Root Canal Therapy is truly Painless at Vistasol Dental in Montebello

A root canal #rootcanal
is the anatomic space within the root of a #tooth. Part of a naturally occurring space within a tooth, it consists of the pulp chamber (within the coronal part of the tooth), the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root.

Tooth structure
At the center of every tooth is a hollow area that houses soft tissues, such as the nerve, blood vessels, and connective tissue. This hollow area contains a relatively wide space in the coronal portion of the tooth called the pulp chamber. These canals run through the center of the roots, similar to the way pencil lead runs through a pencil. The pulp receives nutrition through the blood vessels, and sensory nerves carry signals back to the brain. A tooth can be relieved from pain if there is irreversible damage to the pulp, via root canal treatment.

Dental pulp
The space inside the root canals is filled with a highly vascularized, loose connective tissue, called dental pulp. The dental pulp is the tissue of which the dentin portion of the tooth is composed. The dental pulp helps complete formation of the secondary teeth (adult teeth) one to two years after eruption into the mouth. The dental pulp also nourishes and hydrates the tooth structure, making the tooth more resilient, less brittle and less prone to fracture from chewing hard foods. Additionally, the dental pulp provides a hot and cold sensory function.
Root canal is also a colloquial term for a dental operation, endodontic therapy, wherein the pulp is cleaned out, the space disinfected and then filled.

Root canal anatomy
Root canal anatomy consists of the pulp chamber and root canals. Both contain the dental pulp. The smaller branches, referred to as accessory canals, are most frequently found near the root end (apex), but may be encountered anywhere along the root length. The total number of root canals per tooth depends on the number of the tooth roots ranging from one to four, five or more in some cases. Sometimes there are more than one root canal per root. Some teeth have a more variable internal anatomy than others. An unusual root canal shape, complex branching (especially the existence of horizontal branches), and multiple root canals are considered as the main causes of root canal treatment failures. (e.g. If a secondary root canal goes unnoticed by the dentist and is not cleaned and sealed, it will remain infected, causing the root canal therapy to fail).

Root canal system
The specific features and complexity of the internal anatomy of the teeth have been thoroughly studied. Using a replica technique on thousands of teeth, Hess made clear as early as 1917 that the internal space of dental roots is often a complex system composed of a central area (root canals with round, oval or irregular cross-sectional shape) and lateral parts (fins, anastomoses and accessory canals). In fact, this lateral component may represent a relatively large volume, which challenges the cleaning phase of the instrumentation procedure in that tissue remnants of the vital or necrotic pulp as well as infectious elements are not easily removed in these areas. Thus, the image of root canals having a smooth, conical shape is generally too idealistic and underestimates the reach of root canal instrumentation.

Anatomic complexity by cone-down CT and ultrasound
Root Canal pulp removed, cleaned and made ready for filling and placing a crown.
Root canals presenting an oval cross-section are found in 50%-70% of root canals. In addition, canals with a “tear-shaped” cross section are common when a single root contains two canals (as occurs, for example, with the additional mesial root seen with the lower molars), subtleties that can be more difficult to appreciate on classical radiographs. Recent studies have shown that use of cone-down CT can detect accessory canals that would have been missed in 23% of cases, which can in turn lead to apical periodontitis. The upper molars, in particular, are predisposed to have an occult accessory canal in nearly half of patients.
When rotary nickel titanium (NiTi) files are used in canals with flat-oval or tear-shaped cross sections, a circular bore is created due to the rotational action of the metal. Also, small cavities within the canal such as the buccal or lingual recesses may not be instrumented within the tooth, potentially leaving residual disease during disinfection.
Tissue or biofilm remnants along such un-instrumented recesses may lead to failure due to both inadequate disinfection and the inability to properly obturate the root-canal space. Consequently, the biofilm should be removed with a disinfectant during root canal treatment.

Dr Noushin Adhami D.D.S

Root Canal Therapy is a painless dental treatment

Dental Crown is the best procedure for restoring your broken tooth

Dental Crown

Although permanent teeth are meant to last a lifetime, it’s easy to let them go. Not brushing is one way to surrender your teeth to tooth decay; skipping regular dental visits is another. Truth is there are several things that can make the health of your teeth go awry — which is why a dental crown is such a common dental treatment. Given how many people have dental crowns of their own, it’s easy to see why you’d want to find out more about teeth crowns.
Tooth crowns are one of the most effective dental solutions for restoring a tooth’s shape, size and strength, or to improve its appearance. Your dentist might recommend teeth crowns to:
– Cover discolored teeth or dental implants
– Protect a tooth from tooth decay
– Restore a broken tooth
– Hold a dental bridge in place

The Dental Crowns Procedure
Preparing teeth for teeth crowns usually involves two visits. Tooth crowns can be prepared and placed in a two visits. During the first visit, We will take an X-ray to examine the extent of decay.

