Mid Cities Endodontics

Tooth Trauma – Uncomplicated Crown Fracture – What Now?

Tooth trauma can happen at any time. It could happen during a sports game, a car accident or as a result of something as simple and unexpected as a fall. The more information you have about correctly handling these situations the better. This knowledge could very well mean the difference between life and death for the tooth. The goal in treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth. In the previous tooth trauma entry we covered: avulsion (when a tooth is out of the socket). In this entry we will investigate a different kind of tooth trauma: an uncomplicated crown fracture. In this tooth fracture, the damage is limited to the crown of the tooth. There will be dentin exposed, but no pulp exposure.

(1)Tooth Trauma UncomplicatedIn the instance of an uncomplicated crown fracture the first step an individual should try to accomplish is finding the piece of broken tooth. If a saline solution or distilled water is readily available, place the broken piece of tooth in this solution. Once you reach the dental professional, the rehydrated piece of tooth will be easier to bond, as the hydration increases its bonding strength.

What to expect during your visit, following an uncomplicated crown fracture:

  • X-Rays will be taken
  • Mouth will be checked for soft tissue lacerations and the presence of any other foreign bodies
  • A sensitivity analysis will be performed
  • The doctor or staff member will collect the tooth segment from you if you were able to find and preserve it
  • We will assess the prognosis for the tooth

If the tooth is still vital, the process of reattaching the segment of tooth and the subsequent bonding will occur. Filling the dentin wound and applying calcium hydroxide to the vicinity of the pulp is the second to last step. Finally, smoothing and fluoridating small enamel defects.

Stay tuned in the upcoming months for the conclusion of the “What Now?” blog series!

After the Root Canal

If you have a root canal scheduled with our office, congratulations! You have taken an important first step toward saving your tooth and, thus, your smile and your oral health down the road! You may be wondering what to expect in terms of pain and what to do to relieve it after your procedure. Luckily, we have saved our best tips for you! Read on for information on home-care after a root canal.

After the Root CanalHow much pain will I have?
You will be happy to hear that after root canal treatment, most people report little or no pain. Advancements in endodontic instruments and techniques over the years have made this procedure similar to having a filling done. While it is considered normal to have soreness for a few days following the procedure, make sure you call us if you have extreme pain or pain that lasts more than a week.

Here are our recommended pain management tips following root canal treatment:

Over the Counter Pain Medicine
For the majority of patients, an over the counter pain medication such as ibuprofen (Advil) or acetaminophen (Tylenol) is all that is needed to curb soreness and pain after a root canal.

Prescription Pain Medicine
If we feel that you may need it, we will send you home with a prescription for a stronger pain medication than can be purchased over the counter. Be sure to follow the instructions carefully on the package.

Ice and Heat
For additional comfort at home, you may apply a cool or warm compress to the cheek in the area that the procedure was performed.

Salt Water Rinse
A teaspoon of salt in room temperature water can sometimes help with pain in the days following your procedure. Rinse and spit for reduced swelling and discomfort.

Be Pro-Active with Pain Medication
Have OTC pain medications ready to go at home. Take them before the numbing solution wears off completely so that you are not caught off-guard with pain. If we give you a prescription for pain medicine, fill it before going home, even if you think you won’t use it. Stay on top of timing and dosage until you feel that the soreness is gone.

And, as always, feel free to call us anytime with your questions. We are always happy to help!


Preventing Oral Cancer

While we cannot all necessarily prevent cancer from happening, with most cancers, including oral, head and neck cancers, there are things that you can do (or not do!) to reduce your risk.

  • Preventing-Oral-CancerQuit Smoking: After five years of quitting smoking, your risk of oral cancer is cut down to just half of that of a smoker.
  • Limit Alcohol: Excessive alcohol use is the second largest risk factor for oral cancer. Limit drinks to one per day for women and two per day for men.
  • HPV Vaccine: HPV is the leading cause of oropharyngeal cancer (the back of the mouth and throat). HPV is also responsible for a small number of oral cavity cancers (the mouth).
  • Self-Exams: Be an advocate for your own health by regularly examining your mouth with a mirror and flashlight. Don’t forget to look under the tongue! Watch for unusual bumps, patches, different coloring, and report any to us that don’t heal within 14 days. Feel your lips, cheeks, throat and neck for unusual bumps and masses. There are a number of online guides for performing a thorough at home oral cancer self-exam.
  • Have Regular Checkups: Oral health professionals such as dentists and oral surgeons are the second line of defense (after you) in terms of screening for oral cancers. Be sure to ask us any questions that come up during your exam.
  • Eat Well: A healthy diet includes plentiful vegetables and fruits, is low in sugar and saturated fats, and includes lean sources of protein and whole grains. Incorporate new foods into your diet slowly for long lasting results.
  • Exercise: Aim for 30 minutes of moderate exercise a day or more!
  • Get Adequate Sleep and Minimize Stress: A lack of sleep and stress both contribute to inflammation which has long been recognized as a player in the cancer game.

