My Blog

Posts for: January, 2019

By Randal Bourjaily, D.D.S. P.C.
January 28, 2019
Category: Dental Procedures
ARootCanalCanStopToothDecayandSaveYourTooth

Tooth decay can wreak more havoc than just producing cavities. It can work its way into the innermost parts of the tooth — the pulp and tiny passageways called root canals that lead to the tooth's connection with the bone.

If that happens, you'll need more than “drilling and filling.” Without intervention, your tooth could be lost. That intervention is a root canal treatment, a procedure that removes the infection from within the tooth and preserves it from re-infection.

You've probably heard the old belief that root canal treatments are painful. With modern anesthetic techniques to deaden pain, that's not true. In fact, root canal treatments stop the pain caused by infected nerves within the pulp and root canals. More importantly, it saves your tooth.

Root canals can be performed by a general dentist. More extensive decay or complex root canal networks may require the services of an endodontist, a dentist who specializes in root canal anatomy and treatments. Endodontists have advanced techniques and equipment to handle even the most difficult case.

Regardless of who performs it, the basic procedure is the same, as is the goal: to completely remove all diseased tissue within the tooth and seal it with a special filling to prevent re-infection. To access the diseased pulp, we first drill an access hole, usually in the biting surface of a back tooth or the back of a front tooth. We then use specialized instruments to remove the infected tissue and flush out the space with antibacterial solutions.

We then insert a filling called gutta percha into the empty pulp chamber and root canals, seal off the filling with adhesive cement, and close the access hole with filling. These fillings and sealants prevent bacteria from reentering the tooth. For added protection against infection and fracturing, we also recommend placing a full-coverage dental crown. This also enhances the appearance of the tooth, which must be modified during the root canal procedure.

The end result: your once endangered tooth has been preserved for hopefully many years to come. So if we recommend you undergo a root canal treatment, don't wait — the tooth you save may be your own.

If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation.


By Randal Bourjaily, D.D.S. P.C.
January 18, 2019
Category: Dental Procedures
SingerDuaLipaSeestheWisdominPostponingTourDates

When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.

“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”

The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”

A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.

It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.

So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


By Randal Bourjaily, D.D.S. P.C.
January 08, 2019
Category: Dental Procedures
Tags: crown lengthening  
CrownLengtheningMightbeNecessaryforSeniorswithToothDecay

While tooth decay is a potential problem at any age, the risk increases as you grow older. Not only are senior adults more susceptible, decay is often more difficult to treat. That’s because cavities can occur at or below the gum line, often due to gum recession.

If that’s the case, we won’t be able to fill the cavity in the usual way because the gum tissue is in the way. To make it possible to treat, we may need to perform a minor surgical procedure known as crown lengthening.

As the name implies, the procedure helps expose more of the crown, the tooth’s visible part, from the surrounding gum tissue. In basic terms, we’re repositioning the gum tissue away from the biting surface of a tooth to make room for a filling. It’s also useful for improving a tooth’s appearance by making it look longer, or creating room for a crown or other dental restoration.

After applying a local anesthesia, the dentist (or periodontist, a specialist in the gums) creates a tiny flap of gum tissue with a series of incisions. This allows the dentist to move the affected gums out of the way to access the underlying bone. The dentist then reshapes the bone to adequately support the gum tissue when it’s finally repositioned to expose the crown. In its new and improved position, the dentist sutures the gum tissue in place.

For a few days afterward, the patient will need to restrict their diet to soft foods, avoid strenuous activities and apply an ice pack to help reduce swelling the day of surgery. They will also prescribe a pain reliever and possibly an antibiotic to reduce the chances of infection.

While most people return to normal activities a few days later, you’ll usually have to wait a few weeks for the gums to heal before undergoing any further treatments for the affected teeth. But even with the wait, crown lengthening could make it possible to not only save your tooth but improve your smile as well.

If you would like more information on treating tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”