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Cavities, Root Canal Therapy, and Gingivitis

When going to a general or cosmetic dentist, a lot of patients are looking to do things that improve their smiles. Whether it is the basic cleaning or a little something to make their smile shine even brighter or maybe fix a crooked tooth, dentists offer something for almost everyone. However, most patients associated trips to the dentist with cavities, root canals, and gingivitis and periodontal disease. Why? It is likely because, after the common cold, these are the most common maladies to afflict Americans and people around the world. Your oral health is tied intrinsically to your overall well-being, so it makes sense to discuss these common annoyances in depth from time to time.

The Common Advice

Proper brushing, flossing, rinsing, and seeing your dentist for your routine checkups and cleanings every 3-6 months are essential to avoiding this problem. However, if you are like many of my patients, you will still run into problems from time to time. Nobody wants to hear about how they have a cavity or needs, their big brother, a root canal. Wear and tear, regular illness (such as colds, flu, or a stomach bug), dry mouth, and other common inflictions can cause the damage that leads to cavities. Genetics also can play a role too, because some people have porous or easily worn enamel. It is better to do a good job cleaning so you can avoid getting a cary (fancy word for cavity), but I understand that they happen and they are nothing to be ashamed of. You hear about many people talking about how they’ve never had a cavity or other minor (or major) dental issue and may even envy them. It’s true that some people are generally resistant to the more common problems, but even if they do take proper care of their teeth and gums, they may have problems later in life such as bruxism related wear, chipped or broken teeth, and any number of other issues. Assuming that they will have perfect, or at least healthy teeth their entire lives with no effort is false.

Cavities and Root Canals — D’oh!

Oops! You have a cavity. It’s better to get these taken care of sooner, rather than later, because if left untreated for an extended period, a cavity may become a root canal. Most cavities, when detected, especially if you are judicious about seeing your dentist are small and can easily be remedied with a filling and other remediation techniques. There are two kinds of fillings commonly used, amalgam and composite or resin. Amalgam are the traditional silver and other metal alloy fillings, and have fallen out of favor due to their concerns of toxicity (overblown!) and unattractiveness. Amalgam also require more of the tooth to be drilled away to install and this is why, like many dentists, I prefer composite or resin fillings. These fillings can be made to match the color of your tooth and appear very natural, especially if they are in a place that may be readily visible, such as the front of your mouth. It is important to get a cavity fixed as soon as possible though, because if left to its own devices, it may become infected and require you to get a root canal. Root canals are actually a common procedure and most people will need at least one in their lifetime. Fortunately, their nature has been blown out of proportion by horror and comedy stories about dentists. While never fun, they are actually not as bad as most people think. Patient comfort has become extremely important in the past few decades of dentistry and almost everyone who needs root canal therapy can get through it with minimal pain and discomfort. Like many dentists, I offer various forms of pain relief and anesthesia as well as sedation. Many patients opt for nitrous oxide or a relaxant, which makes the procedure easier for them and the dentist. Some patients who are especially anxious may also opt for IV (intravenous) sedation, especially if they need several root canals or other work done on top of the root canal. When doing a root canal, a dentist will remove the infected pulp of the tooth, which may seem extreme but is actually not that big of a deal. By the time you will need a root canal, the pulp of your teeth will be superfluous as it is no longer required in the formation of your teeth. This process actually does not take that long and you will likely only feel like it was getting a longer filling. Once the root canal therapy is completed, and depending on the technique, the dentist will place a crown or filling, prescribe a course of antibiotics as necessary, a few basic instructions while you recover and send you on your way. It’s really as simple as that. Of course, like many dentists, I will want a followup to make sure there are no complications and ensure the health of the tooth, as well as the rest of your mouth.


The trifecta of our ‘minor issue’ triple threat. Gingivitis is actually the precursor to one of the leading causes of tooth loss, periodontal disease. This usually occurs due to improper flossing, brushing, and other hygiene technique. While minor gingivitis is easily treatable and reversible, periodontal disease is a much more serious condition that may require oral surgery and other mitigative techniques to remedy. Gingivitis is generally caused by bacterial and thus tartar and plaque build up on the teeth, especially around the gum line. If left untreated, it will eventaully develop into periodontitis, which has a cascade effect as the pockets created between the teeth and gums become even further infected and eventually a tooth or teeth will become loose and may fall out. This is the leading cause of tooth loss in adults. This is why it is important to catch gingivitis early and be attentive to proper cleaning techniques and regular checkups. Gingivitis by itself is very treatable and may, depending on the severity, treated at home. If it becomes more serious and plaque begins to grow beneath the gum line, a dentist may have to intervene with minor oral surgery to remove the infection.

Halitosis also known as Bad Breath

Oh, and let’s not forget our friend halitosis — also known as bad breath. This is a very common problem that actually has a very easy solution. When brushing your teeth, be sure to scrape your tongue with your tooth brush for several seconds before you finish to help get the bacteria which causes stinky breath out from the crevices in your tongue, where most bad breath originates. Of course, regular brushing, flossing, and rinsing also help mitigate this problem.
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