Our Blog

For most of our dental concerns, seeing the family dentist is the first and only appointment we need. But when you need specialized treatment for an injured tooth, an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can not only save you pain and discomfort—it can even save your tooth.

Every tooth is protected by its hard enamel covering—in fact, tooth enamel is the hardest substance in the body—but it’s not perfect protection. Beneath that enamel lies less dense tissue called dentin, filled with tubules leading to the inner chamber of the tooth. This small inner chamber and the even more delicate canals inside each root of the tooth contain the sensitive dental pulp, which holds nerves, blood vessels, and connective tissue.

If the pulp has been compromised through decay, injury, or infection, treatment needs to take place to prevent pain, further infection, and even bone and tooth loss. The diagnosis and treatment of the inner tooth are the special focus of endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

Which symptoms could be a clue that your inner tooth needs treatment?

1. Sharp, severe pain when you bite down or put pressure on a tooth: This could be a sign that the pulp tissue inside is irritated, damaged, or infected.
2. Continuous facial pain, toothache, redness or swelling around the tooth: These symptoms could be signs of pulp inflammation, infection, or abscess.
3. Persistent sensitivity to heat and cold: Any sensitivity to temperature is a good reason to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. Cavities and even heavy-handed brushing can cause sensitivity for a few seconds after exposure to heat or cold. Any pain or sensitivity that lasts longer, though, could indicate pulp damage.
4. Unexplained soreness or pressure in the jaws and teeth: Grinding your teeth and certain sinus conditions can cause these symptoms, but if you have ruled out obvious causes, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants should be consulted.
5. A cracked or injured tooth: A crack or other injury can leave the pulp vulnerable to irritation, bacteria, and infection. Endodontists are trained to diagnose and treat the different varieties of tooth fractures, including crown, cusp, and root fractures.

If you are experiencing one or more of these symptoms, don’t put off endodontic treatment at our Worcester office. Once the inner tooth has suffered injury or infection, treatment should take place as soon as possible to prevent further damage to tooth, tissue, and bone. Endodontists work to save injured teeth with a variety of procedures, including root canals, endodontic surgeries on tooth and root structures, and placement of posts and cores to strengthen and stabilize teeth.

If you suspect that you have a tooth that needs endodontic treatment, call your endodontist, or, if you haven’t worked with an endodontist before, ask your regular dentist for a recommendation. Seeing a specialist trained in the latest and most effective endodontic techniques is the best option to save an injured tooth.

A lot of patients go at their teeth like they were sanding an old floor—that is to say, way too hard! Brushing too hard is probably the most common mistake patients make in their oral care routine, and it can be detrimental to the gums and teeth.

What can brushing too hard cause?

• Receding gums
• Bone loss around teeth
• Loss of teeth
• Tooth sensitivity, especially to hot and cold
• Worn down enamel

Brushing too hard wears away at your gums, which can lead to the neck of the teeth being exposed. This part of the tooth isn't covered by hard enamel like the rest of the tooth and hence the soft inner layer, or dentin, is exposed. Dentin is very sensitive to hot and cold and much more susceptible to bacterial decay. Once the gums recede due to improper brushing, it’s usually irreversible.

How to brush your teeth properly

You know you're supposed to brush your teeth twice a day, so why not do it right? First and foremost, you should only ever brush with a soft bristled brush—not medium or hard—unless directed otherwise by Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants. Unless you have braces or specific oral health issues, brushing twice a day for two minutes is usually plenty.

The main purpose of brushing is to remove plaque from your teeth and gums. Plaque is actually soft and is a buildup of bacteria, saliva, and food debris. You really don't need to brush hard to remove it, just make sure you aim your toothbrush at the gum line (where plaque grows) and brush in small circular motions, never a back-and-forth motion.

It's also wise to hold your toothbrush gently. People tend to brush harder the tighter they hold their toothbrush.

Still have questions about proper tooth brushing technique or gum health? Ask any staff member or Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office; we'd be happy to help!

While modern dental science has made remarkable advances in treating oral diseases, prevention is always better than cure. To keep our mouth, gums, and teeth their healthiest, there are some simple practices we can follow to dramatically reduce dram the risk of developing some of the most common oral diseases.

Tooth Decay

We don’t usually think of tooth decay as a disease, but it is, in fact, the most common chronic disease in older children and adolescents. A great majority of adults have had at least some experience with decay. Left untreated, tooth decay can lead to pain, infection, tooth loss, and even loss of nearby bone in the jaw. Luckily, there are several time-tested ways to prevent cavities:

• Brush properly at least twice a day. Ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for the best toothbrush for your individual needs (usually, a soft brush is best), the best technique for angling the brush to reach all of each tooth’s surfaces, and the amount of time you should spend brushing.
• Floss daily. Even with perfect brushing form, you are going to want to use floss to clean between the teeth and around the gum line.
• Use a fluoride toothpaste. Study after study has shown that the risk of cavities is reduced with regular use of a fluoride toothpaste or rinse.
• Watch your diet. Foods high in sugar and simple carbohydrates give cavity-causing bacteria the fuel they need to produce the acids which weaken enamel. On the other hand, a diet rich in protein, vitamins, and minerals is beneficial not only for your teeth, but for your whole body!
• See your dentist for regular checkups to find small problems and prevent them from becoming major ones. Your dentist can also give you tips on better oral hygiene if your brushing and flossing habits aren’t doing the job.

