Clear Lake Endodontics

Do I really need Root Canal Treatment? It is a typical question asked when a patient hears about Root Canal Treatment. Though proper diagnosis can only answer if you need a Root Canal Treatment therapy, there are certain conditions under which, Root Canal Treatment may be required.

If you have a tooth that has severe pain or has a history of being painful or if you have tender gums and/or swelling in gums/ area around teeth, then chances are that you may need Root Canal Treatment.  It should be noted that only diagnosis by an Endodontist can tell if your tooth really needs a Root Canal Therapy. There are chances that the tooth may not necessarily need RCT but can be treated normally.

Typically degeneration/decay of nerve in tooth is the indication of necessity of Rooth Canal Treatment, there are few conditions that may lead the dental expert to opt for RCT.

• There are chances that the tooth nerve gets decayed without any pain and infection inside the tooth does not grow rapidly.  Such condition can remain unnoticed for years. Routine x-ray checkups can show up the need to Root Canal Treatment.
• It could be possible that a pimple is present on gums. Such pimple is formed due to pus in the infected tooth. The pus is discharged from the pimple which gives a bad taste in mouth. Presence of such pimple on gums or its re-occurrence indicates that Root Canal Treatment is required.  This is further confirmed by other dental checks.
• Exposure of nerve while performing dental treatment also indicates the necessity for Root Canal Treatment. At times you may not feel any pain when exposure occurs. A Root Canal Treatment is advised at such stage to prevent complications latter on.
• Dental trauma can be another reason for need of Root Canal Treatment. The nerve may not immediately show signs of decay but gradually it may die off and ultimately you may have to undergo a Root Canal Treatment.

Visit Clear Lake Endodontics for complete diagnosis and treatment of your dental problems.

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Due to various factors, tooth strains can occur. Depending on the strains, treatment is recommended. Veneers is also a treatment done to improve the tooth aesthetically or protect a damaged tooth.  In the process, a thin strip of tooth colored material is applied on the tooth. Based on type of material used, Veneers is classified in to:

• Chairside composite
• Porcelain
• Processed composite

Types of veneers based on the tooth coverage:

• Partial Veneers – Given in areas of localized discoloration or defect.
• Full tooth coverage – Given in areas of generalized defects or staining which are internal.

Indications:

• Malformed teeth
• Discoloration
• Abrasion
• Erosion

Full veneers can be made by 2 kinds of techniques:

• Direct technique – In direct technique, the thin strip of composite material can be directly placed on the tooth.
• Indirect Technique -  In indirect technique, the strip if fabricated in dental laboratory and is latter bonded on the tooth using resin cement.

Comparing Direct and Indirect Veneers Techniques

• In most cases, Direct process requires just single appointment while Indirect process usually require two sittings.
• Direct process is cheaper in comparison to Indirect process.
• Indirect process is more esthetic in comparison to Direct process.
• Indirect process veneers lasts long in comparison to Direct process veneers.

Direct technique:

Direct partial veneers are used to treat the localized, small internal discolorations or defects. On the other hand  direct full veneers are used for diastema closure, enamel hypoplasia involving upper  anterior teeth.

Procedure:

• Preliminary steps are cleaning and shade selection.
• The tooth is polished with polishing paste and brush to remove any stains, smear layer, etc from the tooth surface.
• Then the shade selection is done.
• After this around 0.5 mm of the tooth structure is removed with a course bur using water spray as coolant.
• Then the area is restored with composites after etching and bonding just like a composite filling.
• Once filled, the veneer is smoothened with finishing burs and then polished with composite finishing instruments. 

Indirect Technique

• Indirect technique involves measuring the size and shape of the strip required after milling the tooth.
• It can be done by utilizing imaging camera with computer software.
• The data is sent to milling unit in dental lab, where appropriately shaded porcelain blocks are crafted into desired shape and size.
• The veneers are prepared into the desired color and are then strengthened.
• Prepared veneers are bonded with the tooth using bonding resins.
• Final touch up is then given.

