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Hearing that you need a root canal can be highly intimidating. What is a root canal? It is the removal of the nerve supply from the tooth. Here, Dr. Dale Scharine and Dr. Mark Pflum will describe the parts of a tooth and explain the reasons for a root canal and how it is done when you visit us in our Appleton, WI office.

Your tooth is made up of many layers. The outside layer is called enamel and is made of minerals. The middle layer is dentin, which is also a calcified tissue, but less dense. The center of the tooth is called the pulp, and that hosts the nerves and blood vessels. A root canal is the removal and replacement of this center with a sterile filling.

A root canal is needed when an infection spreads to the center of the tooth. This can be from trauma (recent or previous), a cavity, a severe crack, or other compromise that causes nerve damage. An X-ray and examination are required to see if a root canal is needed. Symptoms may include but are not limited to pain, swelling, change in tooth color, and over-reaction to temperature change or pressure.

When it is time to begin, you’ll receive local anesthesia (via injection) to make you most comfortable. A rubber dam is used to isolate the tooth, while other equipment determines the nerve location and maintains a sterile working environment. All of the infected area is removed including the nerve tissue and blood vessels. Then, medicines are used to sterilize and alleviate any pain. Next is the placement of a filling material in the spot where the nerve used to be.

When your nerve and blood supply are taken away, the tooth is non-vital, or dead, and can become weak and fragile. If your tooth is badly decayed, a large portion of it will have to be removed. It is recommended to place a crown on the tooth to keep the enamel from breaking or falling apart. If you do not get a crown, you could eventually lose the tooth to more decay or infection. The tooth could also break off completely and you would have to have an extraction. The crown fits over the top of the tooth and secures it from breaking down.

A root canal saves the life of a tooth that would otherwise succumb to further infection and eventually extraction. Infection is the cause of most-needed root canals. If you are ever unsure what is happening at your appointment, don’t be afraid to ask questions so you understand the procedure completely.

It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization.

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

Talk to Dr. Dale Scharine and Dr. Mark Pflum at our Appleton, WI office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.

The Importance of Facial Protection

Americans from all walks of life should mark April as National Facial Protection Month on their calendars. The American Association of Pediatric Dentistry, Academy for Sports Dentistry, American Academy of Pediatric Dentistry, and American Association of Oral and Maxillofacial Surgeons have combined forces to sponsor this annual campaign, which aims to educate and remind us of the importance of protecting our face and teeth against impacts and injuries.

Wearing a helmet can save your life and prevent devastating physical damage in a variety of situations, from playing football to riding a bicycle. According to the American Association of Oral and Maxillofacial Surgeons, helmets reduce the risk of various head injuries by as much as 85 percent. Whether helmet laws apply in your area or not, Dr. Dale Scharine and Dr. Mark Pflum and our team at Elite Smiles Dental want you to make sure you and your loved ones wear helmets with the appropriate safety ratings for specific activities. (A sticker on or inside the helmet will usually indicate this rating.) Helmets can also help save your teeth if they come with an attached faceguard, an essential addition for football players and others involved in contact sports.

Preventing Dental Injuries

A mouthguard can protect you against a variety of dental injuries, such as cracked, broken, or knocked-out teeth. The American Dental Association states that mouthguards play an essential role in preventing up to 200,000 dental injuries each year, and many states mandate their use for sports activities such as football and hockey. The Academy for Sports Dentistry warns, however, that these mouthguards must be custom-fitted as precisely as possible to prove effective. Have a professional-quality mouthguard molded and fitted by our team at Elite Smiles Dental for better protection than a generic store-bought or “boil-and-bite” variety can offer. These cheaper versions tend to wear out quickly, interfere with proper breathing, and provide uneven degrees of cushion against impacts. Always have a fresh mouthguard fitted for each new sports season.

Choose the right combination of helmet, faceguard, and mouthguard to protect your teeth and face this April, and tell your friends to do the same! To learn more about mouthguards, or to schedule an appointment with Dr. Dale Scharine and Dr. Mark Pflum, please give us a call at our convenient Appleton, WI office!

Spilling soda on someone’s white shirt, telling an off-color joke at an inappropriate time, or sneezing chewed food all over the dinner table all pale in comparison to the socially unacceptable, embarrassing blunder of having ... bad breath!

Five Possible Causes of Halitosis

• Poor oral hygiene practices. Failing to brush your teeth encourages anaerobic bacteria growth, which involves a type of bacteria that emits volatile sulfur compounds (gases) responsible for smelly breath.
• If you have tonsils, you may have tonsil stones embedded in the fissures of your tonsils. Tonsil stones are hard, tiny pieces of bacteria, dead oral tissue, and mucus that form inside tonsil crevices. When accidentally chewed, they release extremely foul odors that others can smell and you can actually taste.
• You have a chronically dry mouth due to medications, allergies, or persistent sinus conditions that force you to breathe through your mouth. Anaerobic bacteria thrive in dry, stagnant environments where oxygen content is minimal. Consequently, a dry mouth tends to lead to smelly breath.
• You have acid indigestion or GERD (gastroesophageal reflux disease). If you constantly belch stomach gases, this not only causes your breath to smell fetid but it can lead to enamel erosion and tooth decay.
• You have one or more oral diseases: gingivitis, periodontitis, or infections in the gums known as abscesses.

Improving oral hygiene practices may eliminate bad breath, but if brushing, flossing, and rinsing with a fluoride mouthwash twice a day doesn’t stop people from backing away from you when you open your mouth, it’s time to visit Elite Smiles Dental.