Cone Beam CT

Cone Beam CT imageA cone beam CT scan can sometimes diagnose issues that cannot be seen with a standard x-ray. Since the radiation dose exposure is higher than with standard radiographs (and much higher than with digital radiographs), they are not necessarily the best choice for routine use. Here is a Cone Beam CT position paper provided jointly by the American Association of Endodontists and the American Academy of Oral and Maxillofacial Radiology.

Here in Raleigh-Durham-Chapel Hill, we are incredibly fortunate to have an expert at reading these images. Not only is Dr. Bruce Howerton an outstanding oral and maxillofacial radiologist, he used to be an endodontist so he knows what information Dr. Conner needs him to provide. To learn more, visit Carolina OMF Imaging.

Tooth pain!

Dear Doctor has plenty of useful information. Here is an article about tooth pain — the different types of pain, possible causes, and treatments. These are the kinds of questions Dr. Conner asks you when she’s evaluating whether or not you need a root canal treatment. Is it sharp, shooting tooth pain or more of a dull ache or throbbing. Is it sensitive to hot or cold? Does it linger or go away? Do you have pain when you bite down?

tooth painOne thing I’ve learned working in an endodontics practice — it doesn’t get better on it’s own! It only gets worse (and the longer you wait, the more expensive the treatment options become). If you’re having tooth pain, go see your dentist! I know people have a lot of anxiety about going to the dentist (I’m one of them!), but there’s medication for that. Ask your dentist for an anxiolytic…it makes the whole experience virtually stress-free.

Something I see most days is someone whose pain finally was severe enough to overcome their anxiety and they ended up in our office for root canal treatment. Unfortunately, they’re in too much pain to get numb! Then we need several days to get the pain under control enough to actually treat the tooth. So, don’t wait, go to your dentist when the pain is noticeable and before it’s unbearable (and you need a root canal…or worse, have to pull the tooth).

Internal bleaching

Tooth whitening is everywhere. Here in North Carolina, it’s about to get even more commonly available (that’s not necessarily a good thing but that’s another post). There’s another type of bleaching that is done internally when the tooth is discolored from the inside (as opposed to what you usually think of when you hear teeth bleaching). There are different reasons for a tooth getting discolored from the inside. Probably the common reason is there was trauma to the tooth and it bled internally. If a tooth does need internal bleaching, it will need to have a root canal treatment (most have already had one). Typically, we do these when someone has to have a tooth treated or retreated anyway and we do the bleaching at the same time. It will usually take a few visits to get the color to match the surrounding teeth.

Smile Power Day

smile power day

If you have a toothache and can’t smile, go to your dentist!

If you can smile, share it with everyone. Here’s one of my favorite quotes: “Smile. It makes people wonder what you’ve been up to.”

What to expect from a root canal treatment

A root canal treatment is the most feared dental procedure and the butt of many a joke. But, the reality is, it should just be a long, boring filling. Endodontists have great numbing stuff to make sure you don’t feel anything and they can prescribe anxiolytics so you can relax during the procedure. And, the rule for Dr. Conner is if it hurts, she stops.

Zeiss dental microscope Dr. Conner uses a microscope and rubber dam for the procedure. The microscope lets her see into your canals (this is also useful for seeing cracks inside your tooth to determine if your tooth is restorable). The rubber dam ensures bacteria in your mouth do not contaminate the tooth once she disinfects it. That does mean your mouth will be covered so you will need to be able to breathe through your nose during the procedure.

We use digital radiographs (x-rays) that minimize your exposure to radiation. The amount of exposure is similar to your x-ray sensors

The worst pain is what people are feeling that drives them to an endodontist in the first place, not the actual root canal treatment. The good news is, once that nerve is gone the pain goes away, too. The bad news is if it took a while to get that painful, it might take a few days for everything to calm down. Other than that, you might be a little sore just because someone was working in your mouth. Some ibuprofen or Tylenol should take care of any discomfort from the procedure (your dentist or endodontist will tell you what to take).


Basics of a root canal

For a basic overview of what a root canal treatment is, you should read this article on the Colgate website. It has lots of pictures and simple, to the point explanations.

For a more thorough discussion, there’s this article on WebMD about root canal treatments. It discusses what a root canal is, why someone might need root canal treatment, how the procedure it done, the complications and reasons for re-infection, and more. It even gives a few ideas on how to prevent needing one!

And, if you want to know what our patients have to say about their experience, we have video testimonials on our YouTube channel.

All about flossing

floss!Flossing…it’s a good thing. The American Dental Association has a flossing how-to article along with answers to your flossing questions. Basically, you should floss every day. And, it’s a good idea to floss before you brush. That way brushing will remove any little bits that are loosened by flossing. Kids need to floss as well – but they need help from an adult until they have the dexterity to do it themselves.

It’s International Day of Happiness!!

be_happyThis is quite the day. If you haven’t already taken advantage of all the positive omens, now’s your chance to be happy! It’s International Day of Happiness!! Want some suggestions on how to be more happy? Here’s a good article I found on the NBC Today site.

And, if that wasn’t enough for you, it’s about as powerful a celestial day as it gets. Today is the vernal equinox. There’s the super moon (when the moon is closest to the earth). You can read all about the super moon in this Wikipedia article. And, there’s been a total solar eclipse enjoyed in different parts of the world. Here are some shots of it from the top of the world.

Dental trauma guide

It’s probably a good idea to know what to do in an emergency, especially if you have kids, so here is an online dental trauma guide.

gizmo-2013-03And, while we’re talking about tooth trauma, be sure and wear mouth guards for all sports or other activities where you run the risk of getting hit in the mouth. You’d be surprised how easy this is. One of the more common causes we see is where someone is knocked in the mouth by a baby or dog. And the damage is not always obvious. It’s not uncommon for us to see a patient that has no visible tooth damage or decay but needing a root canal. After much wracking of the brain, they’ll remember getting hit in the mouth several years earlier. Gizmo has come close to doing that kind of damage more than a few times. She may look innocent and calm, but she can go from zero to wild in a tenth of a second!

Remedies for bad breath

If you (or someone you love) have concerns about bad breath, there are plenty of articles online to help. Here is one from that is pretty thorough. Another one to check out is from And, if you want the official word on the causes of bad breath, the American Dental Association’s Mouth Healthy website has an article.