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Complications With Dental Crowns – The Crowned Tooth That Now Needs Root Canal Treatment

  • Posted on January 18, 2012 at 9:56 pm



Here’s a disappointing and frustrating event that sometimes takes place in the world of dentistry. A patient comes in with a tooth that is broken or has a large cavity. The tooth hasn’t been bothering the patient but it obviously needs repair. The dentist takes a look at the tooth and decides that the damage the tooth has sustained is significant enough that the tooth requires the placement of a dental crown. The needed work is begun (and even possibly completed) without incident. Then sometime during the next few days, weeks, or even months the scenario changes. Now the tooth does hurt. The dentist tells the patient that they need root canal treatment. So what has happened? Why have things changed?

The apparent answer is that the patient’s “good” tooth has been damaged by the crowning process and because of that it now needs root canal treatment. After all, the tooth didn’t hurt until after the crown procedure had been performed. Well, in response to this train of thought, sometimes the “obvious” isn’t correct. And while creating a dental crown for the tooth no doubt did play a role in the tooth’s subsequent need for root canal treatment, it probably wasn’t the initiating cause. Here’s why.

The housing for a tooth’s nerve tissue is unlike most any other tissue in the body. The nerve, a soft tissue, is encased in a hard shell (the tooth). And because of this, the following complication can occur. When a tooth is traumatized (such as receives a blow, is irritated by the presence of tooth decay, is drilled upon) the response of the dental nerve is to swell (an inflammation reaction). That’s what tissues do when they are insulted. It’s just like when you traumatize (twist) your ankle the tissue surrounding the ankle becomes swollen.

The complication that arises is that this swelling tissue is contained by the confines of the hard tooth. So even though a swelling response occurs, the size of the space in which the nerve lies doesn’t. The net effect is that the nerve tissue is placed under a compressive force, several times what is normal for it.

Now, here’s where the real problem comes into play. As the forces build, the blood vessels contained in the tooth’s nerve tissue become compressed. The net effect of this is that the blood flow to the pulp becomes restricted. So, those necessary duties that the circulatory system provides (carrying oxygen and nutrients to the pulp, carrying away excess fluids) are inhibited. As a result, the nerve tissue’s ability to rebound healthily from the insult is compromised. In the most extreme cases, the nerve tissue will die.

So, with our situation where the patient had a tooth that seemed just fine initially, the dental crown procedure was started (and possibly even finished) and now the tooth hurts, what has taken place? Was the dental crown procedure too traumatic for the tooth? Is it what has caused the nerve in the tooth to become damaged to the point that it now needs root canal treatment?

Well, the answer is both yes and no. Just from the timing alone you would have to suspect that this was the case. The reality of the matter, however, is that the dental crown procedure most likely only precipitated the timing of an event that would have happened anyway. Here’s why.

When teeth experience a traumatic episode, such as that described above, they might sustain enough damage to their nerve tissue that it does die. With many episodes, however, the experience may only result in damaging the nerve, in the sense that it is still alive but debilitated. Because of this, in the future when other traumatic episodes (one or many, each of varying intensity) are experienced, the nerve’s resiliency (ability to healthily rebound) will be subpar. Any one episode might create enough stress for the nerve tissue to push it over the edge, thus causing its death and creating a need for root canal treatment. No one would ever be able to anticipate which specific traumatic episode might trigger this course of events. It’s simply that the potential always exists.

So, in the case of our dental crown, yes the trauma of having the dental crown made could have been stressful enough that it is what caused the degeneration of the nerve. But more likely the tooth was already in a compromised state due to some other experience (most likely the very one that cause need for the placement of the dental crown in the first place). The dental crown procedure was simply the last straw. The debilitated nerve tissue just wasn’t resilient enough to survive the procedure.

This exact same type of scenario can occur with other types of dental treatments. Anything that involves stressing a tooth, either during a procedure or once a restoration has been placed into use, can be the culprit. This means that the placement of fillings, dental bridges, partial dentures or even a person continuing or renewing a teeth grinding habit can set off a course of events just like those described here.

