Showing posts with label root end surgery. Show all posts
Showing posts with label root end surgery. Show all posts

Monday, November 7, 2016

Dental Sealants Prevent Cavities and More Kids Need Them, CDC Says

There's a quick and easy way to prevent 80 percent of cavities, but most kids don't get it, federal health officials said Tuesday. The treatment, dental sealants, works well, but only 60 percent of kids who need sealants get them, the Centers for Disease Control and Prevention says.
                       
    
Dentist inspecting boys mouth before treatment. Universal Images Group / UIG via Getty Images

One good solution: doing it at school. But states often lack the funding to pay for such programs, and often bureaucratic requirements about having dentists on site can hold them up, also, the CDC said.

"Many children with untreated cavities will have difficulty eating, speaking, and learning," said CDC director Dr. Tom Frieden.

"Dental sealants can be an effective and inexpensive way to prevent cavities, yet only one in three low-income children currently receive them. School-based sealant programs are an effective way to get sealants to children."
The CDC says that 20 percent of kids and teenagers have untreated dental decay by the time they are 19. Kids with constant toothaches cannot eat properly and have trouble paying attention at school.

Related: Do Kids Need Dental Sealants?

Even though they are endorsed by the CDC and the American Dental Association, only 43 percent of 6- to 11-year-old children have a dental sealant, federal surveys show.

"Low-income children were 20 percent less likely to have sealants than higher-income children," the CDC's Susan Griffin and colleagues wrote in a report released Tuesday.                    

"School-age children without sealants have almost three times more cavities than children with sealants," the CDC added.

"Applying sealants in school-based programs to the nearly 7 million low-income children who don't have them could save up to $300 million in dental treatment costs."

That's because a filling costs more. In addition, once a tooth has been drilled to put in a filling, it's never as stable again.
But many states struggle to pay for such programs, the CDC team found.

"Federal funding of state oral health programs is largely com­petitive and varies widely by state," they wrote. "Many state and local school-based sealant programs cover part of their expenses by Medicaid billing."

And Medicaid, the joint state-federal health insurance plan for children and low-income people, is already badly stretched in most states.
One big expense is paying a dentist to oversee the program, the CDC found. One solution: Allow lower-paid professionals to administer sealant programs. At least one state has already done so.

"For example, in South Carolina, school-based sealant programs managed and staffed by dental hygienists deliver sealants in approximately 40 percent of high-need schools," Griffin and colleagues wrote.

"CDC currently provides funding to 21 state public health departments to coordinate and implement school-based and school-linked sealant programs that target low-income children and those who live in rural settings," the agency added.

It said the federal government plans to do more. It will classify pediatric dental services as an essential health benefit to be covered by dental insurance as part of the Affordable Care Act, for instance, and match state Medicaid and CHIP costs for sealants.
The sealants are plastic-based coatings that get into the cracks and crannies of molar teeth, stopping food and bacteria from starting the chemical reaction that leads to cavities.
 Studies show they are safe and stop tooth decay, even when they are layered over an existing pre-cavity.

"Studies on sealant effectiveness indicate that sealants delivered in clinical or school settings prevent about 81 percent of decay at two years after placement, 50 percent at four years, and can continue to be effective for up to nine years through adolescence," the CDC said.

 The American Dental Association (ADA) agrees, and says many people don't know that dental insurance often pays for them.

"Dental sealants are one-third the cost of a filling, so their use can save patients, families, and states money," the Pew Charitable Trusts, an independent, public service-oriented nonprofit, says in a statement. "Sealant programs based in schools are an optimal way to reach children — especially low-income children who have trouble accessing dental care."
 One worry that parents may have is about BPA, a chemical found in the sealants that is increasingly linked with health risks. The ADA says the benefits of sealants far outweigh any perceived risk.

"The potential amount of BPA patients could be exposed to when receiving sealants is minuscule, and it's less than the amount a person receives from breathing air or handling a receipt," the ADA says.

By: Maggie Fox, NBC News
http://www.nbcnews.com/health/kids-health/dental-sealants-prevent-cavities-more-kids-need-them-cdc-says-n668266

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

Friday, July 25, 2014

Apicoectomy

Why Would I Need It?
Most dental problems involving an infected tooth root are solved by a root canal. Although endodontic treatment has an extremely high rate of success, it is not 100% effective. Some teeth may not respond as expected to the root canal therapy. Sometimes, it is clear from the beginning that the root canal is not working as planned. Other times, it may be years later that the need for other treatment arises.

Typical reasons for an apicoectomy may include re-infection of the root canal site with signs like pain in the tooth, tenderness or swollen gums that occurs after a root canal.

The first and most desirable method of solving the problem is to re-treat the root canal at one or more roots. In other words, the root canal treatment is redone in a method similar to the original therapy. If it is possible to re-treat the root canal with this nonsurgical approach, this is best.

What Is It?
If not, a different form of treatment, an apicoectomy (root end surgery), must be considered. An apicoectomy is an oral surgery procedure that removes the tip of a tooth root to save the tooth from being pulled out. Keeping your teeth intact is the dentist's mission.

Teeth are held in place by tooth roots. The tips of each root, called the apex, serve as an entrance for nerves and blood vessels into the tooth. During an apicoectomy, the apex is removed, almost with the infected tissue, and then sealed with a tooth filling. 

What Can Be Corrected With An Apico
  • teeth that have narrow, curved roots
  • "blockages" of the canal
  • root resorption
  • persistent infection
  • fractures
  • a wide open apex
  • associated cysts
Reasons Not To Perform The Apico
  • surgical inaccessibility
  • poor or lack of bone support
  • short roots
  • vertical fracture of the root.
The Procedure 
1. The root or roots that are to receive the apicoectomy are measured with radiographs, and the approximate location of the root tip is estimated.
2. The area to be treated is anesthetized with a local anesthetic.
3. An incision of the gum is made over the root tip area and the gum is moved to the side. Access is made through the bone, and the tip or apex of the root can then usually be seen through this "window" in the bone. 4. The infection is visualized and cleaned out.
5. The tip of the root is usually removed, and a sealing filling is placed in the remaining tip opening.
6. The tissue is then sutured back into place.

Done with a surgical microscope, this procedure is also known as endodontic microsurgery and usually takes between 30 to 90 minutes, depending on the tooth's location and complexity of the root structure.

Who Performs The Procedure
Though general dentists can do an apicoectomy, most are performed by endodontists, or root canal experts.

What To Expect After The Procedure
The tooth does not lose significant stability from this procedure. There is no pain during the surgery. Postoperative discomfort will be eliminated with anti-inflammatory and analgesic medication. There is usually some slight swelling of the surgical site. The swelling is temporary and will disappear after a few days. When the "apico" is begun and the tooth can actually be seen, another type of problem may be noted. A fractured root may be the problem, and an apico would not work and the tooth would have to be removed. This procedure can be completed by a general dentist, but it is most often referred to an endodontist (root canal specialist) for evaluation and treatment.

Recovery Tips
  • Apply a cold compress to the area for 10 to 12 hours after the surgery
  • Avoid any strenuous activities and make sure to get enough rest
  • Take over-the-counter pain medication to manage any discomfort
  • Allow your tooth and the gums around it to rest while it heals. Avoid eating crunch or hard foods, as well as brushing the affected area and rinsing too vigorously 
If you have any questions about apicoectomy, please feel free to ask us.