We at Clear Lake Endodontics provide complete range of Dental Solution to patients. Please feel free to consult with dental specialist at our clinic.

Endodontist in Houston – Houston Endodontics

Dental Inlays and Onlays are used to treat rear teeth with moderate decay. In such cases, tooth restorations can be made by using direct and indirect techniques. In indirect techniques, the restoration is fabricated outside of the prepared tooth.

Advantages:

• Material selection: physical properties: Material has high strength. They have better physical properties than direct restorations.
• Increased resistance to abrasion and attrition: Ceramics have much more wear resistance compared from composites.
• Polymerization shrinkage stress reduced: The prefabricated restoration occupies most of the cavity  and flowable composite is used only for bonding the restoration. So, this reduces the polymerization shrinkage, chances of micro-leakage, few marginal voids and reduced post operative sensitivity.
• Strengthens remaining tooth structure: Tooth structure weakened by caries can be strengthened by bonding inlays and onlays to conditioned tooth surfaces.

Disadvantages:

• Increased cost and time: Indirect restorations require 2 patient appointments with temporary restoration given after first visit. It also increases the cost of the restoration because it is fabricated in the laboratory.
• Technique sensitive: A high level of operator skill is required for making an indirect restoration.
• Brittleness: If the preparation is not thick enough, it can fracture easily.

Indications:

• Large cavities.
• Esthetics

Contraindications:

• Less saliva control.
• Heavy occlusal forces.

Procedure:

First visit:

1. Local anesthesia is given to the patient to make the procedure painless.
2. The carious part of the tooth is cleaned with an air rotor.
3. After removing all the carious part the cervical walls are flattened.
4. There should be no sharp edge on the tooth.
5. Once the desired cutting is done, impression of the tooth is made.
6. Shade of the tooth is selected from the shade guide.Then the cavity is filled with temporary filling material and the patient is sent back.
7. Then the impressions are sent in the laboratory and the restoration is fabricated.

Second visit:

• The temporary filling material is removed without touching the tooth preparation.
• The restoration is inserted in the cavity and then the occlusion is checked and all the premature contact points are removed.
• Then the restoration is cemented to the tooth using composite binding materials and flowable composite material.

Clear Lake Endodontics provides complete dental care solutions to patients in Houston and Webster in Texas.

Endodontist in Houston – Houston Endodontics

To remove superficial strains that do not extend more than 1/10th of millimeter in depth, micro abrasion or macro abrasion techniques are used. Both the techniques are aimed at removing the strains by taking off slight structure from tooth.

Microabrasion is a technique where abrasive grit in mild acid solution placed in rubber cup. The strains are polished away. If strains are bit deep then macro abrasion is done. Macroabrasion involves using of dental drill and finishing bur to remove the strains. In most of the cases a combination of micro and macro abrasion is done to remove the strains completely.

Micro-Abrasion

• Incipient carious lesions – They are usually smooth and white in color. If the lesion has roughened a bit, micro-abrasion coupled with re-mineralization program is an initial option.
• Developmental discolored spot – Usually they are present on the occlusal third of the enamel surface. Its surface is smooth, hard and intact.
• Surface discoloration due to fluorosis – If the discoloration is 0.2-0.3mm deep then it can be treated with microabrasion.

Normally in micro-abrasion, Pumice or silicon carbide is mixed with 11% HCL acid into a paste form and is applied on the tongue blade. A topical fluoride is applied immediately after the microabrasion has been done.

Macro-Abrasion
In this a composite finishing bur or a finishing diamond is used on a high speed handpiece to remove the defect. While working on the defect, very light pressure is applied to prevent any irreversible damage to the tooth. The process is finished with abrasive rubber point. During the process, air-water spray is used to maintain the temperature and to keep the tooth hydrated.

Macro abrasion is a faster and easier procedure and no special instrumentation is required. Macro abrasion process has a better control on the removal of tooth structure. It is very important to do the procedure very cautiously as errors can lead to irreversible catastrophic results.