Continue reading Complications With Dental Crowns – The Crowned Tooth That Now Needs Root Canal Treatment

How Will Multiple Sclerosis Affect Your Dental Treatment?

  • Posted on January 15, 2012 at 12:14 am



Muscles

Multiple sclerosis could partially or totally paralyze patients face making it difficult for the dentist or hygienist to work intraorally. MS patients have reported temporary numbness in patient’s teeth, checks, jaw or lips. So you might need to be aware that these signs and symptoms indicate multiple sclerosis not only to identify the early detection of the disease but knowing that the patient has oral symptoms will help you identify the proper treatment planning and proper human needs of the patient. Some MS patients can experience difficulties swallowing, decreased amount of saliva or difficulties of proper use of the tongue. In these conditions its harder for the patient to maintain a good oral hygiene therefore the patients will be at high risk for tooth decay and periodontal disease.

Brushing and flossing

The primary concern that arises in multiple sclerosis patients is the loss of muscle control. This condition can limit the ability to brush and floss using appropriately oral self care tools. In cases where the patient can at least manage to brush easy certain areas of teeth but have difficulties brushing for example posterior teeth, modified brushes or stick floss helpers might be considered ( this depends on the actual muscles that are effected). Every little effort from patients side should be encouraged no matter how little they are. Sometimes patients with severe MS symptoms can require other people assistance to manage oral hygiene care. In this case the caregiver should be motivated to work with the patient, see possible ways that can help the patient become independent and discuss them with the dental hygienist or dentist to find the best possible methods that will help patient maintain a good oral hygiene independently or with less possible help from the caregiver. It is important to emphasize that the most common problems that dental professionals might have to deal with when treating MS patients with severe MS symptoms are: halitosis periodontal disease ( typical problems that are usually associated with poor oral hygiene).

Helping devices during the treatment

It could be hard for the patient to open his mouth for extended periods of time. Controlling patients tongue movements and swallowing could also be a problem. You may use a rubber bite block or a mouth prop in to keep patients mouth open during treatment to avoid any possible tissue trauma. Your can also use a tongue retractor to keep patients tongue steady. A thin piece of rubber or a rubber dam could be so that the patient won’t inhale foreign substances while being treated.

Sedatives

If we use sedative methods like LA , the client may have worse control of the muscles. Make sure you reveal the proper information regarding the medication that the patient is taking so it wont interfere with the sedative injection. You might want to consider patients physician for more information.

Dentures

With time multiple sclerosis might get worse and effect that category of MS patients that wear different types of dental prosthetic aids like full or partial dentures. Muscle spasticity makes it almost impossible the wearing of dentures and the more severe these episodes are the more likely is the patient to hurt him self or even worse swallow them. In fact people that are known to suffer from MS shouldn’t be prescribed or recommended for removable dentures. There are many other possible solutions to avoid all these problems by installing mandibulary or maxillary implants that can support the denture and decrease the accidental risks of dislodging the denture while MS symptoms occur.

Appointment time

You should keep the length of your dental visits at a comfortable length of time because you must avoid as much stress and fatigue as possible for the patient. In general MS clients have a hard time sitting in the dental chair during lengthy appointment and its advised that the dental professional needs to allow multiple brakes of 5 to 10 minutes every half our treatment. When we deal with paralyzed patients that are not able to move upper or lower limbs the situation becomes more complicated. Try to change their position during the appointment to minimize stress. The treatment will require more time due to possible lack of dexterity that affects clients oral hygiene directly and possible muscle soreness since the client is immobile during the appointment time. To reduce patients discomfort its recommended to set up the dental chair with pads. In this way pads will avoid pressure sores and will make the patient feel more comfortable during the appointment. Remember that for these category of patients its best to schedule the appointments early in the morning because it is less stressful for the patient. Also use extra caution in accommodating the patient in the dental. Use specific procedures designed to transfer patients that are on wheel chair. If heavy require the help of a second clinician. You might want to discuss these issues with the patient.

