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February 16, 2015

What is a root canal?

465217799A root canal is a type of dental procedure used to treat advanced tooth decay or severe infection to a tooth. The medical term for a root canal is “endodontic therapy” and a dentist who specializes in root canal work and related treatments is called an “endodontist.”

Root canals have a reputation for being painful, costly, and generally something to avoid. It’s true that this type of dental work is more complicated and time-consuming than others. Most people do not look forward to getting a root canal – this procedure has often been the subject of jokes, as in: “I’d rather get a root canal!”

But if you understand the facts about root canal treatment, hopefully the whole process will be more understandable and reassuring. You don’t need to feel afraid of having a root canal – it’s just part of the process of healing your teeth and getting on with your life.

A journey to the center of your tooth…

The “root canal” is the part of the tooth that includes the internal chamber inside the tooth which is full of pulp and nerves. The tooth’s nerve is not terribly important to the day-to-day functioning of your teeth – the main purpose of a tooth’s nerve is to detect hot and cold. But if your tooth pulp and nerve become infected, it can cause big problems for your tooth.

Abscess makes the heart grow fonder?

When a tooth’s pulp and nerve become infected, or if tooth decay proceeds to the point that it affects the interior of the tooth, this is called an “abscess” – you have an “abscessed” tooth. This means that your tooth is basically being infected and/or damaged from the inside out – the exterior of the tooth might appear normal (or nearly normal), but the inside of the tooth is full of pain.

How do I know if I need a root canal?

One of the first signs that you need a root canal is extreme pain in your tooth – a really bad toothache.

Other symptoms include extreme tooth sensitivity to hot and cold; discoloration or darkening of the tooth; swelling, tenderness, or a recurring pimple on the nearby gums.

At other times, root canal work may be needed even if no symptoms are present – this is one of the things that dentists check for during your regular dental appointments.

What happens during a root canal?

Basically, when you get a root canal, the dentist drills into your tooth, removes the infected/decayed pulp and nerves, gives the tooth a thorough cleaning, and then seals up the tooth. The main portion of the root canal work can often be done in one visit, but the dentist might wait a week before sealing the tooth, especially if there was an infection – the dentist will treat the infected tooth interior with medication prior to sealing. The end result of a root canal is often a dental crown or other permanent restoration – you will end up with a fully functional tooth, even if it’s no longer a “natural” tooth.

How painful is a root canal?

Although root canal treatment has a bad reputation for being painful, most patients report that it doesn’t feel much different from getting a regular dental filling. Your dentist will use a local anesthetic to numb the surrounding area of your teeth and gums. Most patients are able to treat any follow-up discomfort with over-the-counter pain relievers like ibuprofen, and the vast majority of root canal patients are able to return to their normal activities the next day.

So don’t be afraid if you find out that you need a root canal. Far from being the object of jokes, this type of dental treatment can give you many new reasons to smile.

December 16, 2014

What is a cavity?

A cavity is a hole in your tooth. Cavities are caused by tooth decay – the process of wearing down the tooth enamel that is caused by bacteria on the teeth.

Tooth decay happens as a result of sugar being left on the teeth – for example, after eating candy, cakes, cereals, breads, or other foods that contain starches, sugars and carbohydrates. Sugar is the culprit for tooth decay because bacteria that live on our teeth love to eat sugar – and when bacteria eat sugar, they digest the sugar and convert it into acid, which then goes to work attacking the enamel of our teeth.

This probably sounds menacing – it’s not! It’s perfectly normal to eat carbohydrates and sugar; it’s perfectly natural to have bacteria on your teeth – all people do. The problem happens when sugar is left to sit for extended periods on the surface of your teeth – or when we eat too much sugar and do not have a balanced diet. Then the bacteria in our mouths get out of control, leading to buildup of plaque – that thick, opaque substance on the surface of teeth – and the acid buildup on the surface of our teeth gets to be overwhelming. This is when tooth decay and cavities happen.

How can cavities be prevented?

Here are the two most important things you can do to prevent cavities:

  • Eat a good, balanced diet. Most people in modern-day America eat far too much sugar and carbohydrates. This is one of the contributing factors to the obesity rate, and it also leads to poor dental health. If you drink lots of soda and eat lots of sugary foods every day, you are going to be at higher risk for cavities. The health of your teeth is connected to the health of the rest of your body – and it starts with the kind of food that you are putting into your body.
  • Brush and floss every day. Think of the process of avoiding cavities as an ongoing battle – every day, the bacteria in your mouth go to work trying to damage your teeth, and you need to keep stopping them. By brushing your teeth (twice a day – once before bedtime and once in the morning) and flossing every day, you are helping to slow the buildup of plaque and avoid the harmful acids that can break down your tooth enamel over time. There’s no “magic bullet” for fighting cavities; instead it’s a process of ongoing, steady resistance.