For complete dental care visit Clear Lake Endodontics.

Endodontist in Houston – Houston Endodontics

Nowadays esthetics is one of the major reasons why young people go for dental treatment options. One of the considerations in the dental esthetics is the tooth whitening procedure. Any discolored anterior tooth can change the entire look of a person. Even people with normal tooth color want whiter teeth nowadays. For this alone, there are many treatment options:

• Removal of surface stains.
• Bleaching.
• Microabrasion.
• Macroabrasion.
• Veneering.
• Placement of porcelain(ceramic) crowns.

The most conservative treatment option among them is bleaching. Let us discuss that first. Discoloration is classified as:

• Extrinsic
• Intrinsic.

Extrinsic stains:

Etiology:

• Poor oral hygiene.
• Plaque deposits.
• Eating habits.
• Bleeding gums.
• Tea.
• Coffee.
• Tobacco stains.

Intrinsic discoloration:

Etiology:

They are caused by internal injuries and are more difficult to treat. In intrinsic discoloration, the affected teeth may be:

• Vital
• Non vital
• Root canal treated.

The etiology of each one is different.

Vital:

• Hereditary disorders.
• Medications(tetracycline)
• Any kind of trauma.
• Excessive fluoride in water during the tooth development(fluorosis)

Tetracycline drug causes generalized type of intrinsic stains. Localized areas of discoloration occur due to enamel or dentin defect that might occur during tooth development. Ageing effects can also lead to yellower teeth.

Non vital teeth:

Due to some trauma, caries, etc. the tooth becomes discolored from inside. It usually has a blackish or a yellowish tinge to it. In such cases when root canal therapy is done the tooth usually retains its normal color.

Bleaching:

Bleaching is the treatment option in which the color of the teeth is lightened by applying certain chemical agents on them.

Mechanism of action:

Bleaching is basically done with hydrogen peroxide which results in oxidation of pigmented teeth.

Types:

• For vital teeth.
• For non vital teeth.

Lifespan:

• Bleaching has a life span of 1 – 3 yrs. Approximately.

Non vital bleaching procedures:

Indications:

• Root canal treated teeth.
• Bleeding in canal due to trauma.
• Degradation of any pulp leftover left when root canal was done.
• Staining from various filling materials filled in the tooth.

Non vital bleaching is of 2 types:

• Thermocatalytic technique. (in office technique)
• Walking bleach (out of the office technique)

In office technique:

Procedure:

• 35% hydrogen peroxide is kept in the pulp chamber.
• Oxidation process is started by placing a heat instrument into pulp chamber. Nowadays light activated bleaching is done.

Walking bleach technique:

Procedure:

• The coronal part of the tooth is cleaned and completely debrided
• Then 1 drop of 35% hydrogen peroxide with sodium perborate are mixed into a smooth paste and placed inside the cavity.
• The cavity is sealed with temporary filling material. The bleaching material is very active for 24 hours.
• The mixture is changed after 3-5 days.
• 1-2 treatments are required.
• Once the result has been obtained, the chamber is filled with calcium hydroxide powder and saline. This mixture is allowed to remain for 2 weeks. Then it is removed and dentin is conditioned and after etching the enamel, the tooth is restored with light cure composite.

For complete dental care solutions, contact Clear Lake Endodontics, serving Houston and Webster regions in Central Texas.

Endodontist in Houston – Houston Endodontics

Vital Bleaching is done to remove the strains/ discoloration of teeth that can arsise due to various reasons. Vital bleaching procedures are also of 2 types:

• In office technique.
• Outside the office.

In office technique:

Procedure:

• The soft tissues like lips, gums, etc are isolated with the help of Vaseline, cocoa butter and other isolating materials.
• Then 35% hydrogen peroxide soaked in gauze or a gel form of hydrogen peroxide is applied on the teeth.
• Heat is applied with the help of heating instruments to accelerate the oxidation reaction of the hydrogen peroxide. Intense light can also be used instead of heating instrument.
• Once procedure is completed, teeth are rinsed properly.

