We put our teeth through a lot in our lifetime, including the hours we spend eating and drinking. The tooth surfaces must deal with a constantly changing environment. One area that sometimes gets overlooked when choosing our diet is the acidity in maybe causing to our teeth.

Enamel is the hardest substance found in the body but even this amazingly tough outer tooth layer can be damaged by a pH environment lower than 5.5. The pH 0 being the most acidic. If these harsh conditions occur frequently then the top layer can be eroded away over time.

The appearance of acid erosion differs from other types of tooth substance loss as it is smoother in appearance making it less obvious to spot. Here’s what to look out for:

• Saucer shaped depressions, wearing away of biting surfaces and edges that have a smooth shiny appearance.
• Thinner enamel or dentine which sometimes has a darker yellow/brown coloring.
• These visual symptoms are often accompanied by sensitivity to hot, cold, and sweet stimulates
• The surface of the tooth can also feel different to the tongue and touch usually feeling rougher.

Causes include internal factors such as:

• Gastroesophageal reflux or acid reflux. This can be caused by food/drink, smoking, pregnancy, and medical conditions such as hiatus hernia.
• Bulimia is eating disorder which causes frequent vomiting to control a person’s food intake. This causes the enamel to be in contact with strong acids in the stomach.
• Binge drinking and alcoholism can also induce regular vomiting. The acid in the stomach has a pH around 1.

External factors:

• Foods include acidic fruit such as citrus fruits, apples, and tomatoes.
• Anything that has been pickled or preserved in vinegar is also a high risk.
• Drinks such as sodas, alcohol and fruit juices are obvious dangers but there are

I am meeting an endo tomorrow for a first consult on #18.

No pain, no pus, no fever. Acute irreversible pulpitis with periapical abscess.

I do have swelling over both #18 and #19 that has been there for 7 days now already so time is passing. Everyone was closed over Thanksgiving.

Can I get some guidance on the endo steps/choices? How do I judge the quality of his recommendations and commit?

Is this a clear cut case or should I waste time and money on consulting different endos?

At the end of September I had a gum graft procedure performed around my bottom front teeth. Leading up to that surgery, I had experienced gum recession and related pain. (I also have a history of braces and jaw surgery.) I had two post-op appointments with my periodontist, one at two weeks out and another at six weeks out. Both times my periodontist expressed satisfaction with the outcome. However, I mentioned at the last appointment (which was about three weeks ago) that I’m having some pain around the site. It’s not constant, but it’s frequent enough to have my concerned. She thought it might be tooth sensitivity and prescribed me a special toothpaste. Unfortunately it hasn’t resolved the pain. Here is a photo of the site from today. I don’t think it’s changed much over the past few weeks, but it’s in a region of my mouth that I do not closely inspect every day. I’m not so concerned about aesthetics. I’m concerned about general health and not being in permanent pain.

Is some pain normal, even two months out? Or could this be a sign that the tissue is receding again? Should I call and make a new appointment with the periodontist? Thanks! I appreciate you all.

Perfection is in the finer details

Root canals are very small and are often missed by a human naked eye. They are small but very important anatomical structures which can determine the success or failure of a root canal treatment. Only with the help of a dental microscope one can identify, clean, and fill them to perfection.

One of the most common reasons for root canal failure is missing these minute, anatomical details. Human eye has certain limitations and only with the help of a surgical microscope can a clinician overcome these limitations,

“If you can’t see it, you can’t treat it”

Apart from visualizing and treating the root canals, surgical microscope has wide range of other uses in endodontics. To mention a few:

1. Conservative access preparation
2. Retreatment of failed root canal treatment
3. Removal of broken instruments from the canals
4. Removal of dental post, etc.

Of course, the skills and techniques of the operator are also important. Modern endodontics is about science, skill, knowledge of anatomical details and use of appropriate tools and equipment.

Microscope-assisted root canal treatments have a predictable and long-term success.

Perfection is in the finer details

Root canals are very small and are often missed by a human naked eye. They are small but very important anatomical structures which can determine the success or failure of a root canal treatment. Only with the help of a dental microscope one can identify, clean, and fill them to perfection.

One of the most common reasons for root canal failure is missing these minute, anatomical details. Human eye has certain limitations and only with the help of a surgical microscope can a clinician overcome these limitations,

“If you can’t see it, you can’t treat it”

Apart from visualizing and treating the root canals, surgical microscope has wide range of other uses in endodontics. To mention a few:

1. Conservative access preparation
2. Retreatment of failed root canal treatment
3. Removal of broken instruments from the canals
4. Removal of dental post, etc.

Of course, the skills and techniques of the operator are also important. Modern endodontics is about science, skill, knowledge of anatomical details and use of appropriate tools and equipment.

Microscope-assisted root canal treatments have a predictable and long-term success.