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Hearing that you need a root canal can be highly intimidating. What is a root canal? It is the removal of the nerve supply from the tooth. Here, John Pappas will describe the parts of a tooth and explain the reasons for a root canal and how it is done when you visit us in our Boston, Massachusetts office.

Your tooth is made up of many layers. The outside layer is called enamel and is made of minerals. The middle layer is dentin, which is also a calcified tissue, but less dense. The center of the tooth is called the pulp, and that hosts the nerves and blood vessels. A root canal is the removal and replacement of this center with a sterile filling.

A root canal is needed when an infection spreads to the center of the tooth. This can be from trauma (recent or previous), a cavity, a severe crack, or other compromise that causes nerve damage. An X-ray and examination are required to see if a root canal is needed. Symptoms may include but are not limited to pain, swelling, change in tooth color, and over-reaction to temperature change or pressure.

When it is time to begin, you’ll receive local anesthesia (via injection) to make you most comfortable. A rubber dam is used to isolate the tooth, while other equipment determines the nerve location and maintains a sterile working environment. All of the infected area is removed including the nerve tissue and blood vessels. Then, medicines are used to sterilize and alleviate any pain. Next is the placement of a filling material in the spot where the nerve used to be.

When your nerve and blood supply are taken away, the tooth is non-vital, or dead, and can become weak and fragile. If your tooth is badly decayed, a large portion of it will have to be removed. It is recommended to place a crown on the tooth to keep the enamel from breaking or falling apart. If you do not get a crown, you could eventually lose the tooth to more decay or infection. The tooth could also break off completely and you would have to have an extraction. The crown fits over the top of the tooth and secures it from breaking down.

A root canal saves the life of a tooth that would otherwise succumb to further infection and eventually extraction. Infection is the cause of most-needed root canals. If you are ever unsure what is happening at your appointment, don’t be afraid to ask questions so you understand the procedure completely.

Putting off your dental visit to Masterpiece Dentistry at Copley because of fear or anxiety only increases the potential for tooth decay or gum problems. At our office, John Pappas and our team offer solutions that allow you to relax, without any pain, so you can keep your mouth healthy. Our solutions can help with many different anxiety issues for both adults and children.

Help with minor anxiety

Nitrous oxide is an excellent choice for most patients. Sometimes referred to as laughing gas, nitrous oxide can be regulated to provide you with the amount of sedation you need. When used before a local anesthetic, the injection will not be uncomfortable and you should not notice any pain during your procedure.

If you plan to use nitrous oxide, you can drive yourself to your appointment. In most cases, you will be fine to drive after your treatment: the sedation wears off quickly. Nitrous oxide can also be used along with other sedation techniques to produce a higher level of sedation.

Oral sedatives are available in a liquid or pill form. If you experience moderate anxiety levels, you can be given a tablet to take before your appointment. This type of sedation will be beneficial in relieving the anxiety that can build before your procedure. However, if you choose this method, you cannot drive yourself to your appointment.

Help with major dental anxiety

If you experience extreme levels of stress and anxiety about dental treatment, you may wish to discuss deep sedation or general anesthesia. With these techniques, you will be barely conscious or unconscious during your procedure. You will not feel discomfort or pain. Once you have experienced dentistry with a sedation technique, your anxiety level may decrease on its own.

People are not born with the fear of a dental exam. Unfortunately, most anxiety issues are due to a bad dental experience or childhood trauma. Sometimes anxiety comes from listening to the tales of others, who may have exaggerated their story. Talk to John Pappas and our team about your dental concerns or fears. Let us help you so you can get the dental care you need for a healthy mouth for life.

For more information about overcoming dental anxiety, or to schedule an appointment with John Pappas, please give us a call at our convenient Boston, Massachusetts office!

The community health awareness group Oral Health America has reported that 82 percent of adults are unaware of the role that infectious bacteria can play in tooth decay or cavities, and almost three out of five children aged 12 to 19 have tooth decay. Since June is National Smile Month, John Pappas and our team at Masterpiece Dentistry at Copley thought we’d remind our patients about the importance of good oral hygiene visits between office visits.

To keep your family’s smiles healthy and beautiful for years to come, be sure to:

• Brush at least twice a day with fluoride toothpaste
• Floss every day to clean between your teeth
• Eat a healthy, well-balanced diet
• Reduce your intake of sugary foods and drinks
• Visit John Pappas for scheduled appointments

If you want to know more about healthy home care habits, feel free to ask our team at your next appointment, or ask us on Facebook!

Gum (gingival) recession occurs when gums recede from the tops of the teeth enough to expose sensitive roots. People typically experience increased sensitivity to sugary or cold foods when gums no longer cover and protect teeth roots. In addition, untreated gum recession may lead to loosening of teeth and accelerated tooth decay, something John Pappas see all too often.

Causes of Gum Recession

• Periodontal disease – a serious oral disease arising from poor oral habits
• Gingivitis – gum disease characterized by bleeding and swollen gums
• Aging
• Overly aggressive brushing and/or flossing – brushing hard in a scrubbing fashion will erode gum tissue at the roots of teeth
• Genetic predisposition to gingival recession – having inherited thin, insufficient gum tissue facilitates gum recession
• Bruxism – a condition where someone regularly grinds their teeth, usually during sleep
• Chewing tobacco/smoking – promotes chronically dry mouth and reduced gum health

Periodontal gingivitis may also cause causing drooping of the gums instead of gum recession. A gingivectomy removes excess gum tissue weakened by bacterial decay while a gingivoplasty can reshape gums around the teeth. If sagging or receding gums are left untreated, they may develop pockets (gaps) that provide hiding places for food particles, mucus and other mouth debris conducive to anaerobic bacteria growth. As the most destructive type of oral bacteria, anaerobic bacteria is responsible for tooth decay, cavities, gum disease, and chronic halitosis.

Treatments for Gum Recession

Corrective actions need implemented as soon as possible to reverse gum recession by addressing the cause. For example, people who brush with hard-bristled toothbrushes should switch to a soft-bristled toothbrush and brush more gently. If gum recession is the result of poor oral hygiene, improve oral hygiene habits by brushing after meals, flossing, rinsing with non-alcoholic mouthwash, and getting dental checkups and cleanings every six months. For severe cases of gum recession, soft tissue grafts can add gum tissue to exposed roots by removing tissue from the person's palate and attaching it to existing gums at the area of recession via laser surgery.

If you’re worried about gum recession, visit our Boston, Massachusetts office and talk to a member of our team.