My Blog

Posts for: September, 2019

YouMayNeedanEndodontistforaToothWithInteriorDecay

You depend on your family dentist for most of your oral care. There are some situations, though, that are best handled by a specialist. If you or a family member has a deeply decayed tooth, for example, it might be in your long-term interest to see an endodontist.

From the Greek words, endo ("within") and odont ("tooth"), endodontics focuses on dental care involving a tooth's interior layers, including the pulp, root canals and roots. While general dentists can treat many endodontic problems, an endodontist has the advanced equipment and techniques to handle more complex cases.

The majority of an endodontist's work involves teeth inwardly affected by tooth decay. The infection has moved beyond the initial cavity created in the enamel and dentin layers and advanced into the pulp and root canals. The roots and underlying bone are in danger of infection, which can endanger the tooth's survival.

The most common treatment is root canal therapy, in which all of the infected tissue is removed from the pulp and root canals. Afterward, the empty spaces are filled and the tooth is sealed and crowned to prevent future infection. General dentists can perform this treatment, primarily with teeth having a single root and less intricate root canal networks. But teeth with multiple roots are a more challenging root canal procedure.

Teeth with multiple roots may have several root canals needing treatment, many of which can be quite small. An endodontist uses a surgical microscope and other specialized equipment, as well as advanced techniques, to ensure all of these inner passageways are disinfected and filled. Additionally, an endodontist is often preferred for previously root-canaled teeth that have been re-infected or conditions that can't be addressed by a traditional root canal procedure.

While your dentist may refer you to an endodontist for a problem tooth, you don't have to wait. You can make an appointment if you think your condition warrants it. Check out the American Association of Endodontists webpage www.aae.org/find for a list of endodontists in your area.

Advanced tooth decay can put your dental health at risk. But an endodontist might be the best choice to overcome that threat and save your tooth.

If you would like more information on endodontic dentistry, 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 “Why See an Endodontist?


PuttheExtraEffortinYourOralHygieneWhileWearingBraces

The journey to a straighter smile with braces can be difficult. One of the biggest dangers you'll face is an increased risk of periodontal (gum) disease.

Gum disease is caused by dental plaque, a thin film of bacteria and food particles on tooth surfaces. To curtail plaque growth, you must brush and floss daily and visit your dentist regularly for more thorough cleanings. If you don't, accumulated plaque can trigger an infection with potentially disastrous consequences for your dental health.

But wearing braces can make you more vulnerable to gum disease. The braces and wires can get in the way of brushing and flossing. To add to the difficulty, the gums often react to being in close proximity to braces, causing their tissues to swell or overgrow. And if the patient is a teenager, the normal hormonal surge that occurs during these years could compound this vulnerability even more.

To prevent an infection, you'll need to practice extra diligence cleaning your teeth with brushing and flossing. It takes more time and effort, but it's worth it to lower your disease risk. To help even more, consider using tools like specialized brushes that can maneuver better around hardware and floss threaders that can get floss under wires. You might also consider a water flosser, which uses pressurized water to remove plaque between teeth.

In addition to your orthodontic visits, you should also maintain your regular cleaning schedule with your family dentist—or more often if they recommend. Besides cleaning, your dentist also monitors for signs of developing gum disease. They can also prescribe mouthrinses for controlling bacterial growth.

Even with diligent hygiene, your gums may still adversely react to the braces. This may not be a problem if your gum tissues don't appear to be detaching from the teeth. But your dentist or orthodontist may recommend you see a periodontist (a gum specialist) to help monitor that aspect of your care. In extreme cases, it may be necessary to remove the braces and allow the gums to heal.

Keeping your teeth clean and your mouth disease-free is no easy task while wearing braces. But it can be done—and with your dentist's help, you can achieve a straighter and healthier smile.

If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”


September 10, 2019
Category: Dental
Tags: tmj  

Do you experience odd grating, popping or clicking sounds when you chew or open your jaw? Are headaches and ear pain becoming frequent? You may have TMJ, or temporomandibular joint dysfunction. At Stiles Family Dentistry in Salem, NH, Drs. Papapetros, Giraldo, and Masterson understand this quirky and painful disorder and provide real help.

What is TMJ?

TMJ stands for temporomandibular joint, the two hinges which allow you to open and close your mouth, speak, and chew. A truly amazing body part, the jaw joint moves up and down, side to side and even forward and backward.

Unfortunately, for 10 million Americans, TMJ also means temporomandibular joint disorder, states US News and World Report. People with TMJ experience painful and distressing symptoms such as:

  • Weird popping, grating, and clicking noises coming from the jaw and mouth
  • Jaw, facial, ear, neck, and shoulder pain
  • Problems opening and closing the mouth
  • Tinnitus, or ringing in one or both ears
  • Stiffness in the jaw
  • Headaches (even migraines)

Physicians and dentists often attribute TMJ to issues such as:

  • Arthritis, involving the condyle, or disc-like cushion in the TMJ
  • Stress and its associated teeth clenching and grinding (bruxism)
  • Oral injury, such as a direct blow to the jaw
  • Joint dislocation
  • Dental bite issues

While TMJ seems to affect mostly younger women between the ages of 20 and 40, children, teens, and adults of any age may suffer these and other debilitating symptoms.

Treating jaw joint disorders

Many people visit their primary care physicians or ear, nose and throat doctors with symptoms of TMJ. Typically, these health care providers also look to experienced dentists, such as Dr. Papapetros, Giraldo, and Masterson for evaluation and treatment.

If you're struggling with TMJ symptoms, your dentist Stiles Family Dentistry will ask you about your symptoms, including what precipitates or relieves them, how long they last and where they are located. Then, he'll do a complete oral examination to rule out decay or other oral health issues. The examination will include digital X-rays and other kinds of imaging as needed.

If TMJ is indeed the problem, your customized treatment plan may incorporate:

  • Eating a soft diet for a week or two
  • Over-the-counter analgesics
  • Prescription antidepressants or muscle relaxants
  • Ice or heat to the sore jaw
  • Stress reduction techniques
  • Physical therapy
  • Stretching exercises
  • Crowns or orthodontic treatment to correct dental bite
  • A customized acrylic bite guard to relieve bruxism

Feel better

TMJ feels like it's all in your head, but it's very real. At Stiles Family Dentistry, Drs. Papapetros, Giraldo, and Masterson understand, and they can help. Call the office in Salem, NH, today to arrange a one-on-one consultation: (603) 893-4538.


YourQuestforaDentalImplantMightBeInterruptedbyBoneLoss

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

If you would like more information on dental implants, 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 “Dental Implants After Previous Tooth Loss.”