By Vincent J Castellano DMD
February 15, 2022
Category: Dental Procedures
StayonAlertforaDecayRepeatEvenAfteraRootCanal

A deeply decayed tooth is in serious trouble, and something a regular filling may not fix. You may instead need a root canal, a common tooth-saving procedure performed by general dentists or, in more difficult cases, endodontists (specialists in interior tooth treatment).

Regardless of who performs it, though, the basics are the same: The dentist accesses the tooth's decayed interior by drilling a hole and removing diseased tissue from the pulp and root canals through it. They then fill the empty spaces with a rubber-like substance before sealing the tooth and later crowning it to prevent re-infection.

For most, a root canal gives a decayed tooth a new lease on life that can last for years, if not decades. Occasionally, though, a root canaled tooth may become reinfected from tooth decay. There are a number of possible reasons for this unfortunate outcome.

For one, the decay might not have been caught until it had advanced into root canal filling, resulting in contamination. Although root canal treatment may still be effective, the chances of success are much lower than for a decayed tooth diagnosed before it had advanced this far.

Teeth with multiple roots or complex root canal networks are also difficult to treat. The challenge is to ensure all the root canals within the tooth have been thoroughly treated. These types of situations are usually best undertaken by an endodontist with microscopic equipment and advanced techniques that can better infiltrate intricate root canal networks.

These and other situations could make it more likely a root-canaled tooth is reinfected. Depending on the extent of damage, it may be best to extract the tooth and replace it with a dental implant or other restoration. But it's also possible to repeat the root canal—and the second time may be the charm.

As with many other dental conditions, the best outcome regarding a reinfected tooth after root canal is early detection and treatment. You can increase your chances of this with regular dental visits that include monitoring of any root-canaled teeth. You should also see your dentist as soon as possible if you notice pain or gum swelling associated with the tooth.

Root canals are highly effective at saving decayed teeth. But the rare reinfection is possible—so be on the alert.

If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment: How Long Will It Last?

By Vincent J Castellano DMD
February 05, 2022
Category: Oral Health
Tags: gum disease  
TheFirstStepToBeatingGumDiseaseIsUnderstandingHowItStarts

If you're over thirty, you have a fifty-fifty chance of contracting gum disease and your odds worsen as you get older. But your fate isn't sealed, especially if you know what to do to prevent this harmful disease.

But before we discuss your prevention strategy, let's look first at oral bacteria, the basic cause for gum disease. Although most bacterial strains in your mouth are benign or even beneficial, a few can infect your gums. And, the more of them there are in your mouth, the higher your risk for infection.

These bacteria multiply with the help of a sticky biofilm called dental plaque, providing them a ready source of food and shelter. Plaque and its hardened form tartar accumulate daily on dental surfaces, particularly if you don't practice daily brushing and flossing.

Once a gum infection begins, the body unleashes an inflammatory response to isolate the infected tissues from healthy ones. As a result, the gums can become swollen and reddened, and may easily bleed. If you see signs like these, you should seek treatment as soon as possible to stop the infection's advance.

And, advance it will, spreading ever deeper into the gums until it threatens the supporting bone. At this point, with the gums becoming detached from the teeth and the bone compromised, the affected teeth could be in imminent danger of loss.

These basic disease processes underscore the importance of one thing—the daily removal of bacterial plaque through brushing and flossing. The bacteria that cause disease don't thrive well in an environment devoid of plaque.

But even if you're diligent about your hygiene, you may still miss some plaque; this can then calcify into tartar, which is likely impossible to remove with brushing and flossing. That's why you need dental cleanings at least every six months to remove stubborn tartar and any lingering plaque.

Regular dental visits also increase your chances of early gum disease detection. The earlier we're able to diagnose and start treating an infection, the better the outcome.

Gum disease can begin and advance quickly, sometimes without you noticing. But daily brushing and flossing, regular dental cleanings and prompt attention at the first sign of trouble can help you stay ahead of this harmful disease.

If you would like more information on preventing gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Gum Disease Gets Started.”

AstheNewYearBeginsHeresaFreshLookattheEffectsofAlcoholonYourOralHealth

Throughout much of the world, January 1st signifies the first day of a brand new year. It's also commemorated by many as National Hangover Day—aptly so, as scores of New Year's Eve celebrants spend the day nursing their headaches and upset stomachs. It may also be an appropriate time to assess the health impact of alcohol—especially on your teeth and gums.

First, the bad news is that immoderate alcohol consumption increases your risk for tooth decay, gum disease and oral cancer. One of the reasons why has to do with sugar found in varying amounts in alcoholic beverages, often included during brewing or distilling to feed the yeast that produce the alcohol. Sugar is a primary food for oral bacteria, which can infect the gums and produce enamel-eroding acid, a prelude to both gum disease and tooth decay.

Along the same lines, alcoholic beverages are often paired with mixers, many of which like sodas and energy drinks contain sugar and high levels of acid. A mixed drink could thus contribute to an even more hostile environment for teeth and gums.

The frequency of your alcohol consumption may also contribute to enamel erosion. Ordinarily, saliva can neutralize oral acid in about thirty minutes to an hour. But saliva can't keep up if you're drinking one round after another, leading to sustained periods of acid contact with the teeth.

Alcohol—or specifically, too much—may also contribute to oral problems. Being under the influence increases your risk for tripping, falling and, shall we say, engaging in fisticuffs, any of which could result in traumatized teeth and gums. And, heavy drinking over a lifetime could increase your risk for oral cancer.

