Patient safety has always been at the forefront of everything we do at North Shore & Brookline Endodontics, but in light of the COVID-19 pandemic, we’ve had increasing interest from our patients regarding our infection control procedures. While we’ve consistently followed guidelines from the American Dental Association and the Centers for Disease Control to create a safe, sterile environment, we’ve also implemented new protocols specifically designed to prevent the spread of COVID-19.
You can read our COVID-19 safety measures brochure for more details, but you’ll find the most important points below.
Standard Infection Control Procedures
Prior to COVID-19, most patients didn’t give much thought to infection control, but it’s something our team has always taken seriously. These are the protocols we’ve had in place to keep patients safe:
- Annual training in OSHA, HIPAA, and infection control
- Sterilization of instruments after every procedure
- Operatories are disinfected with an EPA-approved surface cleaner between patients
- Staff follows strict hand hygiene, respiratory hygiene, and cough etiquette guidelines
New Infection Control Protocols for COVID-19
Our doctors have closely monitored the latest research on the coronavirus and developed protocols that exceed current CDC guidelines for our patients’ peace of mind. These practices include:
- Training in the appropriate use of personal protective equipment (PPE) and decontamination procedures
- Strict mask protocol, with face masks required in clinical and front desk areas
- Ongoing health screenings and temperature checks for staff
- Scheduling that limits the number of people in the office at any one time
- Offering early morning appointments for high-risk patients
- Waiting rooms have been decluttered and modified to accommodate social distancing
- All high-touch areas will be regularly wiped down with an EPA-approved surface cleaner
- Electric fogger sprayers will be used between patients to sanitize entire rooms in minutes with the touch of a button
What We’re Asking of Our Patients
Finally, we ask all of our patients to also do their part to help limit the spread of COVID-19. We’re asking that you:
- Complete pre-appointment screenings
- Reschedule your appointment if you develop symptoms of a respiratory infection
- Fill out paperwork online to limit time spent in the waiting room
- Wear a face mask at our office—they are required by law
- Use hand sanitizer prior to check-in and entry into the waiting room
- Follow social distancing guidelines
- Come to your appointment alone, unless prior arrangements are made (as may be the case for minors or patients with special needs)
Schedule an Appointment
Our practice is open and scheduling appointments for both new and current patients. Contact us today to schedule an appointment at one of our six greater Boston area locations.
For many, dentistry has developed a complex stigma over the course of time. Even though dental practice has evolved to be patient centered and prioritize comfort, decades of negative experiences continue to color perceptions in the present day. The thought of a root canal alone is enough to trigger significant anxiety for many patients. If you're one of the 36% of Americans who have fear about seeing the dentist, here are a few things to keep in mind.
Dental Phobia vs. Dental Anxiety
These two terms are often used interchangeably, but have some very important differences. Dental anxiety is the experience of nervousness or fear before and during visits to the dentist. A patient with dental anxiety may put off making appointments with their dentist. Dental phobia, on the other hand, has a greater impact on a person's quality of life. A patient with dental phobia may suffer through intense pain and continue to refuse treatment. Dental phobias usually involve feelings of terror or panic at the thought of seeing a dentist, and physical reactions like crying, nausea, or dizziness.
Fortunately, dental anxiety can often be overcome by combining cognitive behavioral techniques and positive experiences with a dentist. Treatment for a true dental phobia requires more intervention and may require a trained therapist or sedation.
The Cycle of Dental Anxiety
In 1984, Ulf Berggren developed a model for dental anxiety that is still widely used today. The cycle is as follows:
Fear and anxiety → Avoidance of dental care → Deterioration of dentition → Feelings of shame, guilt, and inferiority
The feelings of shame lead back to fear and anxiety, creating a cycle that becomes increasingly difficult to break.
If this cycle sounds familiar to you, one way to help you take back control of your oral health is to focus on one stage of the cycle to break at a time. You can begin by making an appointment to see your dentist. Next, understand that dental professionals see people who haven't prioritized their dental health every day. The reasons for not prioritizing dental health vary but there is no need to feel ashamed, embarrassed, or have an excuse at the ready. It happens; you’re human. We're not here to judge you. We’re to help you on your path back to health.
