Many dentists have noticed an apparent increase in the incidence of symptomatic cracked teeth in adult patients. While not every cracked tooth can be saved, many can and our experience with many such cases leads to the retention of teeth that may be initially thought to be hopeless. A recent study by Sung Kang, Bom Kim & Yemi Kim on Cracked Teeth: Distribution, Characteristics, and Survival after Root Canal Treatment, showed a 90% survival rate after two years.
This case demonstrates the value of clinical and radiographic evaluation including precise pulp testing and internal microscopic examination of the tooth to determine prognosis and treatment plan.
A sixty five year old male patient presented with a chief complaint of pain that began when he bit down on something hard.
Clinical and radiographic exam showed that tooth #31 was sensitive to biting and percussion and negative to pulp test. There was a visible crack on the distal proximal surface and there was no probing. The 2-D radiograph showed a small radiolucency at the apex of the mesial and distal roots. There was no periradicular radiolucency typical of teeth with vertical root fracture.
Emergency treatment was performed for pain relief and to provide further diagnostic information. Four canals were located, the pulp tissue was necrotic. Microscopic exam showed a crack was present on the mesial and distal proximal walls of the access cavity. There was no crack extending down any of the canals and no crack on the floor of the pulp chamber.
The tooth was closed with a temporary filling and taken out of occlusion. The patient was advised of the existence of the crack and the possible limitations that placed on the long term success of this case. The patient was also informed that he would need to have his dentist place a crown on this tooth soon after the endodontic treatment was completed. The patient stated that he wanted to try to save this tooth.
One week later the patient presented with no pain or swelling. The endodontic treatment was completed. Two weeks later the patient was checked. He had no clinical symptoms and was referred to his dentist for a crown.
Thirteen months later the patient presented for recall exam. He reported no symptoms and the tooth was normal to clinical and radiographic exam. He patient stated that he was very happy that he had been able to retain his natural tooth.
March 4-10, 2018, has been designated by the American Dental Assistants Association as Dental Assistants Recognition Week (DARW). This year’s theme is “Advancing the profession through collaboration and leadership.”
At North Shore & Brookline Endodontics (NSB Endo), we believe our dental assistants are truly exceptional. They are responsible for completing many tasks throughout the day including maintaining the clinical office, helping patients during their visit, assisting endodontists in procedures, patient recordkeeping, cleaning and sterilizing instruments and operatories, and many other tasks.
The most important task of the Dental Assistant is providing exceptional patient care. Our dental assistants are not only talented and passionate about endodontics, they are kind and compassionate to every patient. They treat our patients with the utmost respect and make sure the patients are comfortable throughout their entire time in our office.
At NSB Endo, we value everything the dental assistants do, and appreciate what each individual dental assistant brings to our endodontic team and practice. Thank you to each of our nineteen dental assistants, YOU ROCK!
Endodontic Practice US, a leading publication and endodontic journal, recently interviewed Dr. Fiza Singh and Dr. Peter Morgan on their involvement in the AAE Foundation for Endodontics’ Outreach Program in Treasure Beach, Jamaica. This program is an initiative to provide patients with the highest standard of care and access to treatment to save teeth that might otherwise by extracted.
Dr. Fiza Singh is an endodontist at North Shore & Brookline Endodontics (NSBENDO) and AAE Foundation trustee. She recently led a team of endodontists to the Helping Hands Clinic in Treasure Beach, Jamaica, where they provided care to the underserved. Dr. Singh explains, “It was an eye-opening experience to see so many people living in pain. They have quickly learned that they can save their teeth by having a root canal by a specialist. The result is that patients who haven’t been able to smile for years now can live and work in confidence.”
Dr. Peter Morgan is an endodontist at NSBENDO and the current President of the AAE Foundation. Dr. Morgan explains, “A lost tooth has serious emotional, social, and physical consequences. The opportunity to preserve a tooth with root canal treatment often isn’t an option for patients who have limited access to care. Our teams are honored to be there to relieve pain, save teeth, save smiles, and improve lives.”
Read the full article here: https://www.endopracticeus.com/columns/improving-lives-saving-teeth/
We are proud to announce that Drs. Peter Morgan, Yuri Shamritsky, Fiza Singh, Paul Talkov, Andrea Chung Shah and Samantha Synenberg have all been named Boston magazine’s Top Dentists™ 2017 for Endodontics!
Check them out online at http://www.bostonmagazine.com/top-dentists/
Last month, North Shore & Brookline Endodontics (NSBENDO) was chosen by BostonVoyager to be featured as one of Boston’s most inspiring independent businesses. They conducted an interview with Dr. Yuri Shamritsky, who is one of the Partners of NSBENDO. Please read this article to learn about Dr. Shamritsky’s story as well as the history of our practice.
