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Pick the right electric toothbrush!

June 9th, 2021

The electronic toothbrush has undergone several technological advances since the 1960s. Everything from design and bristle motions to rotation, oscillation, and sonic vibration has led to dramatic changes in this necessary tool over time.

Rotation oscillation happens when the head of the toothbrush rotates from one direction to the other. The benefit of powered toothbrushes is that they can produce 50,000 strokes per minute, compared to 300 strokes with a manual toothbrush.

When you’re thinking about brush head size, smaller brush heads are best for hard-to-reach areas and small mouths. Brush heads should be replaced every three to six months as needed. A good way to save money is to designate a brush head for each family member which can be taken on and off a shared base motor.

Having a base motor or rechargeable toothbrush can deliver enough power on a full charge for a week of brushing, which makes it convenient for travel or when life gets busy. Some toothbrushes include audible signals that let you know when to switch the area of your mouth you’re brushing or when a full two minutes has gone by.

Do you have sensitive teeth? Studies have indicated that people tend to apply more pressure on their teeth when they use a manual toothbrush. This makes an electric toothbrush a preferable option if you’re having issues with sensitive teeth or gums.

There are even electric models with pressure sensors that will stop the brush from spinning when you press too hard against your teeth!

Everyone can benefit from having an electric toothbrush. A large handle size can be taken into consideration if a member of the household is young, or has a physical disability or arthritis. They’re even recommended for children in order to maintain good oral hygiene from a young age.

Biofilm is a term used for plaque or debris that builds up in your mouth. If not properly addressed, this can cause serious bacterial infections to your gums and teeth. If you want to remove biofilm in the most efficient way, an automatic toothbrush is the way to go.

When you're ready to make your decision, make sure to consult with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office to decide which electric toothbrush is right for you!

June is National Smile Month: Show off your smile!

June 2nd, 2021

The community health awareness group Oral Health America has reported that 82 percent of adults are unaware of the role that infectious bacteria can play in tooth decay or cavities, and almost three out of five children aged 12 to 19 have tooth decay. Since June is National Smile Month, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team at Central New England Endodontics and Implantology thought we’d remind our patients about the importance of good oral hygiene visits between office visits.

To keep your family’s smiles healthy and beautiful for years to come, be sure to:

  • Brush at least twice a day with fluoride toothpaste
  • Floss every day to clean between your teeth
  • Eat a healthy, well-balanced diet
  • Reduce your intake of sugary foods and drinks
  • Visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for scheduled appointments

If you want to know more about healthy home care habits, feel free to ask our team at your next appointment, or ask us on Facebook!

Memorial Day and Getting Ready for Summer

May 26th, 2021

Memorial Day didn't become an official holiday until 1971, but Americans started gathering annually in the spring to remember those who lost their lives in war during the 1860s, right after the Civil War. Celebrated on the last Monday in May, people still decorate the grave sites of war veterans and hold memorial services, but Memorial Day has also evolved into a day that signifies the beginning of summer.

During the summer months, many people take road trips to visit family members. Some head off to the airport to enjoy a long-awaited vacation far away, while others look forward to spending time with friends and family at home. However you spend Memorial Day and the subsequent summer months, there are a few things you can take care of to ensure your summertime is enjoyable.

Checklist for an Enjoyable Summer

  • Have the AC Checked. During the hottest days of summer, many families find themselves sweating it out due to a broken air conditioning system. Be proactive so you can avoid waiting for hours or days because the HVAC repair person is booked solid. Have your air conditioning system checked before or around Memorial Day each year.
  • Ensure Security While You're Away. When you leave for vacation, the last thing you should have to worry about is the security of your home. Install a home security system, if possible, and put a timer on your lights so they go on and off at normal hours. You can also alert your local police department that you'll be gone, and ask them to drive by your house once in a while to make sure everything is okay.
  • Visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants Before Vacation. Many people put off exams until after summer vacation. Avoid the crowds and make sure your physical and oral health are in top shape prior to vacation time so there are no unpleasant surprises.

Our team at Central New England Endodontics and Implantology wants you to look forward to Memorial Day and the days of summer by preparing to spend the time safely and comfortably. As you plan ahead, take care of your health and secure your home, you can place your focus on creating memories with family members and friends while enjoying your favorite Memorial Day traditions.

Fractured Tooth? When You Should Call Your Endodontist

May 19th, 2021

No one looks forward to dealing with a cracked or fractured tooth, but, fortunately, there are treatments available. Fractures take a variety of forms, from cosmetic annoyance to tooth-threatening, so if you suspect your tooth is injured, it’s important to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants right away.

If you have suffered any kind of serious fracture, we are uniquely equipped to help save your tooth. Endodontists have two or more years of advanced training after dental school, and we specialize in treating the inner tooth, which contains the blood vessels, nerves, and connective tissue found in the pulp chamber and root canals. Endodontists save teeth that would otherwise be automatic candidates for extraction.

When should you call Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants? We identify five types of cracks and fractures, and your options will be different depending on which type of injury your tooth has suffered.