Timings:

• Each treatment lasts for 30 to 45 min.
• 2 to 6 treatments are required.

Advantages:

• The use of the chemicals is completely under dentist’s control.
• Teeth are bleached more rapidly.
• Soft tissue is protected in the process.

Disadvantages:

• Post treatment sensitivity.

Home applied technique:

Procedure:

• Upper and lower impressions are made and then models are obtained.
• Then nightgaurds are prepared on the models with the night guard material.
• This is given to the patient and 10 – 15% carbamide peroxide bleaching material is generally used for this bleaching technique.
• Place 2 -3 drops of bleaching solution in the area of each tooth. Usually 6 – 8 anterior teeth need to be bleached.
• Then the nightgaurd is inserted into the mouth.
• Excess material flows out which is then cleaned with a cotton swab.

Precautions:

• The patient does not have to rinse or drink during this period.
• After removing the bleaching material, no foods which can cause staining should be consumed for at least 24 hours. Eg. Tea, coffee, etc.

There are 2 kinds of treatments:

• During the day time.
• During the night time.

If bleaching is done at night time, single application at night time is enough. If it is worn during the day time, then the solution is replaced every 1-1/2 to 2 hours.

Timings:

• Total time the treatment takes is 2 – 6 weeks depending on how many hours the patient wears the night guard.

Side effects:

• Sensitivity of teeth after bleaching..
• Irritation in the gums.

The irritation in the gums occur if the bleaching gel leaks out of the night guard and is not cleaned properly. The sensitivity lasts for a few days and then finishes on its own.

Limitations:

When the patient is suffering from stains caused by intake of certain medications like tetracycline, teeth are resistant to bleaching.  For such teeth, other endodontic procedures are recommended. Eg. Full crowns.

We t Clear Lake Endodontics provide complete range of Dental Solutions and Consultation. We serve Houston and Webster areas in Texas.

Root Canal Specialist in Houston – Root Canal Retreatment, Houston

Endodontist try to protect the teeth as much as possible. There are various advanced Endodontic procedures which can save the tooth even in extreme conditions. Procedures like Root Canal Treatment, Post & Core Restoration, Dental Apexification have proved to be useful and are widely accepted worldwide. In certain cases, there may not be any scope of any dental treatment and the only solution left is extraction. For such cases, implanting an artificial tooth (Dental Implant) in place of an extracted tooth is a recommended solution.

WHAT IS A DENTAL IMPLANT?

A dental implant refers to replacing a tooth artificially. Under this procedure a tooth is replaced by an artificially created tooth by fastening and drilling into bone below tooth (to create base) and screwing up a tooth on top of the base. A crown is then created on top of the tooth to exactly resemble the original tooth or a group of teeth that have been damaged or broken. Dental Implant provides a permanent and reliable solution to all kinds of tooth losses. Concept dental implantation has completely revolutionized dental treatment for missing teeth. Implants are used for complete replacement of the tooth, including the root. Implants are done by creating a base in the jaw bones in place of the missing teeth. After the implant base (usually screw) has been successfully fused to the bone, known as ‘osseointegration’, an abutment can be screwed onto the implant, on which a crown is constructed.

USES OF A DENTAL IMPLANT

• Dental implants can replace the broken, damaged or lost tooth, without harming or grinding the adjoining healthy teeth in any manner.
• Dental implants can easily support a bridge and thus eliminate the need to wear removable partial dentures.
• Dental implants provide good support for dentures and thus make them more durable, stable and comfortable.

DENTAL IMPLANT PROCEDURE

Placing an osseointegrated implant requires boring into the tooth bone manually or by using drills with speed regulation. After some time, when the implanted element has been completely fused into the tooth, some settling time is provided, on the completion of which a new tooth, in the form of a crown or a cap can be conveniently constructed on top of the implant. The amount of time which is provided for the osseointegration is not fixed, it might vary anywhere from 2-6 months. But in case an implant is not given enough and proper time to settle and get fixed and a new tooth is crowned or capped too early, the implant may move or come off, thus leading to a failed treatment. Thus, it is important to provide the implant with a sufficient time to settle and fix itself to the tooth root.