Tooth Sensitivity: What it Means and What You Can Do

You’re eating a scoop of ice cream or sipping hot chocolate, and suddenly your tooth hurts. Or maybe brushing your teeth makes you wince. These are common symptoms of tooth sensitivity, one of the most common complaints among dental patients. In fact over 40 million adults suffer from sensitive teeth at some point. This blog will help you understand just what this common problem is and what the cause may be.

Tooth SensitivityCauses of Tooth Sensitivity.

Tooth sensitivity is caused by the movement of fluid within tiny tubes located in the dentin (the layer of tissue found beneath the hard enamel that contains the inner pulp), which results in nerve irritation. When the hard enamel is worn down or if your gums have receded, the tiny tube surfaces become exposed so that eating or drinking cold or hot food or beverages, touching the teeth, or exposing them to cold air can be uncomfortable. Dental issues that may cause tooth sensitivity include: tooth decay, fractured teeth, worn fillings, worn tooth enamel, and an exposed tooth root. Excessive consumption of foods and drinks high in acid content, such as soft drinks or citrus juices, can also put you at risk for tooth sensitivity. Acid reflux may also result in the erosion of tooth enamel due to acid coating the teeth.

Treatment. If a tooth is highly sensitive for more than three or four days, it is best to see your dentist to diagnose the cause of your discomfort. We have a variety of options to manage tooth sensitivity, including in-office treatments and products you use at home. We may apply a desensitizing agent or a protective coating to your teeth. Or we may prescribe a fluoride gel or over the counter desensitizing toothpaste, which contains fluoride and potassium nitrate or strontium chloride. These ingredients help block the transmission of sensation from the tooth to the nerve. It is also best to avoid using hard bristled tooth brushes that can wear down tooth enamel and expose sensitive areas.

It is important for us to accurately diagnose the cause of your tooth sensitivity for accurate treatment. Sometimes a damaged tooth may require a filling, bonding, or even root canal if the decay is severe.   Proper dental hygiene is the best way to prevent tooth pain and sensitivity. Please let us know if you have any areas of your mouth that experience sensitivity or if you have any questions abut your dental health.

Tooth Trauma – Avulsion – What Now?

ToothTraumaWhatNowYour son is playing a championship game against the team he’s waited all season to play. The score is tied, and as the minutes wind down, the players have gotten more forceful in their actions. You blink, and all of a sudden your son is holding his mouth and a time-out has been called. You run down to him, and your mind is racing, “What happened? How hurt is he?” As you approach him, you see that in his hand he is holding an adult tooth that has been dislodged from the socket. As the sideline paramedics assess for signs of a concussion or hemorrhage you think, “Now what?”

The injury, and circumstances surrounding the injury may cloud your ability to choose your next action. You can rest assured knowing that when you mix today’s technology and the expertise you can expect from a coordinated team approach, the tooth’s fate is looking brighter already!

In the case of avulsion (when a tooth is out of the socket), the approach will most likely be a team effort. Your first course of action following the injury is to rinse off the tooth and try to place it back in the socket. If this is not possible, place the tooth in milk. If you’re expecting an injury like this (as a coach or school teacher etc. might), have Hank’s Balanced Salt Solution on hand to place the tooth in. Water should never be used to place the tooth in. Why milk? Milk maintains the correct fluid balance in the root of the dislodged tooth, which in turn increases the tooth’s chance of survival. Water causes the cells in the tooth to swell and die. If there is no option to place the tooth in any of the approved solutions, place the tooth in between the injured person’s cheek and gum to keep it moist.

After you have arrived at our office, it’s time for us to take over. The investigation phase begins. If a concussion or hemorrhage has not been ruled out, now is the time. When the coast is clear, it is time to move onto a gathering of both radiographic evidence of the injury and clinical documentation about the patient and the incident. From that extracted information, we can make a diagnosis and a subsequent treatment plan. As we mentioned before, depending on the type and severity of the injury, the process may involve a dental professional team.

The aim of treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth.

In the next few months we will cover other types of tooth injuries and treatments. Stay tuned!

