A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form. The crown of
the tooth is the part above the gum line and the part you can see. It is made up of outer hard protective layer of Enamel, a more sensitive layer underneath called Dentin and at the heart of the tooth, is a
hollow chamber filled with blood and nerve tissue called the Pulp.
Bacterial Invasion The pulp is responsible for supplying the tooth with nutrients, keeping it alive. When bacteria enters the pulp of the tooth either through a cavity, a fracture, an old or loose filling or even sometimes through
the gum, the pulp reacts by becoming inflamed. If left untreated, the inflammation in the pulp chamber can result in throbbing pain and swelling in the mouth.
The infection may spread through the openings at tips of the root, forming an abscess in the bone supporting the tooth. The swelling may also cause swelling in the ligaments holding the tooth to the bone making
it feel loose. During a root canal procedure, the decay is removed, and the nerve and pulp are removed from the tooth’s roots. The canals are cleaned and disinfected then sealed using an inert material called
gutta percha which occupies the space where the pulp was. Once a tooth is non vital (has had the pulp removed) it can become brittle due to the lack of a blood supply. Once the root canal is completed the outside
of the tooth must also be addressed in order to restore the tooth’s function and aesthetics. Root treated teeth need Reinforcement!
After root canal therapy the tooth should function and feel like other teeth. A root treated tooth will therefore require a crown to protect the tooth from fracture.
Crowns And Bridges
A crown is an artificial restoration that fits over the remaining part of a prepared tooth making it strong and giving it the shape and colour of a natural tooth. A common term for a crown is a ‘cap’. A crown is
placed to improve the appearance of a tooth that is discoloured, stained chipped or damaged. It is also used to protect and strengthen a tooth that has been fractured or weakened by large fillings or root treatments.
Dental bridges literally bridge the gap created by one or more missing teeth. bridge is made up of two crowns one on each tooth on either side of the gap -- these two anchoring teeth are called abutment teeth
-- and a false tooth/teeth in between.
Implant supported crowns, bridges & dentures An implant may be recommended to you by your dentist. A dental implant is placed in the bone and with time, fuses with your natural bone, providing a strong and sturdy foundation for replacement teeth. They
may be used to replace an individual tooth, preventing the need to use adjacent teeth as support, or for an implant supported bridge or denture.
Dental veneers, sometimes called porcelain veneers or dental porcelain laminates, are wafer-thin, custom-made shells of tooth-coloured materials designed to cover the front surface of teeth to improve your appearance.
These shells are bonded to the front of the teeth changing their color, shape, size, or length. (webmd)
Tooth whitening lightens teeth and helps to remove stains and discoloration. Whitening is among the most popular cosmetic dental procedures since it can greatly improve how your teeth look. Whitening is not a one-time
procedure. It will need to be repeated from time to time if you want to maintain the brighter colour. Before you have your teeth whitened it is important for your dentist to evaluate your teeth. The bleaching
process is affected by numerous factors.
Tooth whitening will only lighten natural teeth. Restorations such as fillings, crowns, or veneers will not lighten in the process and may therefore need to be replaced after tooth whitening in order to match
your new and lighter shade.
The presence of decayed teeth, exposed root surfaces and leaking fillings may result in sensitivity during and after the procedure as the gel may pass through the defect into the tooth. These may need to be
addressed prior to tooth whitening.
A composite (white) filling is a tooth coloured material made up of a mixture of plastic and glass and is used to restore decayed teeth or to improve the cosmetics by changing the colour or reshaping disfigured
A composite resin filling is a cost effective way to restore or improve the appearance of a tooth. It is also a time effective method as it is placed in the dental surgery in one visit unlike procedures such
as crowns and veneers that require laboratory time. The material is placed in the tooth in layers which are hardened with a specialised light. Once the filling is placed, it can be contoured and polished to
mimic the appearance and gloss of the original tooth.
