on the side of caution!
If you would like more information about tooth pain and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Sensitive Teeth.”