Gum Disease Risk Factors

GumDiseaseRiskFactorsHere’s a concerning statistic: according to the Centers for Disease Control and Prevention, 70% of Americans who are over the age of 65 have gum disease. Although brushing and flossing are key factors in preventing gum disease, there are other elements that can contribute to tooth loss as well.


Smoking may actually be one of the most significant risk factor in the development of gum disease. Tobacco is a powerful substance that can damage teeth permanently and actually aid in the progression of periodontitis. Studies have shown that using any kind of tobacco product increases the risk of gum disease.


You might not believe it, but stress is actually a risk factor and can cause gum disease to progress more quickly. Stress is linked to many health issues such as cancer and hypertension. Stress takes a toll on your body and makes it hard to fight off infections. Even infections in your gums!


Sadly, some people just may be more susceptible to gum disease than others. These people need to try harder and brush more often to fight off gingivitis and plaque build up.

Clenching and Grinding:

Grinding your teeth is bad for your teeth’s overall health. Excess force on the tissues that support your teeth can encourage gum disease to progress.


Certain medications can upset your oral health and cause gum disease to progress faster. Anti-depressants and certain heart medications are the biggest culprits. If you’re taking any meds and begin to see a change in your overall oral health, please let us know at your next appointment.

Poor Nutrition and Obesity:

Your diet is incredibly important and affects your overall health. Eating foods low in important nutrients weakens your immune system and makes it harder for your body to fight infections. Gum disease starts with infections, which is why it’s important to take care of your body and think about your overall health.

Make an appointment with us as soon as possible if you think you might be in the early stages of gum disease!

3D Imaging: The Standard in Endodontic Car

3D-ImagingThe future of dental imaging has arrived, right here in our office! 3D imaging is increasingly becoming the standard in endodontic care. In fact, from the endodontist’s office to the general practitioner’s, 3D imaging is rapidly changing the way that dentistry is performed.

3D Pictures for 3D Structures

The structures of the mouth and teeth, including the root systems, are three dimensional, yet traditionally they have been photographed in a two-dimensional manner. With the invention and increasing availability of 3D radiographs, we are now able to take patient care to the next level at our practice by providing better outcomes than ever before!

About CBCT

Also known as Cone Beam Computed Tomography (CBCT) and similar to medical CAT Scans, 3D dental imaging works by rotating around the patient while taking hundreds of pictures per second from different angles. A computer then takes those images and combines them to create a three-dimensional model in the form of a digital picture.

Complex Canals: A Better View

Not surprisingly, 3D imaging gives us a much better view of what is going on inside of your teeth. For example, we are able to see complex canals in much better clarity and with more contrast than ever before. The images also provide a better view of periapical lesions and additional anatomical structures in the axial, coronal and sagittal sections.

Here are some of the benefits of CBCT 3D Machines:

  • Less Radiation than with CAT Scans
  • Compact Machines
  • Allow for Better View of Root Canals
  • Precise Diagnoses
  • More Predictable Treatment Plans and Prognoses

We are proud to provide the newest in technology for our patients to ensure the best care possible!

Getting to the Root of An Apicoectomy

Beautiful golden transparent tooth with roots illustration. Healthy teeth care symbol.

Beautiful golden transparent tooth with roots illustration. Healthy teeth care symbol.

Just saying the word “Apicoectomy” is a mouthful! But don’t be put off by the name, it’s a simple and routine procedure that is effective in treating infections that may occur following root canal treatment.

What is an Apicoectomy? Teeth are held in place by roots that reach into your jawbone. The tip of the root is called the “apex” and this is where nerves and blood vessels enter your tooth. These nerves and vessels travel through a canal inside the root and into the crown, or visible part of your tooth. During root canal treatment, inflamed or infected tissue is removed from the canals. Canals are very complex, with many tiny branches, and occasionally infected debris remains in the tooth and prevents healing or causes re-infection. During an apicoectomy, the root tip, or apex, is removed, along with the infected tissue, and is replaced with a filling to reseal the end of the root.

Who needs an Apicoectomy? An apicoectomy is done only after a tooth has had at least one root canal. In many cases, a second root canal is considered before an apicoectomy. With advances in imaging, we can often detect infected canals that had not been appropriately treated in the past and treat them without the need for surgery. But if an infection persists, it is often near the root tip, and an apicoectomy is an important surgical procedure that can save your tooth from extraction.

What is the follow up? Most apicoectomies take 30 to 90 minutes, depending on which tooth it is and how complicated the root structure is. Your endodontist will use ultrasonic instruments and surgical microscopes to see the area clearly, which will increase the chances of success. The area may bruise and swell slightly in the area around the tooth. Follow up includes over the counter pain relievers or prescription medication. Stitches will be removed 2 to 7 days after the procedure, and full recovery can be expected within 2 weeks. While apicoectomy sounds complicated, most people report that the recovery is easier than that of the original root canal.

