Can a Split Tooth Be Saved Intact?

The short answer is no, but before you surf to another site to get a second opinion, give us a moment to explain the difference between a split tooth and a cracked tooth (which can be saved). We will also discuss treatment options for a split tooth that may, depending on the location of the split, be able to preserve part of the tooth.

The Difference Between Split and Cracked

A cracked tooth starts at the surface of the tooth and extends downward vertically. Sometimes the crack may even reach below the gum line! With the help of a root canal and a full crown, the tooth can be salvaged. However, what happens if the crack continues downward and completely through the tooth- separating it into two segments?

This is now called a split tooth. This generally occurs when some has a cracked tooth for a long time, and either ignores it or perhaps never realizes the crack has occurred. Often, extraction is the only treatment option. Endodontic options, however, may be available if the tooth is split off to one side, leaving the majority of the tooth intact. What can be done?

Endodontic Treatment for a Split Tooth

If only a small portion of the tooth is split from the rest, the tooth still cannot be saved intact, but the larger portion of the tooth may be salvaged. The procedure may involve a root canal, gum surgery, removal of the part of the tooth that has broken away, and other forms of endodontic treatment.

In the end, a permanent crown may be able to preserve the larger portion of the tooth. Again, this is entirely dependent on the extent and location of the split. Thus, if you know that you have a cracked tooth, it is far better to take preventative care and visit a dentist early before a situation becomes worse. Your endodontist is hear to help!

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Beam Brush—Bluetooth Technology

At a mere $29, the Beam brush is accessible to just about everyone that has an iPhone, iPad, or iPod Touch. It is designed for all age groups and connects to an app that records data of your dental hygiene habits via Bluetooth. The app doesn’t need to be open for the information to be transferred; your daily tooth brushings are automatically recorded. The app is designed to get you to brush better and be more informed, accountable, and in charge of your dental health.

Oral B’s Smartseries—Bluetooth with Extras

Oral B’s Smartseries not only sends and records data to its app, but it also records how many brushstrokes you make and offers tips to do better next time. This toothbrush and its app are paramount on user interaction, and have solutions for your dental health that are based on actual data from your brushing. It finds areas that are problematic and then allows you to follow routines for brushing that are customized just for you to better your brushing. It works with iPhone or Android. Track your progress, get guidance in real time, and don’t brush too hard—there’s a sensor that will stop the brushing when you do. Prices range from $120-160.

UltraBlu—Blue Light Technology

Proven to kill bacteria that can be harmful to your mouth, blue light technology steps in to be a part of your toothbrush! This toothbrush has the same light that is used by dentists for teeth whitening and dental fillings. Provides immediate benefits at home rather than trips to the dentist and is safe for use to both whiten teeth and kill bacteria. Damaging bacteria are killed, yet it allows good bacteria to increase. With a built-in two-minute timer, you can be sure you won’t brush more than you need to with this manual toothbrush. $24.95 includes additional brush heads.

Misoka—No Toothpaste Required

Japanese designer Kosho Ueshima created this sleek toothbrush with nanotechnology. Nano-sized mineral ions cover the brush’s bristles to ensure that your smile is clean by removing stains and making a protective coating on the enamel. The design helps to get into tight spots in your teeth. The brush will need to be replaced every 30 days as the healthy mineral ions are used up by this time. This brush is not yet available in the United States and just recently hit Europe for sale. No prices available at this time.

Technology today has a larger role to play in our brushing habits than ever before. With all this technology focused on the consumer taking more responsibility for their dental health, hopefully this means our smiles will be brighter and healthier in the future!

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Root canals are usually performed by specialists called endodontists. General dentists can perform root canals, but many dentists refer their patients to endodontists for root canals. Endodontists have specialized training beyond dental school. Every year in the United States about 15 million root canals are performed. About 95% of root canals are successful and do not require retreatment.

A root canal cleans out the inside of the tooth, removing all decay and diseased tissue. This part of the tooth is called the pulp. After the area is thoroughly cleaned and disinfected, a rubbery material is used as a filler to restore the tooth. The hole that was made in the tooth to enter it is sealed, and in some cases the tooth may receive a crown to give it more strength. The procedure is usually performed in one office visit, with a permanent filling or crown being placed on a second visit.

