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Root canal: Can your general dentist handle it?

Root canal: Can your general dentist handle it?

In spite of what you’ve heard about root canals, they’re not time-consuming or painful, especially if you ask your dentist and get informed about the best treatment for your specific tooth or teeth.

Root canals are one of the best ways to save your tooth after it’s been cracked, infected, or decayed past the point of getting a crown. The earlier the pulp, the living tissue inside your root, is treated, the better your chances of saving your teeth. 

At Signature Smiles, Dr. Scott Howell, a Harvard-trained root canal specialist, has a reputation for being extremely professional and gentle. He’s an endodontist who received an extra years of advanced residency training in the diagnosis and management of diseases and disorders of the dental pulp.

When performed correctly, root canals have as much as a 97-percent success rate, said Thomas P. Connelly, D.D.S., of New York City. 

Not all dentists, though, have the extensive experience that endodontists do. Working with a dentist who specializes in anesthesiology, you can be assured that you’ll get painless and safe treatment. That care is available at Signature Smiles.

You also won’t have to see a new dentist, fill out all the medical history paperwork, and deal with financial and insurance worries.

Not all teeth are alike when root canal is needed, dentists explain. For someone with a small mouth, the surgery is a little more complicated. Back molars also have three canals to check for infection and therapy. 

Although it’s standard to use dental dams inside the mouth during root canal, only 47 percent of dentists always use them, according to a study by the University of Alabama at Birmingham School of Dentistry. The study asked almost 1,500 general dentists about dental dams usage. Researchers found substantial differences in their attitudes.

When The Wealthy Dentist marketing website surveyed general dentists about how often they perform root canals, some were hesitant to do them in their office, especially if complications arise. Only 17 percent of dentists referred out all root canals to endodontists. In rural areas particularly, many male dentists did the procedure themselves.

Patients with small mouths and infected molars should definitely seek out an endodontist. These specialists have all the equipment and expertise needed for the best medical care.

During the procedure, the American Association of Endodontists and textbooks recommend a dental dam for preventing saliva in bacteria from reaching the tooth, which could jeopardize the chances of successful treatment. If the patient has to return due to complications, there’s a much lower success rate.

“Beliefs that dental dam use is inconvenient, time-consuming, not effective, not easy to place, or affected by patient factors were independently and significantly associated with lower use of a dental dam,” said Gregg Gilbert, DDS, professor and chair of the department of clinical and community sciences at UAB.

The cost associated with this treatment can vary depending on the severity of damage to the affected tooth and which tooth is affected, according to Dr. Robert S. Roda of Scottsdale, Arizona. 

In general, endodontic treatment is much less expensive than tooth removal and replacement with an artificial tooth, Roda said.

Don’t be intimidated by the thought of a root canal. With a variety of treatments available it’s easier to find the best treatment for your specific case. 

How General Anesthesia Differs from IV Sedation

How General Anesthesia Differs from IV Sedation

When you or your child need a dental procedure, likely you’re going to need anesthesia. The options can be confusing. It’s important to know the differences between the different types of sedation and anesthesia, so you can make the right decision for you, and ask the dentist the appropriate questions.

One question that dentists hear a lot is what’s the difference between IV sedation and general anesthesia. It’s a great question since they both involve an intravenous line. To answer it, let’s go through the various types of anesthesia.

Local anesthesia

When you get local anesthesia, it means that the procedure area gets numbed. Usually that’s done with a shot of Novocain, perhaps with some numbing gel applied first with a swab. The local anesthesia doesn’t affect the rest of you, and won’t make you more relaxed. It just means the surgical area won’t hurt during the procedure. These shots are often used for filling cavities, doing root canals or removing teeth.

Conscious or minimal sedation

With sedation, the patient gets a form of anesthesia that relaxes them, making it easier to tolerate a dental procedure. Several substances are used to sedate someone for dental procedure. For kids it’s often nitrous oxide, otherwise known as laughing gas. Adults might get nitrous oxide, but they may also take an anti-anxiety pill or a liquid to sedate them. With these types of sedation, the patient is able to breathe independently, so an airway tube isn’t needed, according to the American Dental Association. Like with local anesthesia, this sedation is used for root canals and removing teeth, or for patients who might be anxious or uncooperative during the procedure.

IV Sedation

Intravenous sedation, or IV sedation, makes dental procedures easier to tolerate, especially for nervous patients. It can also make the procedure safer, because the patient is relaxed and will remember less about the procedure. This means less mental trauma, making future dental treatment easier. With IV sedation, the medication is put directly into the patient’s vein, so it is fast-acting and the patient gets a deeper level of sedation. Patients are still conscious during the procedure, but there is some recovery time at the end of the procedure. It’s also used for root canals and removing teeth, and for anxious patients and those who might not cooperate during the procedure.

General Anesthesia

General anesthesia is the deepest form of sedation, as the patient becomes unconscious during the procedure. That means the patient will have no memory of it. Like with IV sedation, the medication is given through the veins. Patients get a breathing tube to make sure they’re getting the oxygen needed. There’s a longer recovery time after general anesthesia, and the procedure is done at an outpatient facility like a dental surgery center. Dentists certified in anesthesia can administer general anesthesia, as it requires additional training. General anesthesia is recommended for extensive procedures or for patients who are extremely anxious or have issues with cooperation or following directions.

Your dentist at Signature Smiles can talk to you about anesthesia recommendations for your dental procedure. 

Past stances on immigration come back to haunt Clinton, Sanders

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Both Bernie Sanders and Hillary Clinton had to battle with past immigration stances at Wednesday's Democratic debate. Sanders went first. 

In 2007, Sanders voted against an immigration reform bill. But since then, he has voted for the DREAM Act in 2010 and immigration reform in 2013

>> PHOTOS: Notable supporters of 2016 presidential candidates

"So senator, were you concerned with working conditions for guest workers or really because you think immigrants drive down wages and take jobs from Americans?" a moderator asked Sanders. 

Sanders hit Clinton on her opposition to driver's licenses for undocumented immigrants. 

"... Provide driver license to those who are undocumented. She said don't do it, and New York state still does not do it," Sanders said.

>> Read more trending stories

That same issue popped up in her first race for president

"I did not say it should be done, but I certainly recognize why Gov. Spitzer is trying to do it," Clinton said during an MSNBC debate.

"I was confused on Sen. Clinton's answer. I can't tell if she's for it or against it," then-Senator Obama responded.

But her campaign says she supports it now

This video includes images from Getty Images and clips from C-SPAN

Photos: Trump under fire at GOP debate

Photos: Republicans debate in Houston

Photos: 58th annual Grammy Awards show

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