Clear Lake Endodontics provides complete range of dental solutions to patients in Houston and Webster region in Central Texas.

Endodontist in Houston – Houston Endodontics

Here are a few simple and easy tips for keeping your teeth clean, healthy and disease free.

• The most simple of all tooth care tips is to brush your teeth twice every day, nearly at a gap of 12 hours. It is advisable to brush your teeth once after you wake up each morning and also before going to bed each night. This keeps your teeth free from the attack of all the bacteria and micro-organisms. These bacteria and micro-organisms lead to cavities and diseases in the teeth and are most active during night time. Dentists also suggest that one must rinse their teeth with dental floss after each meal.
• Make sure to visit your dentist regularly-every 6 months. Do not delay these visits in order to keep your teeth free from diseases. Ensure that your dentist checks for the presence of periodontal disease of gums which can occur in kids and adults alike. This prevents the possibility of bacterial infection and tooth decay or gum diseases. Get the plague removed from your teeth regularly by the a dental expert.
• If you desire healthy and pretty teeth, make sure to not use tobacco products; they can increase your risk of gum disease and cancer of the mouth and throat.
• Eat a balanced diet for good overall health and beauty of your teeth, selecting a variety of foods from the five main food groups (bread, cereals, and other grain products; fruits; vegetables; meat, poultry, fish and alternatives; milk, cheese, and yogurt). Limit the consumption of food items that are too fried or sweet or extremely hot/cold.
• The following are a few symptoms which symbolize the teeth going bad. If you notice any one or more of these symptoms, these must not be avoided or ignored in any case. They might further lead to complex and complicated dental problems in the long run. Thus, keep a watch out for the following symptoms because it might mean that there are chances of a periodontal disease:

Gums bleeding during brushing
Red and/or swollen gums
Gums that have pulled away from the teeth, Pus between the teeth and gums
Bad breath
Loose teeth

• There are various cosmetology based solutions for bettering the look of chipped, discolored or disfigured teeth.
• Make sure the fact that your tooth brush has soft bristles. Brushes with hard bristles greatly harm the teeth and especially the gums as they make them bleed and injure them. Some tooth brushes even come with the quality that the bristles change their color to suggest that it is time to change the tooth brush. Also, do not brush too vigorously. In the want of beautifying your teeth, you might end up harming the gums in the long run.
• Lastly, to maintain good oral hygiene and avoid bad breath, you must clean your tongue of the bacteria settling on it either by cleaning it with your toothbrush or by making use of a tongue cleaner to serve the purpose.

It is important to follow the above mentioned tips to keep your teeth clean. For complete dental check up and consultation, you may visit Clear Lake Endodontics.

Root Canal Retreatment, Houston – Houston Endodontics

Dental apexification is a surgical treatment of inducing the development of root or closing it apically by the deposition of a hard tissue. It basically refers to the stimulation done to form a closed apex in the troubled tooth by making use of necrotic pulp. Apex is the part of the tooth situated at the bottom of the root. When the root canals are not properly closed, it leads to an open apex. It generally occurs in teeth which are not fully developed. A process of erosion of the root ends of the teeth, known as ‘resorption’ leads to a situation of open apex. In general cases, an open apex is treated by a root canal treatment. Apexification is made use of in those extreme cases where treatment is not possible by a simple root canal treatment. In this procedure, a strong and hard barrier is formed at the end of the tooth with the apex root.

Symptoms Of A Tooth With An Open Apex Root: The general symptoms of pulp exposure might include pangs of sudden pain or continued pain in the problem tooth. The tooth might become extra sensitive and might react to hot or cold food items. You might feel that the specific tooth is loose, unstable or fragile. Another important symptom of the troubled tooth can be discoloration. The tooth might appear to be ‘yellowish’.