Aesthetics are a great advantage of composites, since your dentist can blend shades to create a colour almost identical to the original tooth. The fillings are bonded to the tooth, supporting the remaining
tooth structure, thus helping to prevent breakage and insulating the tooth from temperature changes.
Dentures are used to replace single or multiple missing teeth. They are supported by the surrounding soft and hard tissues of the oral cavity.
Dentures may be partial or full, may be constructed in plastic (acrylic) or metal and are removeable appliances. They are a cost effective alternative to fixed implants, crowns and bridges
When a number of teeth are being replaced, the option of a few well placed implants can help to improve the stability of a denture
Bruxing (Grinding your teeth)
We live stressful lives. Along with other effects of stress like gastric ulcers and headaches, a lot of people tend to either grind their teeth consciously or subconsciously (while sleeping) or clench their jaws.
The natural position of rest when a person is relaxed or sleeping is for the teeth to be slightly apart. In this position the muscles are relaxed and at rest. During grinding or constant clenching, especially
at night, the muscles of the jaw are in constant use, they are contracted or tensed for long periods of time. This muscle tension may result in jaw pain, tiredness when chewing some foods like biltong, temporomandibular
joint clicks and disorders and headaches.
The other more obvious effect is on your teeth. Your dentist is able to see the wear facets created by chronic grinding and will then advise you on how best to prevent further damage. After root canal therapy
the tooth should function and feel like other teeth. A root treated tooth will therefore require a crown to protect the tooth from fracture.
Wear on the occlusal or chewing surfaces of the teeth, causes loss of the protective enamel, exposing the more sensitive dentine layer underneath. This can result in sensitivity when drinking cold liquids and
ultimately may lead to inflammation of the pulp (nerve tissue), an unnecessary cause of pulp necrosis (death) and infection.
Premature wearing of the teeth can also cause teeth to shorten, making one appear older than their age!
How to prevent bruxing? Destress! Your body and in this case, your teeth, are talking to you! Try to reduce or manage tension. Ask your dentist to make a bite plate to protect your teeth and create the space between them necessary
to allow the jaw muscles to rest. There a few types of appliances available and your dentist can help you choose one that is most comfortable for you.
Toothbrush abrasion Another way we seem to take out our frustrations on teeth, is by simply brushing too hard. The enamel is literally brushed away and the underlying sensitive dentine is exposed to the thermal changes in the
mouth making teeth sensitive. The tooth is also exposed to bacteria and acids in the mouth making it susceptible to cavities. Once enamel has been removed, or damaged, the body cannot replace it. These enamel
deficient areas need to be treated by covering them with filling material, a tooth coloured material that will not be seen. The filling will cover sensitive dentine, reducing sensitivity, but will also protect
the tooth from further damage by the toothbrush and by acidic foods and bacteria in the mouth.
Gum Disease (Gingivitis and Periodontitis)
Plaque, a sticky colourless substance full of bacteria, builds up on the teeth causing inflammation or swelling of the gums. That’s why we recommend having your teeth cleaned by a dentist at least twice a year.
With a mild gingivitis (swollen gums), you will find that your gums may bleed when you brush your teeth and your breath may smell bad. Though your gums may be irritated, the teeth are still firm in their sockets.
No irreversible bone or other tissue damage has occurred at this stage.
When gingivitis is left untreated, it can advance to periodontitis. In a person with periodontitis, the inflammation in the gums increases and causes the gum and the bone underneath to detach from the tooth,
forming ‘pockets’ around the teeth. These small spaces between teeth and gums collect debris and can become infected. The body's immune system responds as it fights the bacteria in the plaque as itspreads below
the gum line.
The toxins in plaque together with the body’s inflammatory response, begin to ‘attack’ the supporting tissues of the tooth, the bone and connective tissue. At first, as the bone recedes the root surface is
exposed causing sensitivity. As more and more of the bone is destroyed, the tooth begins to loose support and starts to become mobile or loose in the socket and eventually tooth loss occurs. Gum disease is the
leading cause of tooth loss in adults.
