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ARTICLES
That Ugly Discoloured Tooth
By Dr. Robert Wallace (Endodontist)
It sticks out like a sore thumb…..that ugly discoloured tooth in the front of your mouth. You hate seeing it but think that you either have to live with it, spend a fortune to fix it, or worst ….have the tooth extracted. This is far from the truth, because there are a few available options to restore your smile.
The most common cause for a single discoloured tooth is traumatic injury/trauma. The change in colour after the traumatic episode may take weeks to a few months to occur. Generally, the teeth gets darker with time and the discolouration can range from a yellow to a purple grayish colouration.
The first step in correcting the problem is having a thorough clinical and radiographic examination done by your Dentist. This will reveal if the tooth/teeth is /are vital (alive) or non-vital (dead).The vital tooth can become discoloured from traumatic injuries. This causes blood cells from the pulp to invade and stain the dentine, but not enough to cause pulpal death. This injury may also cause filling of the pulp chamber with dentine (calcific metamorphosis).This usually appears as a cheesy yellowish discolouration.
Once clinical and radiographic examinations have ruled out any active pathological condition as the cause of the discolouration, the patient’s aesthetic concern of the single discoloured tooth maybe addressed. As a result, this single discoloured vital tooth now becomes a good candidate for external bleaching.
Severe traumatic injury can cause bleeding within the tooth, caused by ruptured micro blood vessels; Blood components leek into the dentine tubules causing discolouration of the surrounding dentine. Initially the tooth colouration is pink. This is followed by the breakdown of red blood cells and their interaction with dying pulpal tissue, resulting in iron formation. As a result of a series of biochemical reactions involving bacteria, the non-vital(dead) teeth becomes more discoloured and appears dark gray .If the Non-vital tooth has not received root canal treatment ,the patient should be examined and treated to avoid possible future infection and pain.
After root canal treatment of the Non- vital tooth has been completed there are a few options available to you in order to restore the beauty of your teeth. They are as follows;
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Internal Bleaching
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Resin Veneers
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Porcelein Veneers
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Ceramic Crowns
Internal Bleaching is the least expensive option and unfortunately is overlooked. The process requires a minimum of three (3) visits, but this number may vary amongst patients/persons as a result of the response of the tooth to bleaching. If the tooth’s discolouration cannot be managed by Internal Bleaching the next option of placing Veneers or a crown can be attempted. The Veneer involves the placement of a thin layer of tooth coloured material over the front of the tooth, while the crown is a prosthesis placed over the entire tooth.
Finally, regardless of the option appropriate for your traumatized discoloured teeth the important thing is that affordable options exist. Therefore, explore which options are appropriate for you in order to regain that beautiful and confident smile.
Demystifying Myths About Root Canal Treatment
By Dr. Robert Wallace (Endodontist)
You have just heard from your Dentist that you need to have Root Canal Treatment done, but you are horrified based on all the stories you have heard, and are wondering why this needs to be done to your tooth. Root Canal treatment is a process carried out to save your natural tooth. This becomes necessary when the Pulp (middle of the tooth) is affected by tooth decay or traumatic injury. Understanding the truth about these myths will not only Allay your fears of the treatment, but will also help you to make an informed decision of giving your tooth the fighting chance it deserves.
Myths
1. Root Canal Treatments Hurt
According to the American Association of Endodontists, the perception of root canals being painful began decades ago when root canal treatments were painful. Today with modern technology and better anesthetics, root canal treatments are no more painful than having a filling done. Knowing what to expect while having the treatment done can ease a lot of anxiety.
2. If the Tooth Doesn't Hurt, There is no Need for a Root Canal
While a throbbing toothache usually results in the need for root canal treatment, many times a tooth can require root canal treatment when there is no pain present. Dentists and Endodontists are specially trained to test teeth to see if the pulp has been infected or damaged. If this is the case root canal treatment would be necessary to save the tooth.
3. Crowns/Caps Cause Teeth to Need Root Canals
Many people believe that having a crown/cap on a tooth means that the tooth will eventually need root canal treatment. This is not true. If a crowned tooth requires root canal treatment it could be that the tooth has abscessed or that decay has gotten underneath the crown\cap and reached the pulp of the tooth.
4. Root Canals Cause Illness
There is no evidence to support that root canal treatment cause illness. However, there is evidence to support the fact that people who have had root canal treatment are no more at risk for developing illness than people who have never had root canal treatment.
5. Root Canals Involve Removing the Roots of the Tooth
When the dentist or endodontist performs root canal treatment, he or she removes the pulp from the inside of the tooth. The roots of the tooth are not removed.
6. Pregnant Women Can't Have Root Canals
Pregnant women can and do have root canal treatment. Having a root canal does require a small x-ray, but the radiation exposure is very minimal and the x-ray is aimed at the mouth, not the abdomen area. If you are pregnant and your dentist needs to give you an x-ray, he will use a lead apron to cover your belly. The anesthetics that dentists use are also safe for pregnant women.
Be sure to let your dentist know beforehand if you are pregnant.
7. Even With A Root Canal, The Tooth Will Come Out Eventually
If you have your tooth properly restored, maintain good oral hygiene and visit your dentist for regular checkups, your natural tooth could last for the rest of your life.
8. Extracting/Pulling the Tooth is Better than Getting a Root Canal
Keeping your natural teeth for as long as possible is very important for proper eating and chewing functions. There are several options available for missing teeth, such as dentures, partial dentures, dental implants and fixed dental bridges however, these alternatives can be much more expensive than saving your tooth with a root canal treatment.
9. After Having a Root Canal, My Tooth is Completely Restored
After having a root canal, it is extremely important to make a follow-up appointment with your dentist to have the tooth permanently restored. After the pulp of the tooth has been removed, the tooth can become very dry and brittle. Having a permanent restoration will help protect your tooth from fracturing.
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