1. Possible ways that will help the patient maintain a normal oral function

2. Possible ways that will make patient increase oral hygiene care (OSC) and be independent in performing them.

3. How to improve self appearance that will maintain a high level of self-esteem and will make him feel “included” in the society

Continue reading How Will Multiple Sclerosis Affect Your Dental Treatment?

Pregnancy and Dental Treatment

  • Posted on January 12, 2012 at 11:20 am



The myth is that pregnant women can not get dental work done as it can harm the baby. That used to be the case 50 years ago but modern dental techniques are so noninvasive that they do not cause any harm to the baby.

I see at least one pregnant woman in my practice every week, who has been turned away from several offices and has been told that she needs to wait until after the baby is delivered to get treatment. Some of these women are in a lot of pain. I do not recommend an expecting mom to be in discomfort during her pregnancy. God know she has so many other things to worry about.

As long as the OB/GYN has no concerns about the mother’s and/or baby’s health, an expectant mom should be able to get the same dental treatment as any other person. Here are some recommendations:

-Pregnancy hormones cause most women to develop gum disease. This is why I usually recommend getting a cleaning every 3 months as opposed to every 6 months.

-X-rays are completely safe, especially digital X-rays since the radiation dosage is extremely low. I recommend my patients wear a double lead apron just as an added measure.

-Brush and floss regularly. The increased frequency of eating during the third trimester can cause cavities.

-Get all your dental treatment before the baby comes. After the baby, life will get so busy that you may not have enough time or there may be no one to watch the baby.

- If you develop bleeding gums during and/or after pregnancy then let your dentist know since you may have gum disease.

Pregnancy changes your life. It also changes your dental health. Dr’s orders: Seek proper dental care during pregnancy, it could prevent a lot of future dental problems.

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Low Cost Austin Dentists

  • Posted on December 28, 2011 at 7:42 am



Dental treatment can be expensive even if you have dental insurance. Most insurance covers basic cleaning and fillings, as well as x-rays and extractions. However, unless you have the best coverage, you may be responsible for partial payment on procedures like root canals, teeth whitening, gum surgery and cosmetic dentistry. If you don’t have insurance cost for dental care can be astronomical.

Dental treatment usually involves relatively low-cost diagnostic measures and if tooth decay or consequent diseases are diagnosed early, the treatment is less expensive. So, education on dental care and early treatment are good ways to keep the cost down. However, there are ways to lower the cost of your dental care either through your place of employment or through low-income, community dental health care programs.

In a place of employment, an employee is usually offered a few dental plan options. The plans range from basic care coverage to the best dental care coverage you can get. The employer may pay all or part of a monthly premium to the dental insurance coverage. When the employee is seen by a dentist, depending on the coverage, he may have to pay for has much as half or as little as nothing for the procedure. Some types of treatment may not be covered under this plan at all.

For instance, cosmetic dentistry is generally not covered by any insurance, as it is not considered essential dental care. In many low-income community dental health plans, the only coverage is for the least expensive alternate treatment (LEAT) that is listed by the insurance company. For instance, if there is the option of a root canal or extraction the insurance company will pay for the extraction because it is less expensive.

In Austin, there are many private dental clinics and healthcare companies that offer low cost dental services. Check the local phone book or go to http://www.tda.org.

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Getting Your Dental Treatment Abroad – 6 Advantages of Dental Treatments Abroad

