Should root canal treatment be performed in one dental visit or over several visits?

This is an update of a review first published in 2007. Root canal treatment, or endodontic treatment, is a common procedure in dentistry. The main reasons that root canal treatment are needed are persistent inflammation of the dental pulp (pulpitis) and death of the dental pulp (dead or non-vital tooth) caused by tooth decay, cracks or chips, or other accidental damage to teeth. Root canal treatment is considered successful when there are no symptoms, for example pain, and when x-rays show no signs of damage to bone and other supporting tissues of the tooth. The success of root canal treatment depends on the preoperative condition of the tooth, as well as the endodontic procedures used. There are two approaches commonly used. In the first, the root canal treatment is performed in multiple visits to the dental clinic, and a dressing is placed in the tooth between appointments to avoid the build up of bacteria that may cause infections. In the second approach, the treatment is performed in one visit to the dental clinic. Which approach leads to less postoperative complications?

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Relieving the symptoms of burning mouth syndrome: what works?

Scratching her mouthBurning mouth syndrome (BMS) is a common painful condition. Symptoms include burning, dryness or uncomfortable sensations in the mouth and changes to taste. There is no obvious underlying medical or dental cause, however scientific research suggests that BMS may be caused by underlying damage to the nerves. BMS is often a persistent and long term condition, which can lead to a reduced quality of life (QoL).  There are many treatments available including drugs for treating psychological conditions and increasing saliva production, protective barriers, and treatments applied to the mouth surface. Continue reading

Lining the cavity to protect the tooth pulp: what’s the evidence?

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Tooth decay is the most common disease affecting children and adults worldwide. If left untreated, acid produced by bacteria in the dental plaque or biofilm forms cavities or holes in the teeth. A number of techniques and a variety of materials can be used to restore or fill teeth affected by decay. One of these materials is tooth-colored, resin-based composite or RBC. This material is increasingly used as an alternative to amalgam (a mixture of mercury and metal alloy particles).

Since the 19th century liners have often been placed in cavities in the teeth under the filling material. The liners are thought to protect the living pulp of the tooth from filling materials themselves and also from their potential to allow more heat or cold through than the natural tooth would. Although RBC filling materials are thought to be similar to the natural material of teeth in terms of how they conduct heat, sensitivity to temperature change is sometimes still an issue for people after treatment.
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Procedures for retreatment of failed root canal therapy

elderly-man_dental-exam-2In root canal therapy, the infected pulp of a tooth is removed, and the root cavity is disinfected and filled with a sealing material. However, if micro-organisms that caused the infection are not completely removed, after some time they may cause a disease at the tip of the root, called a periapical lesion. Treatment for this requires a second intervention, which can be performed in the same way as the first treatment, from the crown into the root canal, to remove the existing filler and clean and disinfect as well as possible before sealing again. Alternatively, should this procedure fail, or if it is not feasible, a surgical intervention can be used. Continue reading

Chlorhexidine may reduce the risk of ventilator-associated pneumonia in patients treated in intensive care units

CCUCritically ill people, who may be unconscious or sedated while they are treated in ICUs, often need to have machines to help them breathe (ventilators). The use of these machines for more than 48 hours may result in ventilator-associated pneumonia (VAP). VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care, using a mouthrinse, gel, toothbrush, or combination, together with breathing-in of secretions, may reduce the risk of VAP in these patients. Continue reading

Maxillary distraction osteogenesis versus orthognathic surgery for cleft patients

Happy baby is smilingCleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of clefts is lengthy, typically taking from birth to adulthood to complete. Upper jaw growth in cleft patients is highly variable, and in a relatively high percentage, it does not develop completely. A type of surgery called orthognathic surgery, which involves surgical cutting of bone to realign the upper jaw (osteotomy), is usually performed in this situation. An alternative intervention is known as distraction osteogenesis, which achieves bone lengthening by gradual mechanical distraction (cutting of bone and moving the ends apart incrementally to allow new bone to form in the gap). Continue reading