If a root canal isn’t necessary, we will:
– File the chewing surface, sides of the tooth and surrounding teeth.
– Take an impression of the prepared tooth and surrounding teeth.
– Place a temporary crown to cover the prepared tooth while the permanent dental crown is being made.
At your second visit, we will remove the temporary and check the fit and color of the permanent crown, then cement it in place.
Dental crowns are made from a variety of dental materials, including:
– Metal (gold, nickel or chromium)
– Porcelain fused to metal
– All porcelain or all ceramic
– Resin (durable plastic)

Caring for Your Teeth Crowns
Keep in mind that a metal crown requires less tooth structure to be removed, but is less attractive than a porcelain crown. Alternatively, a porcelain crown, though less noticeable, may not last as long as metal or resin crowns.
A new dental crown may make your teeth sensitive to heat and cold. Some dental crown can chip easily and some tooth crowns become loose or fall off. If you experience any problems with your dental crown, call us Today.
Dental crowns don’t keep tooth decay at bay. You still need to brush, floss and have regular dental cleanings. Avoid certain habits such as opening packages with your mouth, grinding your teeth and chewing ice to help prevent tooth crowns from wearing out prematurely. Well-cared for dental crowns can last 5 to 20years.
Reading about dental crowns is a good start; following up with a conversation about tooth crowns with dentist is even better.
Call us today to make your appointment with Dr. Noushin Adhami dentist in Montebello and she will determine if dental crowns are suitable for your dental health.

Dr. Noushin Adhami D.D.S

E-cigarettes just as harmful as tobacco for oral health

Electronic cigarettes are often marketed as a safer alternative to conventional cigarettes. When it comes to oral health, however, new research suggests vaping may be just as harmful as smoking.

Researchers suggest vaping may be equally – if not more – harmful for oral health than smoking.
In a study published in the journal Oncotarget, researchers found that the chemicals present in electronic cigarette (e-cigarette) vapor were equally as damaging – in some cases, more damaging – to mouth cells as tobacco smoke.
Such damage can lead to an array of oral health problems, including gum disease, tooth loss, and mouth cancer.
E-cigarettes are battery-operated devices containing a heating device and a cartridge that holds a liquid solution. The heating device vaporizes the liquid – usually when the user “puffs” on the device – and the resulting vapor is inhaled.
While e-cigarette liquids do not contain tobacco – a highly harmful component of conventional cigarettes – they do contain nicotine and other chemicals, including flavoring agents.

According to the Centers for Disease Control and Prevention (CDC), the use of e-cigarettes has increased in recent years, particularly among young people. In 2015, 16 percent of high-school students reported using the devices, compared with just 1.5 percent in 2011.
E-cigarettes are considered by many to be safer than conventional smoking, but because the devices are relatively new to the market, little is known about the long-term effects of vaping on health.
In particular, study leader Irfan Rahman, Ph.D., professor of environmental medicine at the University of Rochester School of Medicine and Dentistry in New York, and colleagues note that there has been limited data on how e-cigarette vapor affects oral health.