Strategies for Coping with Dental Anxiety
Our practice offers sedation dentistry to patients who need it, however there are other ways to relax before and during your appointment without medication. The American Dental Association recommends the following methods for easing anxiety:
Talk to Your Dentist
First thing's first: when you make your appointment, tell the receptionist that you have dental anxiety. After you arrive, tell the dental assistant, hygienist, dentist, and anyone else who's going to be working with you that you're nervous. Transparency helps us better serve you. When we know a patient has dental anxiety, we can work together with you to make your experience positive and comfortable. This could mean taking breaks during the exam or procedure if you're feeling overwhelmed or taking time before we start working to let you know what to expect.
Distract Yourself
Many of our patients like to bring their phone so they can listen to music or podcasts while we work. Depending on the procedure, you may even be able to watch a movie or TV show. If you like to release nervous energy by fidgeting, use a stress ball. Even thinking about your weekend plans or your next vacation can help you keep your mind off the procedure.
Try Relaxation Exercises
Deep breathing is an effective, research-backed coping mechanism for anxiety. Breathing in through your nose and slowly exhaling through your mouth can help relax your body and mind as you wait for your procedure to start and whenever your dentist is taking a break from work. Progressive muscle relaxation can be done right in the exam chair without anyone knowing.
Make an Appointment at North Shore & Brookline Endodontics
At North Shore & Brookline Endodontics, we provide sedation endodontics for any patient who requires it. Before your appointment, one of our sedation endodontists will discuss your concerns and medical history with you. Together, we can decide the right type of sedation for your individual needs.
If you've been putting off endodontic care because of dental anxiety, it's time to pick up the phone and make an appointment. Our compassionate staff is here to support you before, during, and after your visit. Contact us today to make an appointment at one of our 6 Massachusetts locations.
Although root canal treatment is a common and successful procedure, it is also one of the most feared. Much of this fear is due to myths grounded in long-debunked science, and one of the most common myths of all is that root canals somehow cause heart disease. Here is what you should know.
What Is a Root Canal?
Each tooth has one or more root canals hidden deep inside the tooth’s roots. A root canal procedure is designed to battle infection and decay that have reached these deepest areas of the tooth. This is how it is done, Your dentist would thoroughly numb the tooth and the surrounding tissues, and then drill a small hole through the crown of the tooth into the inner chamber. After carefully removing all damaged tissue and infection the canals are sealed with biocompatible gutta percha, Permanent filling or crown will be later placed to protect the tooth..
Do Root Canals Cause Heart Disease?
In the 1920s, Dr. Weston Price released a study claiming that root canals could cause numerous systemic illnesses including heart disease. Later, his work was thoroughly discredited and the Journal of the American Dental Association released a definitive position paper in 1951 concluding that root canals are the best treatment for teeth that are severely damaged or decayed without any systemic complications.
While Dr. Price’s faulty research implicated root canals as a cause of heart disease and other illnesses, the exact opposite is true. Untreated dental conditions such as root canal infection can introduce bacteria to the bloodstream, allowing it to travel to all parts of the body and raising the risk for a variety of diseases. But a proper root canal treatment prevents such bacterial invasion. Root canal treatment, along with all other procedures that treat tooth decay and gum disease, help to protect your overall health.
Other Common Root Canal Myths
There are two other pervasive myths regarding root canals, neither of which is remotely true:
Root Canals Hurt: At one time, all dental work hurt. Dentists lacked the tools, technology, and pain management protocols for pain-free dentistry. Since root canals are performed on the most sensitive part of the tooth, odds are good that they hurt more than other procedures. Today, dentistry has come a long way, though the myth lives on. The American Association of Endodontists states that those who have actually had a root canal rate the procedure as “painless” six times more often than those who have never had one. Most people go back to work in a day or two.
It’s Better to Pull the Tooth: Dr. Price believed in extraction rather than root canals. Since we know his research was flawed, though, it makes no sense to pull the tooth. It is true that modern tooth replacements are better than ever before, but even the best replacement is not the same as a natural tooth. If a safe, easy, pain-free root canal can save your tooth, it is in your best interest to do so.