What if I brush and floss, and still get cavities? Is something wrong with me?

Some people are at higher risk for getting cavities – even if they don’t have a high-sugar diet, even if they do have good brushing and flossing habits. Often people think of cavities as something that only happens to children who eat too much candy – but cavities can occur in older adults as well. Some people are at higher risk for cavities due to family history or due to the unique characteristics of their teeth. Pregnant women are often at higher risk for cavities because of the sugar cravings that often accompany pregnancy – so if you’re pregnant, pay extra attention to your dental care.

Cavities are best avoided – as with so many other aspects of health, “an ounce of prevention is worth a pound of cure.” If you can do your best to avoid getting cavities, your teeth will thank you for it.

November 16, 2014

What is a filling? What are the different types?

178845072When you get a cavity in one of your teeth, you will need to get a filling. This is also called a “restoration” because it involves repairing and renewing a tooth. There are several main options for dental fillings – talk with your dentist to determine which option is best for you.

Fillings fall into two main categories: direct and indirect restorations. The type of filling you receive is affected in part by the type of restoration you need.

In a direct restoration, the work is fairly straightforward and uncomplicated –the dentist is able to remove any tooth decay, create the filling and complete the work of repairing the tooth all within the same office visit.

With an indirect restoration, the dental work is usually a bit more complicated and requires two or more visits to your dentist – for example, there might be bridgework involved that affects multiple teeth, or crowns or veneers to repair damaged teeth, or other complications. Your dentist will take an impression of your affected teeth and send the work to a dental laboratory to create the permanent restoration. Then, at a follow-up appointment, your dentist will do the final step of cementing the restoration onto your teeth.

Depending on whether you need a direct or indirect restoration, you and your dentist can choose from the following types of filling materials. Each one has its various advantages and disadvantages; your dentist can help you decide on the material that is best for your needs.

Direct restoration fillings:

  • Amalgam: This is the most common type of filling and has been used for over 100 years. The amalgam is made from a mixture of mercury, silver and other metals – they are often called “silver fillings” because of their silver color.
    • Advantages: Inexpensive, durable, highly resistant to further tooth decay, and can usually be placed in just one office visit. Amalgam also performs well as a biting surface – it holds up to the pressures and wear of chewing and eating over time.
    • Disadvantages: Placement of amalgam requires the removal of a small amount of healthy tooth material. Amalgam also tends to be less attractive looking than some of the other options for filling material – after all, natural teeth are not silver. For this reason, amalgam fillings are usually used only on the back teeth.

 

A note about amalgam and mercury: Some individuals and advocacy groups have questioned the safety of dental amalgam because it contains mercury and releases a small amount of mercury vapor over the course of its life. Dental amalgam has been the subject of numerous research studies over the years, and no valid scientific research has proven that dental amalgam causes harm to patients, except in rare cases of allergy. So if you need to get amalgam fillings, rest assured that they are safe – and if you do have an allergy to the materials, a different filling can be used.

  • Composite resin: Composite is made from a combination of acrylic resin and glass-like particles that create a natural-looking tooth material.
    • Advantages: Natural looking – the color can be matched to your existing teeth. It tends to allow for the preservation of a greater portion of the original tooth.
    • Disadvantages: Composite fillings are usually more expensive than metal fillings. They also tend to wear down faster and can be prone to breaking more often – resulting in the need for additional dental work in the future to repair or replace the fillings. Composite fillings cannot be used for certain situations – as always, talk to your dentist.
    • Glass ionomer: Glass ionomers are made from acrylic and glass powder and are used primarily for small fillings.
      • Advantages: Natural tooth color. Low incidence of allergic reaction – most people do not have allergies to this material. Glass ionomer fillings can be made to include fluoride to help resist further tooth decay.
      • Disadvantages: This is not as durable of a filling material as the other options – it is only used for small fillings and in areas that are not subject to a lot of heavy biting and chewing. This material can become rough as it ages, resulting in plaque buildup. It is also more costly than amalgam fillings – similar in price to composite resin.
      • Resin ionomer: This type of filling is made from glass filler, acrylic acids and acrylic resin. It is often used for fillings in baby teeth and on non-chewing surfaces.
        • Advantages: Natural tooth color – is even more translucent than glass ionomer fillings. Can contain fluoride. More durable than glass ionomer.
        • Disadvantages: Not recommended for biting surfaces in adult teeth; less durable than composite and amalgam.