Flavored vapor worsens damage to gum tissue cells
To address this gap in research, the team exposed the gum tissue of nonsmokers to either tobacco- or menthol-flavored e-cigarette vapor.
The tobacco-flavored vapor contained 16 milligrams of nicotine, while the menthol flavor contained 13-16 milligrams of nicotine or no nicotine.
The researchers found that all e-cigarette vapor caused damage to gum tissue cells comparable to that caused by exposure to tobacco smoke.
“We showed that when the vapors from an e-cigarette are burned, it causes cells to release inflammatory proteins, which in turn aggravate stress within cells, resulting in damage that could lead to various oral diseases.”
Irfan Rahman, Ph.D.
The researchers note that nicotine is a known contributor to gum disease, but e-cigarette flavoring appeared to exacerbate the cell damage caused by e-cigarette vapor, with menthol-flavored vapor posing the most harm.
While further research is needed to investigate the long-term effects of e-cigarette use, Rahman and team believe their findings indicate that the devices may have negative implications for oral health.
“Overall, our data suggest the pathogenic role of [e-cigarette] aerosol to cells and tissues of the oral cavity, leading to compromised periodontal health,” they conclude.
E-cigarette vapor damaged, killed 53 percent of mouth cells in 3 days
Another study recently published in the Journal of Cellular Physiology builds on the findings from Rahman and colleagues, after finding a high rate of mouth cell death with exposure to e-cigarette vapor over just a few days.
To reach their findings, Dr. Mahmoud Rouabhia, of the Faculty of Dental Medicine at Université Laval in Canada, and colleagues placed epithelial cells from the mouth in a chamber that contained a liquid similar to saliva.
To simulate vaping, the researchers pumped e-cigarette vapor into the chamber at a rate of two 5-second puffs every 60 seconds for 15 minutes a day. This was performed over 1, 2, or 3 days.
On analyzing the vapor-exposed epithelial cells under a microscope, the researchers identified a significant increase in the rate of cell damage and death.
The rate of damage or death in unexposed cells is around 2 percent, the researchers note. However, they found that with exposure to e-cigarette vapor, the number of dead or dying cells rose to 18 percent, 40 percent, and 53 percent over 1, 2, and 3 days, respectively.
While the cumulative effects of the cell damage caused by e-cigarette are unclear, the researchers believe their findings are a cause for concerna-woman-using-an-ecigarette

Heart disease risk higher with latent tooth infection

If you missed your last dental checkup, a new study might encourage you to book that appointment right away; researchers have identified a higher risk of heart disease for individuals who have hidden tooth infections.

Researchers suggest people with apical periodontitis are at greater risk of heart disease.
Heart disease is the leading cause of death for both men and women in the United States, responsible for around 610,000 deaths every year.
Coronary artery disease (CAD) is the most common form of heart disease, caused by a buildup of plaque in the coronary arteries, reducing blood flow to the heart.
Common risk factors for heart disease include obesity, physical inactivity, smoking, high blood pressure, high cholesterol, and diabetes. However, researchers are increasingly suggesting poor dental health should be added to the list.

Last year, for example, a study published in Infection and Immunity suggested that the bacterium involved in gum disease may also raise the risk of heart disease.
Now, researchers from the University of Helsinki in Finland have uncovered a link between dental root tip infection, known as apical periodontitis, and greater risk for acute coronary syndrome (ACS) – an umbrella term for conditions that involve blocked blood flow to the coronary arteries.
Study co-author John Liljestrand, of the Department of Oral and Maxillofacial Diseases at the University of Helsinki, and colleagues publish their findings in the Journal of Dental Research.
Apical periodontitis is a condition characterized by inflammatory lesions of the pulp in the center of the tooth, most commonly triggered by infection. Dental caries, or tooth decay, are the most common cause of apical periodontitis.
While the condition can cause pain, this may not present until later on in the infection, meaning some people who have apical periodontitis are unaware they have it; most cases are uncovered unexpectedly through X-rays.

Apical periodontitis ‘independently associated’ with CAD, ACS

The research involved 508 individuals of a mean age of 62 years who were part of The Finnish Parogene study and who were experiencing some heart problems.
All patients underwent angiography – an X-ray of the blood vessels. This revealed that 36 percent of the patients had stable CAD, 33 percent had ACS, and 31 percent had no significant CAD.
Using panoramic tomography, the researchers assessed the patients’ teeth and jaws. They found that up to 58 percent of the patients had at least one inflammatory lesion, a sign of apical periodontitis.
The results revealed that patients with apical periodontitis were more likely to have CAD or ACS; this association was strongest for patients whose apical periodontitis was untreated and required a root canal, with a 2.7-times greater risk of ACS.
These results remained after accounting for a number of possible confounding factors, including patients’ age, sex, smoking, type 2 diabetes, body mass index (BMI), and number of teeth.
Based on their findings, the researchers believe apical periodontitis can be considered a risk factor for heart disease:
“Our findings support the hypothesis that ELs (endodontic lesions) are independently associated with CAD and in particular with ACS. This is of high interest from a public health perspective, considering the high prevalence of ELs and CAD.”
Additionally, the team found that patients with apical periodontitis had higher levels of antibodies in their blood that are associated with other common bacteria, further suggesting that oral infections can affect other areas of the body.
In order to protect heart health, the team suggests individuals should adopt strategies to prevent or treat oral infections, which are often asymptomatic.

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