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Posts for: July, 2014

AlternativestoRootCanalTreatmentCanSaveanInjuredImmatureTooth

When a permanent tooth has been injured, our first priority should be to save it. A root canal treatment (where the interior pulp of the tooth is removed and the pulp chamber and root canals are filled and sealed) is usually the best approach for tooth preservation.

An immature permanent tooth, however, presents a different challenge. While the pulp is less essential to a mature tooth’s vitality, it serves a critical purpose in the tooth’s early development before early adulthood. The pulp produces layers of dentin necessary for the tooth’s root system development. Completely removing the pulp at this stage may retard root development and cause the tooth to eventually weaken, and become brittle and darkened.

For younger teeth, we should therefore use alternative techniques that preserve as much healthy pulp as possible. One of these alternatives is Indirect Pulp Therapy, used when the pulp hasn’t been exposed by the trauma. With this technique we remove as much damaged dentin as possible while preserving the harder dentin closer to the pulp. After applying an antibacterial agent to protect against infection, and then filling and sealing the tooth, the pulp can continue to produce dentin in a normal way.

If pulp exposure has occurred, some form of pulpotomy — the partial removal of any damaged or infected pulp — would be in order. Our goal here is to leave as much of the pulp as possible, and then apply substances that stimulate the remaining pulp to create dentin. The most common type of growth substances are calcium hydroxide or mineral trioxide aggregate (MTA).

If the pulp isn’t at all salvageable, we may then turn to a procedure known as apexification. After removing the pulp we insert MTA at the root end of the tooth, then fill and seal the remaining interior as in a regular root canal treatment. The MTA will help the surrounding bone to heal and continue to grow around the root to further support the tooth.

Recent research into pulp stem cells promises further advances in this area. The regenerative qualities of stem cells could eventually help us “engineer” root development. Until then, there are still effective ways to give a young, damaged tooth a fighting chance to survive.

If you would like more information on preserving injured teeth, 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 “Saving New Permanent Teeth After Injury.”


By Aaron M. Bliley, DMD, LLC
July 02, 2014
Category: Oral Health
TheScareThatMadeIronChefCatCoraBelieveinMouthguards

Cat Cora, philanthropist, author, chef, restaurateur and the first female chef on the Food Network's hit series Iron Chef America is a dynamo driven by a desire to change people's lives for the better. And she is no different when it comes to tackling her most challenging role: caring for the needs of her four active young sons. This includes monitoring the food they eat, their oral hygiene habits and protecting their teeth from injuries.

During an interview with Dear Doctor magazine, Cat describes a backyard accident in which one of her boys, Zoran, was accidentally knocked in the mouth by another child while jumping on the family's trampoline. While her son was not seriously injured, it did cause her to take proactive steps to avoid future injuries. She had her dentist make a custom-fitted mouthguard to protect his newly erupted adult teeth. He now wears the mouthguard while on the trampoline and when playing soccer.

If you and/or your children routinely participate in contact sports — boxing, football, hockey, lacrosse, soccer, water polo, rugby and basketball, for example — or other forms of vigorous physical activity, you too should consider getting a professionally made mouthguard. A properly fitted mouthguard can help prevent injuries to the jaws, lips and teeth. And unlike those cumbersome “boil and bite” mouthguards you can purchase at a drugstore, the ones we make will stay in place, making it easier for you to breathe and talk.

If you are still not convinced, consider these facts: According to the American Dental Association, an athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard. And the US Centers for Disease Control reports that sports-related dental injuries account for more than 600,000 visits to the emergency room each year. Furthermore, people who do not have a knocked out tooth properly reserved or replanted may face a lifetime cost of $10,000 to $20,000 per tooth, according to the National Youth Sports Foundation for Safety.

To learn more about mouthguards, continue reading the Dear Doctor magazine article “Mouthguards.” Or if you are interested in obtaining a mouthguard for yourself and/or your child, contact us today to schedule an appointment. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”