If you are having any pain or swelling from a tooth that has had a root canal procedure, please don’t hesitate to call us! We can review your treatment options and answer any questions you may have. Fortunately, an apicoectomy is usually a permanent solution and should last for the life of your tooth!

Five Foods for Healthy Teeth

food tips for healthy teethWe all know that foods high in sugar and acid are bad for teeth, but did you know that some foods are actually good for them? Incorporating these dental friendly foods into your family meals can both fight tooth decay and prevent gum disease. Here are five oral health friendly foods!

Almonds, Brazil Nuts, and Sesame Seeds. These foods contain phosphorous, magnesium, potassium, zinc, and most importantly, calcium. Dietary calcium is not only good for your bones, it may actually contribute to tooth remineralization and fight tooth decay. Make sure to get the unhulled variety of sesame seeds, which are incredibly high in calcium.

Strawberries, Kiwi, and Citrus Fruits. These fruits have the highest concentration of Vitamin C, which helps to increase collagen in gum tissue and prevents gum disease.

Onions. Toss some raw onion on your salad or eat them on your hamburgers. Onions contain powerful bacteria fighters because of their sulfer-containing compounds and are natural cavity fighters.

Shitake Mushrooms. Recent studies show a natural sugar found in shitakes, called lenithan, specifically targets the bacteria which causes gingivitis (gum inflammation) and tooth decay while leaving non-harmful bacteria alone.

Apples and Celery. Water rich fruits and vegetables stimulate saliva production, which rinses teeth of bacteria. With their high fiber content, they act as natural tooth brushes, scrubbing your teeth as you chew, removing plaque and bacteria that may otherwise build up.

These simple everyday foods are great choices for snacks or to add to meals your family already enjoys. Put onions or shitakes as toppings on your pizza. Serve celery and apples with peanut butter and make a smoothie with your strawberries and kiwi. Nuts can be eaten as a snack on their own or try them as nut butter spread on toast. You can even throw nuts and sesame seeds in a stir fry for added texture and flavor as well as the nutritional benefit. 

Green Tea. Besides these five teeth healthy foods, you can even get a boost for your oral health by drinking this powerhouse liquid! Green tea contains “catechins” that actually fight inflammation and control bacterial infections. One Japanese study found that regular green tea drinkers had less incidence of periodontal disease compared with people who drank the tea irregularly. So try drinking green tea instead of that second cup of coffee or have a refreshing green iced-tea on a hot afternoon.

Besides brushing and flossing, what you eat can make a difference to your oral health. It’s nice to know you can eat foods that taste good and be doing something good for your teeth at the same time. Now that’s something we can all smile about!

No Root Canal? What’s the Worst that Could Happen?

No Root CanalHave you ever wondered: “Do I have to have root canal therapy?   What’s the worst that can happen if I don’t?”

We are glad you asked! Having a root canal may seem like an intimidating and painful experience, so we are not surprised when some patients are hesitant to go through with it.

But, the fact of the matter is that: root canal treatments save natural teeth. And saving your natural teeth is the most important thing we do as oral health professionals.

Still not convinced? Here are some more compelling reasons to follow through with that root canal treatment:

  • An infected root won’t get better on its own. The pain may go away after some time, but that is not because the infection is gone, it is because the nerves are no longer working properly due to that infection.
  • Abscesses and Systemic Infections: Left untreated, an infected tooth can spread to the gums, causing a serious abscess in the jaw that requires emergency treatment. In rare cases, that could spread even further, creating a systemic (whole body) infection, which has the potential to be life threatening.
  • The role that natural teeth play in the overall health of your body during its lifetime is something that we are learning more about every day. This important role cannot be overstated. A lost, permanent tooth may not seem like a big deal to you now, but it creates a domino effect of health problems down the road. For example, a missing tooth causes nearby teeth to shift, exposing them to more decay and more tooth loss down the road. This can affect your ability to maintain a healthy diet and, in turn, affect the quality and even the span of your life.
  • Money: Even if aesthetics don’t matter to you, a lost tooth will probably cost you more money in the long run than a root canal will, now. When a tooth is missing, the jaw underneath that site atrophies. This makes it more expensive to perform restorative procedures such as dental implants in the future, as they will require more extensive prep-work such as bone grafting.

The bottom line is that your natural teeth are best. Endodontic therapy is typically the best way to save a natural tooth. It is also the most commonly used procedure, that we as oral health professionals have to help you keep your natural teeth for life.