Questions for the Dentist

Posted by Dr. Edward Magida | Filed under

Due to the large amount of e-mails I get about all aspects of dentistry, I have decided to have a question and answer column every so often. Here goes:

Recently I had a root canal procedure done. It only took the dentist one visit to complete. I seem to remember in the past that this type of treatment took multiple visits. Did something change in the way root canals are done?

For the most part the procedure is done the same way. The nerve is taken out of the root of the tooth with little files. These files grind up the nerve and the remnants are flushed out of the tooth. Once there is no more nerve tissue in the root, a special filling material called “gutta percha” is placed inside the root to seal the area and prevent bacteria from re-entering the inside of the tooth and re-infecting it.

What has changed is the equipment used to do the procedure. The files used to be moved up and down in the tooth by hand. This tended to be tedious and took lots of time. Nowadays the files are placed in something that rotates them like a dental drill. This rotary action of the files makes a much cleaner cut inside the tooth and it removes the nerve tissue much quicker. It is a lot faster way to prepare the inside of the roots to accept the gutta percha. Also, the placement of the gutta percha also has been changed. In the past, many little, fine points were placed inside the root one at a time. This took a lot of time. Today, there is a new kind of gutta percha filling that gets heated up to soften it and then it is quickly placed inside the cleaned out root. This new type of gutta percha requires only one piece instead of the many pieces it took in the past. This also shortens the length of the procedure to the point that many root canal treatments are done in one sitting.

My dentist prescribed a pill for me to take to help me cure my periodontal disease. She said it must be taken for months at a time but that it should help stop the gum problems I always seem to have. Does this stuff work?

The pill you are talking about is called "Periostat" and it has been prescribed for several years now. It is very good at cutting down on the inflammation associated with periodontal disease. The patients in my practice who are on it have seen much less bleeding associated with their gums. It is a very low dose antibiotic that helps to stop the body’s inflammatory response mechanism. The pills are taken twice a day for at least six months. Please be aware that there is nothing that will "cure" periodontal disease. These pills as well as routine periodontal treatments will help control the disease, but there is no cure. A person who is susceptible to the disease will always be susceptible and should remain on constant guard to keep it under control. This drug is one of many ways to do this.

If you would like to have me answer any dental question that you might have, please e-mail me at I will do my best to answer as many questions as I can.

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