Indirect restoration fillings:

  • Porcelain (ceramic): This type of filling material is commonly used in indirect restorations. The ceramic porcelain can also be fused to metal as part of the tooth restoration – which improves the durability of the filling but also increases the complexity and cost of the dental work.
    • Advantages: Natural tooth color. Requires very little healthy tooth material to be removed.
    • Disadvantages: Tends to be more brittle than other materials. May not be recommended for molars. Usually requires two or more office visits to place the filling, and tends to be more costly.
    • Gold (or other metal) alloy: Gold alloys (containing gold, copper and other metals) are another option for indirect restorations.
      • Advantages: Excellent durability, does not break under stress.
      • Disadvantages: Gold is usually the highest-cost option for a filling. Not a “natural” tooth color.

As always, talk with your dentist to find the right choice of fillings for your needs.

April 16, 2014

What is a dental implant?

Dental ImplantIn the old days, it was common for people to lose their teeth. In fact, many elderly people could expect to lose all their teeth and have to use dentures instead.

Due to the many advances in dental care and oral health over the past 50 years, today it is increasingly rare for people to lose their teeth. But when tooth loss does occur, whether it’s due to injury (a bike accident or car crash) or advanced tooth decay, dental implants are available to replace missing teeth.

Here are some of the reasons why dental implants are such a big improvement over dentures:

  • They look better. Dental implants look almost exactly like real teeth. Your friends and family probably won’t be able to tell the difference.
  • They feel better. Dental implants don’t cause discomfort (whereas dentures tend to pinch the mouth and  cause pain).
  • They’re better for eating. Many patients find that dental implants perform almost the same as the rest of their real teeth – the implants hold up well to the daily work of biting and chewing.
  • No slurring your speech. With dentures, people’s speech tends to be affected – because the dentures tend to slip and move around in their mouth, altering their speech patterns. Dental implants stay securely fitted inside your gums, thus avoiding any interference with your ability to talk.
  • They’re convenient. Remember those TV commercials for denture cleaner that you could leave your teeth in overnight? Dentures require cleaning, maintenance – sometimes they break or get misplaced. None of these issues is a concern when you have dental implants. The dental implants stay in one place – inside your mouth – and you clean them the same way you clean the rest of your teeth.
  • They’re longer-lasting. If well maintained, dental implants can last for many years – often they can last for the rest of your life.
  • They’re better for the rest of your mouth. Dental implants are a good choice because they don’t cause any impact on the rest of your mouth; whereas with bridgework, surrounding teeth have to be filed down in order to create the bridge. Dental implants tend to be better for your overall oral health.
  • They make you feel better about yourself. Dental implants create a more natural-looking smile – no dentures to worry about, no bridgework to explain to others. You can get your teeth fixed and go on with your life.

Here are a few other facts to keep in mind about dental implants:

Dental implants are not for everyone. If you are healthy enough for routine dental work, you will probably be a good candidate for dental implants. People with certain chronic health conditions, heavy smokers and people who have recently received radiation treatment to the head and neck region might not be able to receive dental implants.

Dental implants take awhile to get done. Getting dental implants is a bit of a complicated process. In addition to talking with your regular dentist about the treatment plan, you might need to be referred to an oral surgeon and/or to a dentist who specializes in restorative dentistry. You will go through a multi-step process where an implant is affixed into your jaw bone, your jaw is allowed to heal for 6-12 weeks, a small connector piece called an “abutment” is added to the implant in your jawbone, and then the replacement tooth or “crown” is added on top. This process does take some time, but the results will (hopefully) last for the rest of your life.

Dental implants might not be covered by your insurance. Talk with your dentist’s administrative staff to see what options you might have to pay for dental implants. Many dental insurance plans do not cover this type of complex restorative dental work. However, many dentists offer reasonable payment plans – and when you consider that a dental implant is likely to last for the rest of your life, getting it fixed “the right way” is often a good investment.

March 5, 2014

What are the different types of crowns?

Dental crowns are a common dental procedure used to repair a tooth that has decayed or been damaged. There are a number of different types of crowns used for different patients and various situations – talk with your dentist to find out what type of crown is best for your needs.

First, there are two broad categories of crowns: Temporary and Permanent.

Temporary crowns: These crowns are just like their name implies – they’re a short-term fix. Temporary crowns are made in your dentist’s office and are used as a stopgap, so to speak, until a permanent crown is available. Temporary crowns are not meant to be used for longer than 2 or 3 weeks, and they’re not meant to handle the heavy workload of a regular tooth or a permanent crown. So after you receive your temporary crown, your dentist will give you special instructions on what foods to avoid (hard, chewy, sticky – no apples, peanut brittle or chewing gum, please) and how to care for your temporary crown while your permanent crown is being prepared. Temporary crowns are usually made of acrylic or stainless steel.

Permanent crowns: These crowns can be made from a variety of tough, durable materials. They are built to last – a well-made, well-fitted crown can last for up to 15 years. A permanent crown is meant to be an extension of your natural tooth – you can bite, chew and eat just as well (if not better) than you could before the crown was added to your “starting lineup” of teeth.