Root canal is performed under local anesthesia and is described by most patients as virtually painless. Pain after the procedure is usually limited to soreness or sensitivity for a few days. Root canal eliminates toothache pain that is caused by a decayed tooth. After a root canal the newly restored tooth may feel different, but normal eating can be resumed quite quickly.

When a dentist recommends a root canal, the tooth is at the point where it cannot be saved any other way. The only alternative to root canal is to lose the tooth. A lost tooth can be replaced by an artificial tooth or an implant, but saving your natural teeth is the best option.

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Root canal saves a tooth by cleaning out diseased and dying tissue from its inner chamber. The chamber is then filled with a strong material, the entire area is sanitized, and then the tooth is reinforced with a filling or crown. A tooth that has been treated with root canal therapy is restored, strong and can last a lifetime.

Having a dying tooth pulled may seem like an easy alternative to root canal, but most people are not aware of the problems that can be caused by a missing tooth. An open space between your teeth can weaken the foundation of the rest of your teeth. Beginning with the teeth that surround the missing one, the other teeth can gradually begin to shift out of position. Losing just one tooth can lead to crooked teeth and bite problems in the future.

Oral hygiene becomes difficult as teeth shift out of position, because gaps are created that can be difficult to clean. The chance of gum disease is increased as food particles are more likely to be left behind.

When a tooth is lost, replacing it can eliminate some of these problems, but saving a natural tooth with root canal is always recommended. A root canal procedure is generally less expensive and less complicated than getting an extraction and replacement like a bridge or implant. The success rates for root canal and implants are about equal, and both are very high; but with root canal, the tooth you have is your own, with its own natural root still intact.

Root canal today is described as painless by the majority of patients who have undergone the procedure. It can be completed in usually just two office visits, with the second one being for the placement of the crown on the tooth.

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After a root canal, the treated tooth should heal and be pain free. You should be able to chew normally and there should be no sensitivity to the treated tooth after a few days of healing. If you still have pain after a root canal procedure or develop pain in the tooth again in the future, this could be a sign that the tooth has been infected again.

Sometimes when a tooth has a complex inner structure, the first root canal may not completely clean out the infection. If the tooth was not properly restored with a crown after a root canal, new infection can enter the tooth. Damage from injury like a broken crown can also expose a restored tooth to bacteria and the possibility of infection. In any of these cases, endodontic retreatment may be necessary.

The retreatment process is similar to the first root canal. The tooth is opened and the canals are cleaned. The filling materials that were placed during the first root canal may have to be removed so that the endodontist can access the canals. After cleaning, new filling materials are placed and the tooth is sealed. The tooth will again need to be restored with a crown.

In some cases, very small canals are not accessible in a root canal procedure. In such a case, endodontic surgery may be recommended. Surgery allows the endodontist to access small or narrow canals.

Root canal has a 95% success rate, so the chance of requiring retreatment is low for most patients. You can increase the chances of a successful root canal the first time by following your endodontist’s instructions after the procedure, returning for follow-up appointments and continuing to brush and floss your teeth regularly and see the dentist for regular checkups.

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White tongue

A white tongue can be sign of a condition called leukoplakia. This is an excess of cell growth that is not actually dangerous, but sometimes it is a sign of cancer forming. Leukoplakia can also be caused by using tobacco products or because your tongue has been irritated.
Oral thrush also causes white tongue. Oral thrush is a yeast infection, and can be treated by eating plain yogurt or with medications.
White lines on your tongue may be oral lichen planus. Doctors and dentists do not know what causes this condition, but it usually goes away on its own without treatment.

Red tongue

A tongue that is too bright pink or red could be a sign of vitamin deficiency, particularly vitamin B-12. A peculiar condition that is called geographic tongue because it involves reddish spots on the tongue that look like a map is harmless and usually goes away by itself. If you have a red tongue accompanied by fever, you could have Scarlet Fever. You should see a doctor immediately because Scarlet Fever must be treated by antibiotics. Children under the age of five can develop Kawasaki syndrome, a blood vessel disease that is indicated by a red tongue and fever. If treated early, Kawasaki syndrome usually has no long-term negative effects.

Black tongue

Black, hairy tongue sounds and looks terrible, but it is usually harmless. It involves bacteria attaching papillae, the small bumps on the tongue. Good oral hygiene can prevent this from occurring. A healthy tongue should be pink at most times. Any unusual coloration of your tongue that you cannot attribute to a food or beverage warrants a visit to a doctor or dentist. Any unusual bumps, sores or markings on your tongue or inside your cheeks should be checked on as well.