Gum Disease

Preventing gum disease is a lot like preventing tooth decay—your daily habits really make a difference. When plaque builds up around the teeth and gums, the bacteria in plaque cause gum tissue to become inflamed, swollen, and painful. Left untreated, the gums pull away from the teeth, leaving pockets where bacteria collect and lead to infection. Infections harm not only gum tissue, but can destroy the bone which supports the teeth. What can you do to prevent gum disease?

• Use proper brushing technique. Remember to angle the brush toward the gums to gently clean around and below the gum line.
• Floss daily—flossing removes particles and plaque between the teeth, and it also helps remove plaque from the area under the gum line.
• Smokers are at higher risk for gum disease, and smoking has been linked to slower healing. Giving up tobacco products of any kind is always a good way to protect your dental health.
• Regular dental exams will catch gingivitis (early gum disease) while it is still reversible. Periodontitis (serious gum disease) can require treatment by a specialist. Certain diseases such as diabetes increase the risk of developing gum disease, so checkups are especially important.
• Having your teeth cleaned every six months, or as recommended, will remove plaque that brushing alone can’t handle. If there are signs of more serious gum disease, a periodontal cleaning will remove plaque and tartar from both above and below the gum line.

How Can Your Endodontist Help?

Endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants have the advanced education and training not only to treat several oral diseases, but to help repair the damage they can cause. Endodontists are experts in such procedures as:

• Root canals—your first option for preserving your tooth when the inner pulp has been damaged or infected
• Surgeries which allow access to tiny root fractures and canals, calcium deposits, or damaged roots and bone which can’t be reached non-surgically
• Apicoectomies, which treats recurring pain and infection by removing the tip of the root and any inflamed or infected tissue, then cleaning and resealing the root
• Endodontic surgeries such as root resections, which retain as much of the natural tooth as possible when a tooth is too damaged for normal restorations
• Implant surgery to provide a permanent, natural looking replacement for a lost tooth

An ounce of prevention is worth a pound of cure, and when it comes to your dental health, there’s a lot you can do to prevent oral diseases. But should you need endodontic treatment at our Worcester office, we have the knowledge and experience you need. After all, you can’t weigh the worth of your oral health—that’s priceless!

In a perfect world, we would all jump out of bed ready to greet the day with a big smile and a toothbrush close at hand to clean our teeth immediately. But if you can’t even find your toothbrush before you’ve had your first cup of coffee, does it really make a difference if you brush and floss after breakfast? Perhaps! Let’s talk biology.

Normal saliva production during the day benefits our teeth and mouths in surprising ways. Saliva washes away food particles to keep our teeth cleaner. It contains cells which combat bacteria and infection. It even provides proteins and minerals to help protect our teeth from decay. But saliva production slows dramatically as we sleep, and the amount of bacteria in our mouths increases. While one of the nasty—and obvious—side effects of bacterial growth is morning breath, there is an invisible effect, which is more harmful. Bacteria in plaque convert sugar and carbohydrates into acids which attack our gums and enamel and can lead to both gingivitis and cavities.

• If You Brush Before Breakfast

Brushing and flossing first thing in the morning removes the plaque that has built up during the night and takes care of many of the bacteria who are ready to enjoy the sugar and carbs in that breakfast with you. If you brush before eating breakfast, rinse your mouth with water after your meal, floss if needed, and you are good to go.

• If You Choose to Brush After Breakfast

But if you decide that doughnut simply can’t wait, you should ideally postpone brushing for 20-30 minutes after your meal. Of course, these are minutes in which bacteria can make use of those new sugars and carbohydrates. So why shouldn’t you brush immediately after eating? Many foods and beverages, especially acidic ones such as grapefruit and orange juice, can weaken the surface of your teeth. If you rinse with water after eating and wait at least 20-30 minutes before brushing, your enamel will be “remineralized” (another benefit of saliva) and ready for cleaning.

No matter if you take a “seize the day” approach and brush first thing in the morning, or a “seize the doughnut” approach and brush soon after eating, the important word here is “brushing.” Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our Worcester team are happy to make suggestions as to the best morning routine for you. One thing is certain: if you give your teeth and gums two minutes of careful brushing and flossing in the morning, you can’t help but start your day off right!