Diagnosis: The diagnosis of the problem can be done by an endodontist with the aid of thorough dental check-up and examination. You might be asked to get an x-ray of the troubled tooth done, which will be studied and compared on the x-ray film by the endodontist for further evaluation. Some simple diagnostic tests might also be performed. Once the problem is diagnosed/detected, your endodontist will perform apexification treatment.

Course Of Treatment: First of all, the tooth is numbed by the endodontist so that no pain is felt in the tooth during the treatment by the patient. The patient might even be sedated for some time by making use of a local anesthesia. Then, by making use of a small dental drill, the endodontist digs two holes in the tooth : in the front and the hind in order to easily access the infected pulp which is then removed. The root canals are then measured and medically cleaned. After that the root canals are temporarily sealed by the use of medicated canal filling material. This medicated material usually Calcium Hydroxide is regularly replaced every 2-4 months. The number of sittings required for the treatment may vary individually. After multiple sittings, when the root end is formed; the treatment completes its first stage. A few months after the treatment, the infected tooth root is permanently sealed by making use of crowning or restoration. Mineral Trioxide Aggregate (MTA) filling is used in one-sitting apexification. Unique medical and setting properties of MTA has encouraged its usage in Apexification techniques.

Make sure to be regular in your appointments and follow all the precautions as well as course of medication as and how advised by the endodontist. Apexification results in an easy and permanent treatment of a tooth with an open apex root.

Clear Lake Endodontics provide complete dental treatment including Apexification, Root Canal Treatment and Retreatment. Clear Lake Endodontics serves Houston and Webster region in Texas.

Houston Endodontics – Root Canal Specialist in Houston

A root canal treatment (Endodontic treatment) refers to the procedure of treatment followed to remove the decayed pulp of a tooth and to prevent further infection in tooth. An important aspect of the root canal treatments, which is not generally paid much attention to is the Post-treatment care and precautions which are required to be undertaken for the proper recovery of the tooth. A few points to be kept in mind in this respect are as follows:

• Immediately after the treatment, the patient might feel some kind of tenderness in the treated area which may last for a few days while the tooth is undergoing its natural healing and must not be overly reacted to. Consult your endodontist only in the case of a severe pain.
• Practicing good oral hygiene after the treatment is a must-do. This includes regular brushing, flossing, regular check-ups and cleanings as directed by Endodontist.
• Get an x-ray of the treated tooth done nearly a fortnight after the treatment in order to ensure proper recovery. Also, as this treatment involves severing related nerves, one might not feel or come to know of any pain or any kind of tooth decay taking place in the treated tooth. So, make sure to pay regular visits to your endodontist to check the healing of tooth.
• An important point is not to bite on the treated tooth for few days. It might hinder its recovery.
• Root canal treatment makes the tooth brittle. So, do not eat or bite any hard objects using the treated tooth for a period of at least 2 months after the treatment.
• The most important post-treatment step to be kept in mind is CAPPING / CROWNING. One month after the treatment, you must visit your endodontist in order to get it capped or crowned before the tooth can start functioning normally or as directed by Endodontist.
• In case of any kind of cavity in the treated tooth anytime after the treatment, the best possible filling is a Glass Inomer filling. Generally such teeth are filled up using silver metal, but silver being a hard metal might cause injury to the treated tooth. Accurate treatment for already treated tooth will be decided by your Endodontist.
• In case infection remains in the tooth after the treatment and pus comes through the gums, the next procedure to be followed is ”Apisectomy” which means removal of the dead root tip through the gums by a surgical method.
• After a root canal treatment, the treated tooth generally changes shade, showing discoloration. This is not a thing to be worried about. Visit your doctor in order to get the natural color of your tooth restored.

Both root canal treatment as well as Apisectomy is chair-side treatments, meaning hereby that they do not require any kind of post-treatment rest. Visit your dentist regularly after the treatment to keep the recovery of the tooth under check and follow the techniques of good oral hygiene. Your treated tooth will soon be as good as new, rather better!

Houston Root Canal – Dental Implants Houston – Clear Lake Endodontist