Contact your dentist for any additional questions- and remember to keep your mouth healthy and happy.

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Enamel, the hardest substance in the body, covers the crowns of teeth while cementum, a bony material that helps attach teeth to the supporting bone, covers the root. When protective enamel or cementum covering the dentin is lost due to tooth decay, over-brushing or periodontal disease, your dentin will become exposed. As a result, microscopic tubules present in dentin conduct thermal stimuli from the exposed surface into the pulp, triggering a painful response.

Enamel is most commonly affected by caries and cementum by aggressive brushing, made worse if combined with constant exposure to very acidic foods or drinks. Proper oral hygiene is an important step in reducing the chance of developing hypersensitivity. If teeth are brushed too aggressively, brushed with a hard brush or brushed with unpolished bristle tips, recession of protective gum tissue may be caused.

Periodontal disease, or gum disease, is also a leading cause of hypersensitivity. When gums and bone that support the teeth are affected, bacteria growth can live in untreated areas between the teeth and gums and aid in recession. Regular dental checkups are vital in identifying and treating these problems before they become serious.

Sensitive teeth can be successfully treated by use of over-the-counter desensitizing toothpastes, but improvement is typically gradual and can take as long as 6 weeks to show changes. In some cases, eliminating highly acidic foods or drinks in your diet may greatly reduce the problem. Exposure to foods or drinks that have a particularly low pH should be reduced or eliminated, especially if imbibed between meals. Adding lemon to beverages, wine (especially white), apples, grapefruits, pineapples, athletic drinks and soft drinks can be especially detrimental.

If using desensitizing toothpaste or eliminating acidic foods and drinks does not work, application of a fluoride-containing gel may be an option. This may be done by a dentist, however take-home versions may also be prescribed. Always follow suggested precautions as swallowing products high in fluoride are hazardous. Depending on your individual needs, dentists may also recommend a gum graft, filling, crown or in rare cases endodontic treatment (root canal).

Teeth sensitivity is a highly unpleasant experience, but it does not have to be permanent. With minimal effort, relief can be found by a small change in habits or seeking assistance from a professional who can help.

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Unfortunately, many older patients suffer from reduced saliva flow, also called “dry mouth” or “xerostomia,” resulting in increased decay. There are various reasons that a person may be affected by dry mouth, which is actually not a disease in itself, but rather a symptom of a systemic disorder or the side effect of certain medications. Some medications causing dry mouth include antihypertensives (blood pressure), antihistamines, decongestants, anti-anxiety drugs and many others.

Dry mouth can result in a higher incidence of halitosis or bad breath because saliva that controls some bacterial populations is not present in adequate volume. Dry mouth may be associated with difficulty swallowing, trouble speaking, burning feeling or a constant sore throat. If you have dry mouth due to the result of a medical condition, speak to your physician or dentist about possible treatment to increase saliva flow or tactics to reduce the effects. If the dry mouth is a result of medications, ask if a substitute may be recommended.

Having a dry mouth requires more frequent visits to the dentist for check-ups and cleanings. Your dentist may recommend that sweets and highly acidic foods or drinks not be consumed between meals and that you use a toothpaste or mouthwash containing a high level of fluoride, available only by prescription. Studies have shown that enamel and dentin are the softest after exposure to sweets or acidic foods, so waiting 20-30 minutes before brushing will allow available saliva to re-mineralize the enamel and dentin.

If you have been diagnosed with dry mouth, consider the following tips:

1. Limit sweets and sugar-containing fruits to mealtime when your saliva flow is optimal. Hard candy and all kinds of chocolate will generate significant decay.

2. Since some foods and drinks are also acidic, brushing right after eating or drinking them can magnify the problem. It is better to rinse with water to neutralize the acids and brush/floss after 20-30 minutes.

3. Eating sticky foods like raisins, dates and dried fruit can magnify the amount of acid in intimate contact with your teeth. Try to limit consumption of these foods, especially between meals.

4. Chewing sugarless gum can increase saliva flow by up to 10 times normal, so consider chewing it after meals or after eating between meal sweets or acidic foods or drinks.