Permanent crowns are made from the following types of material:

  • All-metal: Metal crowns are usually made from gold alloy, palladium or a base-metal alloy like nickel or chromium.
    • Advantages: One advantage of metal crowns is that less of the original tooth structure needs to be removed, and there tends to be less wear on the opposing teeth that make contact with the crown during chewing and speaking. Metal crowns rarely break and usually last the longest – it takes a long time to wear down a piece of metal.
    • Drawbacks: Metal crowns are clearly visible in the mouth – the metallic color definitely does not look like a natural tooth. If you’re sensitive to appearance, you might prefer to use a metal crown only for molars at the back of your mouth, where no one can see.
    • Porcelain-fused-to-metal: These crowns contain metal, but also have a porcelain veneer that can be made to match the color of your other teeth.
      • Advantages: Natural color and appearance – it looks the most like a “real” tooth and is a good choice for front or back teeth.
      • Drawbacks: More likely to chip or break, tends to cause more wearing-down of the opposing teeth. Sometimes the metal under the porcelain top is visible as a dark line.
      • All-resin: These crowns are made of inexpensive synthetic material called resin – a chemical composite used in dental restorations.
        • Advantages: These crowns are the least expensive.
        • Drawbacks: Sometimes you get what you pay for – all-resin crowns tend to be the most likely to break and wear down over time.
        • All-ceramic or all-porcelain: These crowns are made entirely of ceramic or porcelain material – no metal.
          • Advantages: These crowns offer the best natural color match – if you want the crown to look like a “real” tooth, then this is a good choice – especially for front teeth. The non-metallic crowns are also a good option for people who are allergic to metal.
          • Drawbacks: Not as strong as porcelain-fused-to-metal crowns. Also, they tend to wear down other teeth more than the metal or resin crowns.

Talk with your dentist to find out what kind of crown will best fit your needs. You’re going to be living with this crown for several years, so make sure you are comfortable with the crown’s cost, fit, durability and style.

February 5, 2014

What is a crown?

Sometimes during the course of your life, your dentist might tell you that you need a “crown.”

“What is this crazy person talking about?” You might think. “Is there some kind of coronation ceremony going on here?”

Wrong!

A dental crown is basically a solid “cap” that is placed over a tooth – either to repair damage to the tooth or to prevent further tooth decay. Although having a crown is not an ideal situation to be in as a dental patient, it’s a very common dental procedure that is used to help shore up the strength and health of injured and damaged teeth.

Here are some of the common reasons why you might need a crown:

  • If your tooth is broken (from a bike accident or fist fight) or severely worn down (from years of grinding your teeth while you sleep), a crown can be used to restore the tooth, making it possible to eat, sleep and bike again. (But please, no more fist fights!)
  • If your tooth has decayed or cracked, a crown can be used to hold the pieces of the tooth together.
  • If you have a large cavity, a crown can be used to cover the tooth and keep it safe and strong.
  • If you have a dental bridge or dental implant, a crown can be used to hold it securely in place.
  • If you have a misshapen or badly discolored tooth, a crown is used to cover it up.

Getting a crown is nothing to be embarrassed about or afraid of. The crown is going to make it possible for you to resume the normal use of your teeth, without pain or injury.

What happens when you get a dental crown?

Dental crowns are a rather elaborate dental procedure, and they typically require two separate visits to your dentist.

On the first visit, your dentist will examine your tooth that needs the crown. He/she will then anesthetize (numb) the tooth and surrounding gum area, file down the surrounding tooth in order to make room for the crown (and/or build up the tooth with filling as needed), and will then make an “impression” of your tooth to show how it will look after the crown is added. Finally, the dentist will apply a temporary crown to the top of your tooth. Now you’re ready to go home. Since this is only a “temporary” crown, you need to be careful with it – no hard, chewy or sticky foods, and be very careful when brushing and flossing. (Your dentist will give you more detailed instructions on the day of your appointment.)

Then, after you’ve made your appointment for the second visit, the dentist sends the impression of your “to-be-crowned” tooth to a dental laboratory, which manufactures a permanent crown. This is going to be the new little “part of you” that the dentist will add at your second visit.

Finally, when you arrive for your second visit (usually 2-3 weeks after the initial visit), the dentist will cement the permanent crown onto the top of your tooth. You may now resume regular chewing, biting and eating.

That doesn’t sound so bad, does it? Getting a dental crown is meant to be a safe, comfortable procedure that gets your chompers back into chomping form – we dentists call it “the royal treatment.”

555 N. New Ballas Rd., Suite 355, St. Louis, MO 63141 USA
Dr. Jeffrey Dalin Dalin Dental Associates is the dental office of Dr. Jeffrey Dalin and is located in St. Louis, MO offering cosmetic dentistry, general and restorative dentistry to families. (314) 567-3555 (314) 567-9047 jeff@dfdasmiles.com