Ready to Get Started?
If you need a root canal from an endodontist you can trust, contact North Shore & Brookline Endodontics today at the location that is most convenient for you.
Root canal therapy is generally safe and effective, with a success rate of more than 95%. Like any other medical or dental procedure, though, a root canal can occasionally fail. This is normally due to a loose crown, tooth fracture, or new decay. Root canals can fail soon after the procedure, or even years later. Here are the top 3 symptoms of a root canal failure, and what to expect if it happens.
1. Pain
It is normal to have some discomfort for a few days after your root canal. If you have severe pain that lingers, though, or if your tooth feels better and then starts hurting again, you may be experiencing a root canal failure.
2. Swelling
You may experience some mild swelling around the treated tooth or in your face for a day or two after your root canal. New swelling or swelling that persists, though, could mean that your root canal failed.
3. Discharge
A bloody or pus-filled discharge from the treated tooth or surrounding gums could mean that a new abscess has formed. Pain typically accompanies an abscess, but not always, so it is important to have any discharge checked out.
Treating a Failed Root Canal
If you notice any signs of a root canal failure, call your endodontist right away. There are treatment options that can quickly get you back on the road to oral health without extracting the affected tooth.
Root Canal Retreatment: A root canal retreatment is typically the first course of action. We will disassemble the restorative materials and carefully examine the inside of the tooth to find the problem. We will treat the issue, clean the canal(s), and rebuild your restoration.
Apicoectomy: If the retreatment also fails, you may need an apicoectomy. This procedure removes the tip of the tooth root and replaces it with a filling.
A failed root canal can be scary, and you might even worry that you will lose your tooth. When it is caught quickly, though, we have options to restore your tooth. Although more than 95% of root canals go off without a hitch, it is important to be aware. Keep an eye out for the signs of a root canal failure not only in the days following the procedure but also in the future. If you have pain, swelling, or discharge, call us right away.
Ready to Get Started?
If you need a root canal from an endodontist you can trust, contact North Shore & Brookline Endodontics today at the location that is most convenient for you.
A root canal is a straightforward and simple procedure that can save a badly damaged or decayed tooth. We will thoroughly numb the tooth and the surrounding tissues, and then create a small opening to the root chamber. Next, we will carefully remove all damaged tissue and infection, and seal the canals with a biocompatible material.
Despite its simplicity and commonality, a root canal remains one of the most feared dental procedures of all. Here is the truth behind some common root canal myths.
1. Root Canals Hurt
At one time, there was some truth to this. After all, we are working on the most sensitive part of the tooth. However, modern technology and pain management techniques have rendered root canals virtually pain-free. In fact, according to the American Association of Endodontists, people who have had a root canal are a stunning six times more likely to rate the procedure as “painless” than those who have never had one. Most people are back to work in just a day or two.
2. Root Canals Can Cause Illness
This pervasive myth dates to the 1920s. A dentist named Dr. Weston Price released a study claiming that root canals led to numerous diseases throughout the body. The study was debunked in the 1930s, and the Journal of the American Dental Association concluded in 1951 that root canals are the optimum treatment for teeth that are badly damaged or decayed.
Unfortunately, no myth ever truly dies in the Internet Age. It is easy to find websites claiming that root canals cause illness, but all of their information can be traced to Dr. Price.
The reality is that the mouth is full of naturally-occurring bacteria, but a root canal protects the tooth from bacterial invasion by sealing it. With no way to enter the tooth, bacteria cannot cause an infection, let alone allow one to spread to the point of systemic infection.
3. Extraction is a Better Option
Dr. Price claimed that extraction was a safer and better option than a root canal. With his research debunked, though, it is easy to see that this idea simply does not hold up.
It is true that modern dentistry can create tooth replacements that restore most of the chewing ability, bite strength, and aesthetics of a missing tooth. However, even the best replacement is no substitute for a natural tooth. Natural teeth have a fully stabilized system of roots and provide 100% of bite strength and chewing forces. If an easy, safe, pain-free root canal can save the tooth, it only makes sense to do so.
Ready to Get Started?