5. Rinsing your mouth with water after consuming highly acidic foods such as fruit or wine, especially white wine, will also help neutralize harmful acids in the mouth. For example, sipping wine while cooking dinner will extend the exposure of your teeth to acid, with significant long-term consequences.

6. Carefully brush two times a day and floss daily to remove decay-causing plaque.

7. Visit your dentist for a prescription for high-fluoride containing toothpaste or mouthwash. These items are generally used at bedtime so that the fluoride will stay on your teeth the longest. Be sure to follow the directions carefully. Research continues to show that using a fluoride-containing toothpaste will help improve your resistance to decay.

7. If available, continue to drink fluoridated city water to maintain protective fluoride levels.

I would be remiss if I did not take this opportunity to remind you of the most basic tenets of a good oral hygiene program: minimize between meal sugars and acids and cleaning twice daily with a soft-bristled brush and flossing once daily. When choosing a toothbrush, make sure it will allow access to every corner of your mouth and replace it every three months.

I hope this information will prove useful and wish you a future of healthy smiles.

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The otolaryngology literature reports that the dental-related causes of maxillary sinusitis are often underdiagnosed, leading to persistent symptoms in patients and the possible failure of medical and surgical sinusitis treatment.

A recent retrospective study published in the Journal of Endodontics showed that of 243 patients scanned with 3D cone-beam computed tomography (CBCT) for dental implants, sinusitis was 9.75 times more likely to be associated with teeth that showed root canal lesions. More than 80% of the lesions in the study sample were associated with sinus mucosal thickening. “A collaborative approach to the diagnosis and treatment of suspected dental maxillary sinusitis between dentists and otolaryngologists may be an effective patient-centered strategy,” the authors noted. Because of the study design, no causal relationship could be established, but expert opinion suggests that dental abscesses are responsible for sinusitis in some cases.

Endodontists are dentists who specialize in root canal treatment. Our practice, Bethesda-Chevy Chase Root Canal Specialists, is a pioneer in the use specialized, high-resolution 2D and 3D (CBCT) digital imaging as an aid in the accurate diagnosis of endodontic disease. We collaborate with otolaryngologists to assess dental health to determine if the cause of the maxillary sinusitis is of dental origin. Please consult your otolaryngologist if you suspect a dental cause for your sinusitis, and consider an endodontic evaluation. 

I will discuss the evidence that supports the use of advanced technology such as cone-beam computed tomography, at the summer meeting of the College of Diplomates of the American Association of Endodontists. The lecture will focus on how 3D radiographic assessments have improved our understanding of the true nature of jaw infections associated with root canals.

Martin Levin | Your Dental Health Resource Magazine

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Root canal treatment is performed when the soft tissue of a tooth, called the pulp, is infected or inflamed due to untreated decay, injury or trauma. During the procedure, an endodontist removes the affected pulp before cleaning the root canal and finally filling and sealing the space. Following the procedure, the tooth may undergo restorative work, after which it functions, looks and feels just like any other natural tooth.

A reflex reaction when considering a root canal, is that root canal treatment is extraordinarily painful, but in fact, if people were to take the opportunity to talk to patients who have had one recently, they would learn that many of those patients report feeling little to no pain. Not having the necessary endodontic treatment to remove an infection or inflammation is actually more painful than the procedure itself, and endodontists take care to prevent as much pain as possible during and after the procedure, and many can also offer sedation dentistry to address any patient anxiety.

If given the option to consider a root canal versus tooth extraction, it is important to consider the potential longer term impact. Once a (non-wisdom) tooth is extracted, the remaining teeth will begin to move and over time, and your bite will most likely become misaligned. This can potentially be a significant problem for your mouth and overall oral health, especially as you get older and there are visible impacts on your smile and impacts on your ability to properly chew your food. Additionally, restorative work in the future to correct this effects of tooth extraction might involved dental bridges or implants, which can cost significantly more than root canal treatment.

Discuss the benefits and potential near and long term impact of root canal therapy with your dentist or endodontist, and decide for your self if keeping and preserving your natural teeth and smile is preferable to having one or multiple teeth extracted. I would suggest that a root canal is preferable over tooth extraction for these reasons outlined above (and more), as one of the main goals of your dentist and endodontist is to help preserve and maintain your natural teeth for years to come, and root canal treatment allows them to do just that.

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