What causes gum disease? Poor oral hygiene habits such as inadequate brushing and not flossing regularly, make it easier for gingivitis to occur. However there a number of other factors that can predispose on to developing gum disease.
These factors include:
Hormonal changes due to pregnancy, menstruation, stress
Underlying health issues such as diabetes, cancer and HIV
Certain medications that may reduce the flow of saliva
Familial history of gum disease
Signs and symptoms Swollen gums, persistent bad breath, bleeding when you brush, exposure of root surfaces and loose teeth are all signs that you may have gum disease. Gum disease sometimes only affects certain teeth and often
you may not even notice the signs that you have gum disease. That’s why it is so important to consult your dentist twice a year, only a dentist or a periodontist can recognize and determine the progression of
Treatment The goals of gum disease treatment are to promote reattachment of healthy gums to teeth, to reduce swelling and bleeding, reduce the depth of pockets, eliminate the source of infection through oral hygiene
education, to stop disease progression and prevent tooth loss. Treatment options depend on the severity of the disease. There are both non surgical and surgical options available.
Gum disease can be reversed through adequate plaque control!
Extractions (minor oral surgery)
As a last resort, a tooth may need to be removed if it is severely decayed, is very loose due to extensive bone loss, or if space needs to be created when teeth are over crowded. Partially impacted teeth that cause
food traps and repeated infections may also need to be removed.
Xrays are taken to determine the position of the roots of the tooth. At this point the case is evaluated and if necessary you may be referred to a specialist. In uncomplicated cases, the tooth is removed under
If you have had an extraction, please read and follow the post operative instructions.
Our goal is for your healing process after an extraction to be as comfortable as possible. The removal of teeth is a surgical procedure, and post-operative care is imperative.
Immediately Following Surgery Keep the gauze pad placed over the surgical area with pressure applied by biting down until the bleeding stops. (+- 30 minutes)
Take your prescribed pain medication as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming less effective. Pain or discomfort following surgery should subside
more and more each day.
Do not take Aspirin (Dispirin, Compral, Anadin, Grandpa) as it will increase bleeding.
Don’t rinse your mouth for the first post-operative day or while there is bleeding. Do not suck on a straw, spit, smoke or consume alcohol following surgery. Vigorous mouth rinsing or touching the affected
area following surgery can initiate bleeding caused by dislodging the blood clot that has formed. After the first day, use a warm salt water rinse. Mix a teaspoon of salt into a cup of warm water and rinse every
4 hours and after meals to flush out particles of food and debris that may lodge in the area.
Bleeding - A certain amount of bleeding is to be expected following a surgical procedure. If bleeding has not decreased in 3-4 hours, bite on a dampened tea bag placed directly over the surgical
site. The tannic acid in the tea helps the blood to clot. Tannic Acid is not present in herbal teas.
Swelling is expected after an extraction and varies depending on the type of surgery. Swelling around the mouth, check, eyes, and side of the face is not uncommon. The swelling sometimes may
begin up to 2-3 days post-surgery. You can help to minimize the swelling by applying ice packs to the affected area.
Antibiotics: take the medicine as directed and complete the course. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. NB. If you are taking birth control pills,
they will be inactivated by the antibiotic.
Sutures - If any sutures were required, they will dissolve on their own in 7-10 days. It will not be necessary to return to the office for sutures to be removed unless stipulated.
Diet - It is advisable to eat only soft foods for the first few days following surgery. Avoid hot food or liquid that could agitate the already inflamed area.
Special Considerations- Trismus (stiffness) in the jaw muscles, aching from other teeth due to referred pain, bruising in the area of the extraction are normal but temporary consequences.
Dry Socket - A “dry socket” is the loss of the blood clot in the socket resulting in delayed healing. The discomfort usually begins about the third day after surgery and can present as pain
in the ear, chin, adjacent teeth, and jaw. The cause of a dry socket is unknown, but it can be attributed to the difficulty of the surgery, increased age, medications (such as birth control pills), and smoking.
If pain or swelling persists contact our offices for a follow up appointment.