Last year, the AAE Foundation for Endodontics launched an Outreach Program in Treasure Beach, Jamaica. The program is designed to provide endodontic care to patients in underserved communities. Although The Helping Hands dental clinic in Treasure Beach has been helping patients for over 15 years, last year was the first time that endodontists were on site to save teeth that might otherwise be extracted. Each mission is staffed by an endodontist mentor and two residents, who work with Drs. William Griffin and James Carney, the founders of the clinic.
A few months ago, I was offered the opportunity to travel to Treasure Beach, Jamaica, as the endodontic mentor for the March 2017 Outreach Program. Although during dental school I participated in an outreach mission to the Dominic Republic, this mission would be more difficult, as I would leave behind a husband and toddler. Ultimately, I accepted this mission to educate patients about the importance of saving teeth and to improve the lives of patients that normally don’t have access to endodontic care.
During our mission in Treasure Beach, hundreds of patients waited for hours, and sometimes days for dental treatment. Some traveled over four hours to get there. It was rewarding to know that we were able to perform root canal therapy, eliminate pain, and give patients the confidence to smile.
It was an honor to work beside Dr. James Carney, two endodontic residents, Drs. Juheon Seung and Eduardo Andres, and dozens of wonderful dentists and dental students. The clinic was held in a functional church, so the equipment had to be put up every morning and taken down every evening. The days were incredibly long and hot, the conditions challenging. There were times when equipment broke and electricity faltered, making us nervous we wouldn’t be able to continue. Through all of these obstacles, we persevered by working together. During the four days in our clinic, the entire team treated 381 patient, completed 333 extractions, 155 fillings, 84 cleanings and 42 root canals.
Although I have been in practice for approximately 10 years, as well as serving as an instructor at Harvard Dental School, my clinical background could never have prepared me for this journey. I returned from the mission awed and inspired by all of the work we accomplished and the gratitude of the patients we treated.
Special thanks to Seiler Precision Microscopes for donating one of their microscopes to be used on the trip.
When it comes to root canals, there are a lot of myths about the procedure. Endodontists are trained in root canal therapy and know exactly what is fact and what is fiction.
Here are a few myths about root canals that you need to know about before making a decision regarding your oral health.
1. Root canals are painful
False. That’s right, all the moans and groans you’ve heard about root canal treatment are wrong. While in the past people may have experienced severe pain from a root canal, they no longer do, if any pain is felt, it is minor. Modern treatment aims to relieve the pain of an infected tooth rather than cause more. A root canal removes the damaged and infected tissue in the tooth, which alleviates pain. Cutting edge technologies and anesthetics make it possible for an endodontist to perform the procedure mostly pain-free. Some difficult cases may experience minor pain, but the majority of cases experience little to no pain.
2. Root canal treatment causes illness
MYTH! For a long time it was believed that endodontic procedures caused other illnesses throughout the body. There was no medical evidence behind this at the time, and there is still no medical evidence that confirms a link between root canals and the cause of other illnesses, this belief is false.
In fact, root canals strive to remove bad bacteria from the infected part of the mouth and work to prevent reinfection. These measures are taken to promote healing and overall health. This means that root canals are designed to fight off illness and infection, not cause it.
3. Tooth extraction is a good alternative
False, the truth is that saving your teeth is the best option. If you have the choice between a root canal and an extraction, try to get a root canal. This is because nothing can replace your natural tooth. No denture or implant will work exactly the same as a natural tooth.
An artificial tooth might cause you to avoid some foods because it is not strong enough to withstand chewing them. But, if you receive a root canal, then, most of the time you will be able to keep your tooth for life, and continue to enjoy all of your favorite foods.
Now that you know the truth about root canals, you can make an informed decision when talking to your dentist about the best decision for your oral health.
When you think of an endodontist, you might just think about root canals. While endodontists are specialists in root canal therapy, they can also help treat cracked or chipped teeth.
Our teeth are meant to last a lifetime, however, over time day-to-day activities such as eating and drinking wear away our enamel. This can lead to cracks or chips in our teeth. A crack in a tooth can cause pain when biting or chewing, as well as sensitivity to hot and cold. Sometimes, however, there are no symptoms at all for a cracked tooth.
Having a cracked tooth can lead to further oral health issues. A crack can cause inflammation that will eventually spread to the inside of the tooth, into the area of the tooth that is called pulp. Spreading this pain to the pulp can lead to infection.
An endodontist can treat cracks, by using a root canal treatment to protect the pulp and the tooth. After your cracked tooth has been fixed, you will need to consult your dentist to get a crown.
There are many different types of cracked teeth. Whether you are suffering from a fractured cusp, a split tooth, or a vertical root fracture, an endodontist can help. Talk to your endodontist to find out which treatment is best for your tooth.
If you have a cracked tooth or think that you may have a cracked tooth. Visit an endodontist to alleviate your pain and to get treatment.