You could avoid these and other outcomes by abstaining from alcohol altogether. But if you do like the occasional wine, beer or spirit, here are a few tips to lower the risk of harm to your mouth, teeth or gums.

Limit your daily consumption. A rule of thumb, according to the Mayo Clinic, is to have no more than two drinks a day if you're a man, one if you're a woman.

Pause between drinks. Rather than downing one drink after another, wait at least an hour before your next round to allow saliva to neutralize any accumulated mouth acid.

Go easy on mixers. While it's fine to indulge in the occasional Old Fashioned or Margarita, choose unmixed beverages like beer, wine or straight spirits more often.

Brush and floss afterward. After a night on the town, don't turn in until you've cleaned your teeth and gums of any residual sugar or acid.

If you would like more information about how alcohol could affect your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Nutrition—It's Role in General and Oral Health.”

By Vincent J Castellano DMD
January 16, 2022
Category: Oral Health
EmmaRobertsConfessestoHavingaMajorSweetToothWhileExpecting

Emma Roberts, star of American Horror Story (and niece of actress Julia Roberts), welcomed her first child at the end of 2020. She confessed that her love of sweets made pregnancy challenging. She couldn't get enough of cupcakes with sprinkles and a Salt & Straw ice cream flavor called The Great Candycopia. But Roberts isn't unique. Hormonal changes in pregnancy often bring heightened cravings for certain foods. Unfortunately, this can increase an expectant mother's risk for dental disease, especially if they're consuming more sugary foods.

In fact, around four in ten expectant women will develop a form of periodontal disease called pregnancy gingivitis. It begins with dental plaque, a thin film that forms on tooth surfaces filled with oral bacteria that can infect the gums. And what do these bacteria love to eat? Yep—sugar, the same thing many women crave during pregnancy.

So, if you're expecting a baby, what can you do to minimize your risk for dental disease?

Practice oral hygiene. Removing dental plaque by brushing and flossing daily is the most important thing you can do personally to prevent both tooth decay and gum disease. It's even more important given the physical and hormonal changes that occur when you're pregnant. Be sure, then, that you're diligent about brushing and flossing every day without fail.

Control your sugar intake. If you have strong cravings for sweets, cutting back may be about as easy as stopping an elephant on a rampage through the jungle. But do give your best effort to eating more dairy- and protein-rich foods rather than refined carbohydrates like pastries or candies. Not only will reducing sugar help you avoid dental disease, these other foods will help strengthen your teeth.

Maintain regular dental visits. Seeing us for regular cleanings further reduces your disease risk. We can clean your teeth of any plaque deposits you might have missed, especially hardened plaque called tartar that's nearly impossible to remove with brushing and flossing. We'll also monitor your teeth and gums for any developing disease that requires further treatment.

Undergo needed treatments. Concerned for their baby's safety, many expectant mothers are hesitant about undergoing dental procedures. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association endorse necessary dental treatments during pregnancy, even if they include local anesthesia. We will make you have only a safe type of anesthesia, and we can advise you when it is prudent to postpone certain treatments, such as some elective procedures, until after the baby is born.

Emma Roberts got through a healthy pregnancy—cravings and all—and is now enjoying her new baby boy. Whether you're a celebrity like Emma Roberts or not, expecting a baby is an exciting life moment. Follow these tips to keep your teeth and gums healthy throughout your pregnancy, and be sure to let the dental team know of your pregnancy before any treatment.

If you would like more information about dental care during pregnancy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Pregnancy and Oral Health.”

By Vincent J Castellano DMD
January 06, 2022
Category: Oral Health
Tags: thumb sucking  
LateThumb-SuckingCouldCauseBiteProblems

Of the many concerns pediatric healthcare providers hear from parents, thumb-sucking is definitely on the short list. Such a worry isn't totally unwarranted—persistent thumb-sucking could influence poor bite formation.

But if you have an infant or toddler who can't seem to keep their thumb out of their mouth, there's no need to panic—yet. Thumb-sucking is a nearly universal habit among young children, but the vast majority won't suffer any long-term harm from it.

That being said, though, it can become a problem if the habit continues on into late childhood, especially as permanent teeth begin to come in. That's because of the habit's relationship with the transition that occurs in child's swallowing patterns.

Babies initially thrust their tongue forward as they swallow, which helps them maintain a seal on the breast or bottle. This causes the jaws to remain partially open and not completely shut together, what's known as an open bite. Later, when weaning off milk for solid food, the pattern will change as the child begins moving the tongue down and away as they swallow. This in turn allows the jaws to completely shut.

Thumb-sucking often coincides with the initial infant swallowing pattern, and it usually fades about the time the child is moving into the more adult pattern. Persistent thumb-sucking, however, interferes with that process, essentially extending the open bite longer than normal, which in turn creates the conditions for poor bite development. Thumb-sucking can also put undue upward pressure on the front teeth, which could disrupt their alignment.

If thumb-sucking causes these conditions to develop, a child could eventually need extensive orthodontic treatment later in childhood or adolescence to correct their bite problems. The better course, though, is to avoid this by encouraging your child to end their finger-sucking habit, preferably by the age of 3.

It was common in years past to coat a child's thumb with something spicy that although not harmful was definitely not pleasant to taste. Today, most care providers recommend a more positive approach like offering praise or rewards to a child when they avoid sucking their thumb.

It may take time, but persistence and patience can win out. And, the biggest winner in ending thumb-sucking will be the child's long-term oral health.

If you would like more information on the dental effects of thumb-sucking, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”





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