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Five words no one welcomes: “You need a root canal.” But if you are delaying treatment because you are worried about pain and an uncomfortable day in the dentist’s chair, please think again! Modern root canal procedures are designed to repair your damaged tooth gently and efficiently, and leave you with a restored natural tooth that can last a lifetime.

• Why might you need a root canal?

First, a little tooth biology. Each tooth has a crown (the part we see above the gums) and one or more roots (the part of our tooth below the gum line that is attached to bone in our jaw). The tooth has three basic layers: the hard enamel and cementum that cover the outer crown and root, the softer dentin beneath that layer, and, on the inside, the pulp. Pulp is made of living tissue, and contains the blood vessels and nerves that nourish the tooth and keep it vital.

Even with the protection the enamel and dentin provide, sometimes the pulp can be infected or damaged. If you have suffered an injury to your mouth or jaw, or an infection has developed from an opening in the tooth caused by a deep cavity or crack, you may need a root canal to prevent further infection, pain, and even tooth loss. Call our Ashland office immediately if you feel pain with chewing or pressure, prolonged sensitivity to heat or cold, swollen, and tender gums around a tooth, or tooth discoloration.

• The Root Canal Procedure

If a root canal is necessary, the procedure is very straightforward. After the area around the tooth is numbed, we will make an opening in the crown to allow access to the pulp inside. Very small instruments will be used to clean the inner tooth and removed bacteria and dead or dying tissue. The area will be thoroughly disinfected, and the inside of the tooth shaped and then filled and sealed. A temporary filling or crown might be placed on the tooth to prevent bacteria and food from entering the site if a permanent crown needs to be created. The entire process usually takes from one to three visits.

If we suggest a root canal, it is because this is the best way to save your tooth. Please feel free to talk to us about your particular needs and concerns. Which tooth is affected, how many roots are involved, what type of filling or crown might be best—we will work with you to provide all the information you need and all the options you have available.

Common Concerns

• Are you concerned about pain?

The most painful part of a root canal is often the severe discomfort your tooth causes before treatment. And infections and damaged nerves can affect not only the injured tooth, but the gums, tissue and even bone surrounding it. With our modern dental techniques, a root canal procedure is often no more uncomfortable than a regular filling. The local anesthetic we use will prevent you from feeling any pain during the procedure, and, while the area around your tooth might be a bit sensitive following treatment, the pain caused by the infection or injury should be gone.

• Are you anxious about the procedure?

If dental treatment causes you anxiety, please let us know. There are several sedation options we can pursue to make this procedure less worrisome. Our goal is to make your treatment as gentle and comfortable as possible.

No one welcomes the news that a root canal is necessary, but with today’s procedures, this treatment can be just what you need to relieve your pain and keep your natural tooth where it belongs for many years to come. And that is welcome news, indeed!

Spilling soda on someone’s white shirt, telling an off-color joke at an inappropriate time, or sneezing chewed food all over the dinner table all pale in comparison to the socially unacceptable, embarrassing blunder of having ... bad breath!

Five Possible Causes of Halitosis

• Poor oral hygiene practices. Failing to brush your teeth encourages anaerobic bacteria growth, which involves a type of bacteria that emits volatile sulfur compounds (gases) responsible for smelly breath.
• If you have tonsils, you may have tonsil stones embedded in the fissures of your tonsils. Tonsil stones are hard, tiny pieces of bacteria, dead oral tissue, and mucus that form inside tonsil crevices. When accidentally chewed, they release extremely foul odors that others can smell and you can actually taste.
• You have a chronically dry mouth due to medications, allergies, or persistent sinus conditions that force you to breathe through your mouth. Anaerobic bacteria thrive in dry, stagnant environments where oxygen content is minimal. Consequently, a dry mouth tends to lead to smelly breath.
• You have acid indigestion or GERD (gastroesophageal reflux disease). If you constantly belch stomach gases, this not only causes your breath to smell fetid but it can lead to enamel erosion and tooth decay.
• You have one or more oral diseases: gingivitis, periodontitis, or infections in the gums known as abscesses.

