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  1. Does root canal therapy hurt?

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    We often find that the perception of pain is a barrier to some people electing to have root canal therapy when advised by their dentist. It is therefore worth understanding what root canal therapy is, why it is sometimes advised by your dentist and whether it is in fact a painful procedure.

    The nerve sensation that supplies feeling to your tooth is not a simple nerve entering the root of a tooth. It is in fact a delicate jelly-like mixture in the middle of the tooth root containing nerve fibres and blood vessels and this is called the pulp. It is not too dissimilar to the marrow inside your bones.

    When teeth are subjected to decay that is close to the pulp, or if a tooth is injured in some other way, this delicate pulp can die. The result is that the root chamber, known as the root canal, will be left with tissue products on which bacteria can feed and this in turn allows infection to occur.

    So why does a root canal infection hurt if the nerve has died? The pain associated with a root canal infection is due to the fact that the root canal is a closed system. This means that as the infection grows, the limited space makes the pressure build up and it is this increase in pressure that causes pain. In some case, a small channel will develop to the outside gum and a “gum boil” will allow the infection to drain out naturally, relieving the pressure. But in either scenario the source of the infection, the dead pulp tissue in the root canal, will need treating before the infection can be removed.

    The only way to save a tooth when the pulp dies is to remove the pulp. This is what root canal therapy does. In nearly all cases, the procedure will be painless. Good local anaesthetic techniques will mean that you will not feel anything that your dentist is doing. Occasionally, if you present with an acute infection and throbbing pain, the dentist may place a painkilling cream inside the tooth prior to the root canal therapy appointment. This will start to settle the infection so that on the day of the appointment the anaesthetic will work as described above. You really need not let the worry of pain prevent you from saving a tooth with root canal therapy.

    Here at the Dental Clinic- Radlett, to make the root canal appointment even more comfortable, you can pick from a large selections of films, dramas, comedies or documentaries to lighten the experience. If you ever have any questions regarding this or any other treatment, please feel free to ask your dentist.

    Book a check up appointment online now to help maintain healthy teeth.


  2. Teeth grinding and the Temperomandiblar Joint (TMJ)

    Young Woman Thinking

     

    Teeth grinding is the lateral movement of the jaw whilst the top and bottom teeth are in contact, rubbing the teeth together. It is often done in the form of a chewing action, but with no food in the mouth to chew on. In most cases teeth grinding is done during sleep, for this reason most teeth grinders are unaware of their habit. The medical condition of grinding your teeth is known as bruxism.

    Teeth grinding has the potential to wear away the enamel from your teeth, eventually leading to exposed dentine (which is softer than enamel) after which the rest of the tooth will be ground away even faster. You may also wake up in the morning with a stiff jaw or tenderness when you bite together.

    A soft diet and physiotherapy exercises can often help. In some situations hypnotherapy can help reduce or stop you grinding your teeth but in most cases the best that can be done is to control the condition by protecting the teeth by wearing a night-guard. Some drugs can help in certain cases, but this is usually only temporary.

    There are a few different types of guard that can be worn at nightime to `ease` the pressure on the joint capsule. Sometime we make a `soft` guard (usually to wear over the lower teeth) and this can be constructed for those patients who need immediate relief of jaw pain. I do not like my patients wearing a soft guard for the long term because it can eventually have a negative effect- causing the patient to bite into the guard and hence increasing the load on the jaw joint.

    A more long term solution is to construct a hard acrylic `splint` that is usually worn over the upper teeth. This is accurately made to fit over the teeth surfaces to conform to the patient’s bite and will reduce the loading effect on the jaw joint. This in turn will help to alleviate the symptoms of jaw pain and headaches and in some instances may even help with neck and back pain.

     

    Dr. Simon Assor BChD MSc

     


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