If you need a root canal from an endodontist you can trust, contact North Shore & Brookline Endodontics today at the location that is most convenient for you.
Having your blood pressure checked is a routine part of any physical or visit to the doctor. In recent years, many dentists have also begun using this test to determine the safety and viability of treating patients as well. Whether your visit is for a routine cleaning or a more lengthy dental procedure such as a root canal, you should go into every dentist’s office knowing the risks of having dental work done with high blood pressure.
Causes of High Blood Pressure
Nearly one in three adults suffers from hypertension, or high blood pressure, in the United States. In a normal, healthy person, the heart pumps blood across your body through arteries. For someone with high blood pressure, however, the walls of those arteries are under a significant amount of stress, putting extra strain on the heart as it attempts to move blood throughout your system. Men are more prone to high blood pressure than women, and your risk of developing the condition goes up as you age. In addition, there are a few other factors that may make you more prone to high blood pressure.
- Diet. High cholesterol levels are present in nearly half of those with hypertension. Diets that are high in unhealthy fat and sodium increase your cholesterol, clogging arteries and making it more difficult for your heart to pump blood.
- Stress. While many tasks and events may be temporary sources of stress, more chronic problems have been shown to increase blood pressure, as well as lead to other habits that increase the risk of high blood pressure.
- Tobacco & Alcohol Use. Smoking and drinking shrink blood vessels, increasing pressure on your arteries. Additionally, tobacco reduces the amount of oxygen in your blood, causing your heart to work harder than it should.
Detection & Prevention
Although regular physicals and trips to the doctor should be a part of every healthy person’s routine, regular cleanings at a dental practice tend to happen much more often than visits to a doctor’s office. By providing blood pressure checks, dentists can help patients discover they have high blood pressure, which may be a warning sign for more serious illnesses like diabetes and cardiovascular disease.
If you have an abnormal blood pressure reading, you may want to consider making an appointment to see a doctor for a proper diagnosis, and to receive the care and medication you may need to avoid serious and life threatening complications like heart attacks in the future.
Risks of Hypertension
While a good dentist will do everything in their power to make you as comfortable and relaxed as possible during your visit, the reality is that having any dental work done is incredibly stressful for many people. In most cases, stress raises blood pressure, which could cause problems if your reading is already particularly high. Root canals, although typically no more painful than a regular filling, are a more lengthy and costly procedure that may cause your brain and body more stress than you realize.
Root canals also require a good deal of anesthesia to keep the area numb and pain-free. Depending on what anesthesia your dentist uses, it may contain epinephrine, a form of adrenaline that makes the numbing effects last for a more extended period of time. Epinephrine shrinks your blood vessels, which in turn could increase your blood pressure.
Although most dental procedures are relatively safe, your dentist may recommend you cancel or postpone your root canal if your blood pressure is at an abnormal level to avoid any potential threats to your health.
Need More Information?
If you’re in need of dental care and looking for an experienced and professional practice, contact North Shore & Brookline Endodontics at 617-735-8500 today to schedule your appointment.
If you have been told you need a root canal, you probably have a lot of questions and more than a little fear. Myths and legends about this common procedure persist, despite the fact that modern dentistry has rendered root canals virtually pain-free. Knowledge is power, and understanding exactly what to expect can help ease your mind as you wait for your root canal.
Why Do I Need a Root Canal?
A root canal is often considered the last chance to save a tooth from extraction. It is performed when a tooth’s pulp tissue becomes infected. Trauma and tooth decay are the most common reasons for this infection to occur.
If you need a root canal, you have likely had trouble with the bad tooth for a while. Swelling in the gums, temperature sensitivity in the tooth, and severe pain when chewing are extremely common symptoms. If you have waited out these symptoms, you may have even developed an abscess. You might be experiencing severe pain and swelling, as well as bleeding and pus discharge from your gums.
How Will a Root Canal Fix My Tooth?
A root canal goes deep into the tooth’s root chamber to clean out all the infection and decay, restoring the tooth to health. The tooth is then sealed with a crown to prevent infection from recurring.
Step by Step Procedure and What to Expect
A root canal is a relatively minor, common dental procedure. Here is a step by step overview:
- We numb the tooth completely with local anesthesia.