Improving oral hygiene practices may eliminate bad breath, but if brushing, flossing, and rinsing with a fluoride mouthwash twice a day doesn’t stop people from backing away from you when you open your mouth, it’s time to visit Zarrella Dentistry.

By now, everyone knows that smoking is bad for you. But the truth is its broad-reaching health effects are not all known by everyone. This is especially true of oral health. Smoking can have serious repercussions in this regard. To give you a better idea of how smoking can affect your oral health, Dr. John Zarrella and Dr. Peter C. Rider and our team have listed some issues that can arise.

Oral Cancer

Oral cancer can have steep ramifications for anyone that gets it. Surgery can be required to eliminate the cancer before it spreads to more vital parts of your body. Any type of cancer is about the worst health effect you can get, and this especially holds true to the affects that smoking has on your mouth. The type of mouth surgery required with oral cancer can leave your face deconstructed in certain areas, and it is all due to smoking or use of other tobacco products.

Tooth Discoloration and Bad Breath

At the very least, it is fair to say that as a smoker you will often have bad breath, and while you may try to cover it up with gum or mints, tooth discoloration is a whole other story. The chemicals and substances in cigarettes stick to your teeth staining them brown and yellow colors that are increasingly difficult to disguise.

Gum Disease and Loss of Bone

Another effect of smoking is the increased risk of gum disease. Your gums may start to recede, which can eventually lead to the loss of teeth. Smoking can also increase bone loss and density in your jaw which is vital to the health of your mouth. Gum disease and bone loss are two signs that smoking is definitely bad for your mouth.

When it comes to the health of your mouth, the question is not whether smoking affects your health, it's how does it affect your health and to what degree. If for no other reason than because smoking involves your mouth as its entry point, it is safe to say that it can have long-lasting and detrimental consequences on your oral health.

To learn more about smoking and your oral health, contact our Ashland office to schedule an appointment with Dr. John Zarrella and Dr. Peter C. Rider.

HPV, or human papillomavirus, is the most common sexually transmitted infection in the country. There are over 100 strains of HPV, and, while most of these infections leave our systems on their own with no long-term ill effects, some cancers have been linked to certain “high risk” strains of the virus. One of these strains, HPV16, increases the risk of oral cancer.

HPV-related oral cancer most often appears in the oropharynx. This area of the mouth includes:

• The base, or back, of the tongue
• The soft palate
• The tonsils
• The back and sides of the throat

While HPV-related oral cancers can appear in other parts of the oral cavity, they most typically occur at the back of the throat and tongue and near the folds of the tonsils. Because of this location, oropharyngeal cancer can be difficult to detect. This is one more important reason to maintain a regular schedule of dental exams. Our examination doesn’t focus only on your teeth and gums. We are trained to look for cancerous and pre-cancerous conditions in the mouth, head, and neck to make sure you have the earliest treatment options should they be needed.

If you discover any potential symptoms of oropharyngeal cancer, call us for a check-up. These symptoms can include:

• Trouble moving the tongue
• Trouble swallowing, speaking, or chewing
• Trouble opening the mouth completely
• A red or white patch on the tongue or the lining of the mouth
• A lump in the throat, neck, or tongue
• A persistent sore throat
• Ear pain
• Unexplained weight loss
• Coughing up blood

Not every symptom is caused by cancer, but it is always best to be proactive. HPV-related oral cancer is rare, but it is on the increase. While HPV-positive oral cancers generally have a better prognosis than HPV-negative oral cancers, early diagnosis and treatment are still essential for the best possible outcome.

Finally, if you are a young adult or have an adolescent child, talk to Dr. John Zarrella and Dr. Peter C. Rider and to your doctor about the HPV vaccine, which is effective before exposure to the virus occurs. Most HPV vaccines, while not designed specifically to prevent oral cancer, prevent the HPV16 strain from infecting the body—the very same strain that causes the majority of HPV-related oral cancers.  Although no studies have shown definitive proof yet, there is strong feeling in the scientific community that these immunizations might protect against HPV-positive oral cancer as well as cervical, vaginal, and other cancers. It’s a discussion worth having at your next visit to our Ashland office.