  • Posted on November 9, 2011 at 9:02 pm



Dental treatment can be an expensive proposition, especially in the European countries. But, it is more affordable in many foreign countries, such as Croatia, India, Malaysia, and China etc. and this is one reason people with dental ailments prefer to get their dental treatment abroad.
One reason for getting expensive dental treatment abroad is because insurance companies are increasingly promoting dental tourism and medical tourism. The cost of medical treatment and dental treatment abroad is just a fraction of what it would cost back home in any of the developed countries. Because of this reason, insurance providers are more than willing to pay for the treatment, if it is sought from a medical facility in a foreign country that has been approved by them. Even if they include the cost of the ticket and visa fee, the total cost of the claim will be lower than it would have been were it have to be settled at home. Yet another reason why people are opting to get their dental treatment abroad is because the doctors and associated staff are far more pleasant and deliver much more personal care to their patients. Though it is true that many of the developing countries may not have the advanced infrastructure, such as roads and transport, they do have medical facilities of the most advanced kind and this is mainly because established insurance companies have helped them set up these medical facilities. Additionally, huge business organizations have begun to realize the potential of medical tourism and are keen to develop it further, so they too have invested heavily in dental treatment hospitals and clinics in a big way. Dental treatment abroad can be very satisfying as it will have to be completed within a certain time frame and the dentist will have to work within timelines with no excuse to call in the patient repeatedly. It is a definite advantage to have this treatment done abroad as the complete procedure is done in one or two sittings. For example, if a patient has had an extraction the dentist will immediately, or the next day, implant a ceramic tooth in its place without having to recall the patient repeatedly. Insurance companies gladly pay for this treatment because of the cost effectiveness and efficient time frame of the dental care rendered to the policyholder. The dentists are of the highest caliber and dedicated to their vocation. They are keen to carve a niche in an ever-increasing competitive field such as dentistry, which includes a lot of cosmetic surgery as well. So, be it root canal treatment, bridging, braces, implants, cosmetic surgery or extractions, patients are moving to dental treatment abroad in a big way. Finally, the benefits of opting for a dental treatment abroad apply to the patient as well as the insurance company, both of who gain by choosing a dental treatment abroad plan – and the patient gets to tour a new country as well!

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Why Do You Need Orthodontic Dental Insurance?

  • Posted on October 31, 2011 at 6:30 am



Orthodontic dental treatment is very popular among the young people especially the teenagers. Many parents came under pressure from their kids who want to wear braces and looks good.

Of course the treatment is best done at a young age for better results. The only drawback that makes the parents step back is the cost of the treatment. Orthodontic treatment could cost anywhere between $4000 to $6000 on average.

I try to answer many questions that parents are asking regarding the orthodontic dental treatment cost.

Is there an orthodontic dental insurance coverage?

Yes orthodontic dental insurance is meant to takes care the cost of orthodontic procedures,equipments and general orthodontic care. If you already have dental insurance, your policy might included orthodontic coverage already. If your policy do not cover orthodontic then you may need a supplementary form of dental orthodontic insurance in order to cover your costs. This is very true if you have family members that need braces or orthodontic work.

How does the orthodontic coverage works?

Just like your regular health or dental insurance coverage,you will be required to pay for the monthly or yearly premium. Your insurance provider will normally pay for your orthodontic care up to a maximum amount. How much is the maximum amount covered and what percentage that your provider would pay depend on your insurance plan and insurance company. There are some insurance companies that will cover up to 50% of the orthodontic care costs.

Why do orthodontic dental insurance necessary?

As mentioned above, orthodontic care expenses can run into thousands of dollars per year or until the completion of the treatment.If you have a few family members that need the treatment at the same time, this could be quite a financial burden.

Why do orthodontic care a lot more expensive than regular dental care?

The chunk of the expense are from the equipment cost such as braces,retainers and other additional products. Also the costs of dental x-rays, regular monthly checkups and adjustments that would need to be made.

All of this expenses make the cost of orthodontic care more expensive than the regular dental care.

On the average the basic dental plan only required a provider to cover up to a certain amount of dental care per year. After this maximum yearly amount, you are responsible for all of the dental costs on your own. For orthodontic treatment, braces alone can cost more than $1000. That’s the reason why a basic dental coverage normally do not cover orthodontic care. In a lot of cases orthodontic procedures are considered as dental cosmetic, therefore many insurance providers do not cover orthodontic work at all.

For all of the above reasons orthodontic dental insurance seems to make a lot of sense. Even though you have to pay additional premiums on top of your regular dental or health insurance, it is still a wise long term investment.

Continue reading Why Do You Need Orthodontic Dental Insurance?