- We drill a small hole through the tooth into the root chamber, exposing its canals.
- We use a series of files to clean out all infection, then smooth and reshape the canals.
- We fill and seal the canals with a biocompatible material.
- We place a temporary filling or crown to protect the tooth.
- You return to your general dentist in a few days to receive a customized crown on the treated tooth.
Despite its fearsome reputation, a root canal is no more painful than any other dental procedure. In fact, since abscesses are highly painful, many people feel a great deal better immediately. If you experience any pain during the procedure let us know, as you will need more local anesthesia.
When the anesthesia wears off, you will likely feel some discomfort that can be easily relieved with over the counter painkillers. Your tooth may feel sensitive for a couple of days, so try to avoid chewing directly on it. Most people feel just fine after two or three days. If you have any lingering pain, call us immediately.
Long Term Prognosis
The overall success rate for root canals is around 95%. There is a very slight risk of reinfection if the sealing material breaks down over time, but the vast majority of teeth that have had root canals never need any further treatment. Out of an abundance of caution, try to avoid biting down directly on the tooth until you receive your permanent crown, which will not only make the tooth look and function just like the rest of your teeth, but will also provide additional protection.
Are There Any Alternatives?
Unfortunately, if a tooth needs a root canal, the only other option is to pull the tooth and replace it with a dental implant, a partial denture, or a bridge. While these are wonderful options for teeth that cannot be saved, they are no substitute for your own natural tooth. If a root canal can save your tooth, it is by far the best alternative.
Ready to Get Started?
If you need a root canal from an endodontist you can trust, contact North Shore & Brookline Endodontics today at the location that is most convenient for you.
After 44 years at North Shore & Brookline Endodontics, Dr. Peter A. Morgan retired from the practice of endodontics at the end of August, 2019. His presence at our practice will be missed, but his principles of quality patient care and collaborative referral relationships will continue as hallmarks of our practice.
Dr. Morgan began his career as a Captain in the U.S. Army Dental Corps after graduating from the University of Pittsburgh School of Dental Medicine. During this time, he served at Womack Army Hospital in Fort Bragg, NC and Walter Reed Army Medical Center in Washington, DC. Dr. Morgan later completed his endodontic specialty training at Boston University School of Dental Medicine, earning a Master of Science in Dentistry.
Some of Dr. Morgan's many professional achievements include being named a Diplomate of the American Board of Endodontics in 1985, and serving as president of the North Shore Dental Society and the Massachusetts Association of Endodontics. He also served as Associate Clinical Professor at Boston University Goldman School of Dental Medicine. Dr. Morgan served three terms on the Board of Trustees of the American Association of Endodontics, and on the AAE Committee on Endodontic Software and as Chair of the Annual Session Planning Committee. More recently, he served a 2-year term as President of the AAE Foundation for Endodontics.
As part of his work with the AAE Foundation for Endodontics, he was instrumental in developing and securing funding for the Outreach To Care Program. This program provides patients at clinics in underserved areas with access to endodontic treatment to save teeth that might otherwise be extracted. By establishing these Outreach Projects, the Foundation for Endodontics fulfills its mission to provide care to underserved populations,domestically and abroad, and promote public awareness of the value of saving natural teeth.
“Dr. Morgan served the specialty of endodontics by offering his time to participate in the AAE Foundation. The non-profit foundation is dedicated towards the continued strength of the endodontic profession and to preserve the endodontic specialty. Dr. Morgan looked beyond his self interests and beyond his private practices to help the general profession which will be impacted in a positive way for many years to come.” Jim Gaitan, Co-Founder of Dentalfone
Dr. Morgan has brought a passion for endodontic technology to North Shore & Brookline Endodontics, embracing new therapies and technologies to improve both comfort and outcomes for our patients. At a recent function celebrating his retirement, he said, “I will miss the excitement that is coming with the constant evolution of technology and treatment techniques in endodontics. Based on the history of our practice, I am sure it will be in the vanguard of appropriate application of these new technologies, resulting in even better results for patients and more natural teeth preserved.”
