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It is common to experience dentine hypersensitivity, with symptoms ranging from moderate to severe. Why does it happen and how do you know if this sensitivity is something to be concerned about? The first step is to determine the cause.

The most common cause of the sensitivity is exposure of the dentin. Dentin is the layer immediately surrounding the nerve of the tooth. It is alive and usually covered by the gum tissue. When gum recession is present hypersensitivity is common. Other contributors to temporary tooth hypersensitivity include teeth whitening and dental procedures such as fillings, periodontal treatment, and braces placement or adjustment. These are temporary and should be of no concern.

Permanent hypersensitivity, however, may require treatment. To understand the cause of sustained hypersensitivity, let us explain the structure of dentin and why it serves as a ‘hot spot’.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When dentin tubes are exposed, there is a direct connection between the mouth and dental pulp, which houses the nerve and blood supply of the tooth. External stimuli, such as mechanical pressure (tooth grinding or clenching - bruising the ligaments holding the teeth in place), temperature changes, as well as chemical stimuli (sweet–sour) are transmitted to the pain-sensitive dental pulp and activate nerve endings. A short and sharp pain is the result. These external stimuli cause fluid movement in the open tube that is transmitted as pain sensations. Something needs to be placed into the dentin tube to plug it and stop this fluid movement.

The first step in doing something about dental hypersensitivity is to determine the cause; our professional team at Central New England Endodontics and Implantology can help you with this. Whether the sensitivity is due to exposed dentin or an underlying cause such as abscess or decay, corrective measures are needed. Contact us sooner rather than later so Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can reduce the sensitivity, and provide you with some relief!

Advancements in dental treatment, and in dental training, have made it possible for specialized dentists, called endodontists, to treat inflammation and infection deep within the core of a tooth. Endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, receive two additional years of specialized training beyond dental school, where they learn the sophisticated techniques needed to treat problems related to the inside of the tooth. Historically, the only solution for problems within the tooth was to extract the tooth. Today, people who eat a healthier diet have better oral health. They also take better care of their teeth and have regular dental checkups and twice yearly cleanings, all of which contribute to better oral health. Sometimes, however, unforeseen problems arise, and a tooth gets injured, or somehow becomes infected or inflamed. This leads to the need for endodontic treatment.

Understanding Tooth Anatomy

Understanding basic tooth anatomy will put things in proper perspective. The tooth is composed of several parts. The outer layer consists of the enamel and the hard layer called dentin. These layers protect the inside of the tooth, which has a canal that extends from the very top (crown) of the tooth all the way down to the roots. Surrounding that canal is soft tissue known as the pulp. The pulp contains the "guts" of the tooth — or the living parts. Those living parts include blood vessels, connective tissues, and nerves.

Importance of Tooth Pulp

The pulp is most important when your teeth are developing. It connects the area from the top of the tooth to the roots, and then to the supporting tissues around the roots (or gums). Once teeth are fully mature, they can still survive without the pulp because as long as the surrounding tissue is healthy, it continues to nourish the tooth.

Can all teeth be treated endodontically?

Most infections benefit from endodontic treatment. The only reason that a tooth can't be treated endodontically is when the tooth itself isn't salvageable. That might include the inability to access the root canal, a severe fracture of the tooth root, inadequate bone support, or a damaged tooth that can't be restored. Endodontic surgery might be a viable alternative treatment.

Although endodontic treatment is sometimes inevitable and unavoidable, good oral hygiene keeps the teeth, mouth and entire oral cavity in good health. If you experience pain, prolonged sensitivity, swelling, gum sensitivity, swollen lymph nodes, or fever, give our Worcester office a call or consult your general dentist. You may then be referred to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for specialized treatment at Central New England Endodontics and Implantology.

You have been recommended to Central New England Endodontics and Implantology for an endodontic treatment — commonly known as a root canal — and now you may be wondering if there are any alternatives to this procedure? Before discussing other options, it’s important to understand exactly what this common procedure accomplishes.

What is the purpose of an endodontic treatment?

Endodontic treatment is done when a tooth’s pulp — the inside of the tooth that houses the nerves and blood vessels — becomes infected or inflamed. In order to eliminate any pain and save the tooth, the damaged pulp is removed, the area is cleaned, and the tooth is sealed.

What are my other options?

According the American Association of Endodontics (AAE), the alternative to endodontic treatment is usually the complete removal the damaged tooth. If you have a tooth extracted, the AAE recommends replacing it with a dental implant, a bridge, or a removable partial denture. Failure to replace the extracted tooth could result in problems with chewing and biting, shifts in your remaining teeth, and self-consciousness.

Here are more details on the most common types of tooth replacements:

• Dental implants – According to the American Dental Association, dental implants are effective and common options for replacing teeth. The implant is made from materials that are compatible with the human mouth and the device includes an artificial tooth. The placement of the implant and artificial tooth can be completed in one day, although some patients may need to wait up to several months before an artificial tooth can be added to the implant.
• Bridges – Bridges do exactly what their name suggests: they bridge the space left by one or two missing teeth. Your dentist will bond the bridge to your remaining, natural teeth in order to keep it in place. Bridges can only be removed or put in place by a dentist.
• Removable partial denture – Much like bridges, removable partial dentures are made up of replacement teeth that attach to your natural teeth. These, however, may be removed and replaced by the patient on a daily basis.

The AAE notes that dental implants have the same success rates as endodontic treatments. Even so, nothing can fully replace the look, capabilities, or the feel of your own teeth, which is why endodontic treatment (preserving the natural tooth) with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is an important decision!

Don't hesitate to contact our Worcester office if you have further questions!

Regardless of the type of dental emergency you experience, it is important that you visit Central New England Endodontics and Implantology for emergency dental care as soon as possible. A chipped or cracked tooth requires professional attention, as bacteria may gather in these areas, potentially causing infection that could require a root canal. Remember, you may be capable of managing pain, bleeding, and swelling at home, but by visiting our office for immediate treatment, you can fight infections and minimize lasting damage to your mouth, teeth, and gums under the expert care of our emergency dentist.

24/7 Emergency Dental Care

Central New England Endodontics and Implantology is proud to offer emergency dental care around the clock, seven days a week. Dental emergencies do not wait for regular business hours, and if you experience a serious dental emergency, you need immediate treatment. Whether you have a broken tooth or if you have bitten through your tongue, do not hesitate to visit us day or night. Until you arrive at our office, however, there are some helpful steps you can take if you encounter a serious dental dilemma.

Managing Your Dental Emergency

If a toothache is causing problems, you can probably keep the discomfort under control until our emergency doctor can treat you. Start by checking the gums that surround the affected tooth for inflammation, bleeding, or foreign objects. There may be food lodged in the gum that could be removed by flossing. You can control pain by placing a cold compress against your mouth, or by using an over-the-counter oral numbing agent.

More serious situations may be extremely time sensitive, and require immediate emergency attention. For example, if a tooth is completely knocked out, carefully clean it with water. Try to place the tooth back into its socket or briefly store it in a cup of milk if it will not fit back into the gum. Never pick up a tooth by the root or force it into the socket. Come straight to our office, as your tooth will need to be replaced within a short amount of time. Similarly, if you have bitten through your lip or tongue, the American Dental Association recommends carefully cleaning the area before coming as quickly as you can to our emergency dental office for treatment.

Remember, there is no reason you should live with discomfort. By visiting our Worcester office immediately in an emergency, you can take control of your oral health comfortably and safely.