Dr. Morgan and his wife Jessie Morgan who is an established contemporary artist, live and work on the North Shore of Boston where they enjoy boating and spending time with their grandchildren.
Please join the doctors and staff members of North Shore & Brookline Endodontics in extending warmest retirement wishes to our senior partner, mentor and friend, Dr. Peter A. Morgan.
Endodontics is a dental specialty focused on the pulpal tissue within teeth. Endodontic procedures can oftentimes save a tooth with extensive decay from requiring an extraction. The most common endodontic procedure is a root canal. However, saving some teeth may require additional procedures. Here is what you should know.
Root Canal
Although root canals can cause many patients anxiety, they are actually quite simple. Modern technology and pain management techniques have made them nearly pain-free.
Root canals are performed when the pulp tissue within a tooth becomes inflamed and/or infected. Left untreated, the infection can develop into an abscess, compromising the jawbone and inviting the risk of serious complications. If a tooth needs a root canal, the only alternative is extraction.
First, we numb the entire tooth and surrounding tissues with a local anesthetic. Next, we drill a small access in the crown of the tooth to expose the pulp chamber. Using specialized tools, we carefully remove all the damaged tissue from the root canal(s). The canals are then shaped to allow disinfection with a cleansing solution. The remaining space is then filled with gutta percha; a biocompatible material. Finally, a temporary filling is placed to seal the access from bacteria. You will then visit your regular dentist to begin the process for a crown. Pain is usually minimal and responds well to over the counter pain medications, with most people returning to work in just two days.
Root Canal Retreatment
Root canals have a success rate of 95% when performed by an endodontist. However, a root canal can fail. Common causes include a tooth fracture, a loose crown, or new decay in the tooth. When this happens, a root canal retreatment is the ideal course of action.
After thoroughly numbing the tooth and surrounding tissues with a local anesthetic, we remove the crown, reopen the tooth, disassemble any restorative materials, and remove the gutta percha. We then carefully examine the inside of the tooth to locate the source of the problem. We can then clean the canal(s) and re-seal the them. Your dentist will place a new customized crown.
Apicoectomy
If a root canal retreatment fails, an apicoectomy may be the treatment of choice. In this procedure, we remove the tip of the tooth root and replace it with a filling.
After using a local anesthetic to thoroughly numb the tooth and surrounding tissues, we push back the gum tissue, exposing the tooth root. We use highly precise instruments and magnification to carefully remove the tissue believed to be causing the infection, which is typically just a few millimeters of the tooth root. We then place a retrograde filling and replace the gum tissue with sutures. Over the next several months, the bone will heal around the treated root.
Endodontics can also include some less-common procedures such as root resection or repair. In all cases, our focus is on treating the tooth’s roots, helping you keep a tooth that would otherwise have to be extracted.
Ready to Get Started?
If you need a root canal from an endodontist you can trust, contact North Shore & Brookline Endodontics today at the location that is most convenient for you.
The doctors and staff of North Shore & Brookline Endodontics (NSBENDO) are pleased to announce the addition of two new endodontists to our team. You can access their bio pages by clicking the following links: Dr. James V. Pastore and Dr. Miguel A. Roque.
At NSBENDO, we recognize and appreciate that the growth of our practice is due to the support from doctors and staff members of the dental community. We strive to deliver the highest quality of endodontic treatment so that you may continue to refer your patients with confidence. We pledge to always return your patients to you with appreciation for your referral.
We have integrated technology, such as surgical microscopes, Schick digital imaging, Electronic Health Records and 3D imaging with the latest Sirona XG-3D-CBCT scan, to provide every possible advantage for achieving successful outcomes in our cases.
The addition of Dr. Pastore and Dr. Roque to the professional team at NSBENDO will allow us to provide even more comprehensive coverage to our network of offices. With more endodontists, our practice will be well-positioned to meet our long-standing commitment to providing timely service for emergency patients and expedient endodontic treatment.
We hope that you will join us in welcoming Dr. Pastore and Dr. Roque. We are confident that you will find them to be excellent endodontists and caring individuals to whom you can confidently refer your patients.
Sincerely,
Peter A. Morgan, DMD, MScD