  • Crazing fractures

These are the small, shallow cracks that appear over time in the exterior enamel. They are often a cosmetic concern more than a medical one, and usually require no treatment. If the cracks are very bothersome, whitening treatments or even veneers can take care of the problem. If there is any pain in the tooth, it is caused by something other than a surface crack in the outer enamel.

  • Cusp fractures

When the cusp of a tooth has broken off, treatment will depend on the degree of damage. The chewing surface of the tooth can be treated by your dentist with a crown or even a filling, depending on the extent of the cusp loss. Cusp fractures rarely extend to the tooth’s pulp, but, if they do, a root canal will probably be necessary. This is a good time for an endodontic evaluation, because endodontists specialize in root canal procedures.

  • Cracked Tooth

A crack which begins in the tooth crown and travels toward the root should be treated as soon as possible. If the damage has extended to the pulp, a root canal will be necessary, and a crown will protect the tooth from further damage and help prevent the crack from growing. If the crack is not caught in time and extends below the gumline and into the root, the prognosis for the tooth is much less favorable.

  • Vertical Root Fracture

In this type of fracture, a crack begins in the root of the tooth and can gradually spread toward the crown. This is one of the more serious types of tooth fractures, because it can be difficult to detect and often has no immediate symptoms. By the time you feel pain, it might be because the bone and gum tissue surrounding the root have become infected. If the fracture is limited, endodontic surgery can sometimes save the tooth by removing the damaged root, but extraction is often necessary with more serious fractures.

  • Split Tooth

This type of fracture goes all the way through the tooth, splitting it into two distinct segments. These sections cannot be put back together, but, depending on the type and location of the break, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may be able to save a portion of the tooth with endodontic surgery.

When you are treated for a broken bone, over time the bone will knit together. A crack in a tooth, however, does not heal. If you have suffered any kind of traumatic dental injury, it’s important to visit our Worcester office as soon as possible. With proper treatment and restoration, even a tooth that has suffered a serious fracture might be saved.

Top Five Best Foods for Oral Health

May 12th, 2021

Some foods are just terrible for your teeth — think cookies and candy bars — but there are certain foods that are beneficial to your oral health. Below, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have covered five of the top foods to keep your teeth and gums healthy!

1. Crispy, low-acid fruits and vegetables: Fruits like apples and vegetables such as carrots and celery act like “natural toothbrushes,” helping to clear plaque from your teeth and freshen your breath.

2. Kiwis: These little green superstars are packed with vitamin C which is essential for gum health. The collagen in your gums is strengthened when you consume foods that are high in vitamin C, like kiwis, thus helping to prevent periodontal problems.

3. Raw onions: Onions have long been studied for their antimicrobial, antibacterial, and antioxidant properties. Proliferation of bacteria is what leads to tooth decay and cavities. By including raw onions in your diet, you'll be doing your part to wipe out those little microbes before they can multiply!

4. Shiitake Mushrooms: A specific compound in shiitake mushrooms, lentinan, has been shown to have antibacterial properties that target the microbes that cause cavities while leaving other beneficial bacteria alone. It may also help prevent gingivitis, or inflammation of the gums.

5. Green Tea: Often lauded for its high antioxidant content and many health benefits, it turns out green tea also benefits your oral health! A Japanese study found men who drank green tea on a regular basis had a lower occurrence of periodontal disease compared to men who drank green tea infrequently. It's believed this is due to the catechins in green tea, a type of flavonoid that may help protect you from free radical damage, but more research needs to be done. Either way, drink up for your overall health, as well as your teeth!

If you have any questions about your oral health, or are looking for even more oral health tips, contact our Worcester office!

Summer is Almost Here: Tips for a bright, white smile!

May 5th, 2021

Summer is almost here, which means a season full of vacations, adventures and great memories is just around the corner for our patients at Central New England Endodontics and Implantology.

Everyone wants a glowing and radiant white smile when the sun comes around and we have a few reminders to keep your pearly whites healthy and beautiful over the summer! Try to stay away from drinks that will stain your teeth like coffee, soft drinks, or dark colored juices. Not only will drinks like this weaken your enamel but they will also darken that fabulous smile you're working on! Another tip is to try and focus on brushing your teeth; everyone knows that when busy schedules start picking up, getting a good brushing session in tends to take the backseat! A good tip for keeping your mouth safe from staining and other possible pitfalls is to rinse your mouth with water after any meal you can’t fully brush your teeth after. Your teeth, inside and out, will benefit!

And remember, whether you are headed to a barbecue, a camping trip, or just having fun in the backyard this summer, we want to hear all about it! Make sure to let us know what you’re up to below or on our Facebook page! We also encourage you to post any photos from your adventures!

How Endodontic Treatments Save Teeth

April 28th, 2021

When you have a dental health concern about one or more of your teeth, the best option is always to keep your natural teeth! Often, the only alternative to endodontic treatment (also known as root canal treatment) is extraction of the tooth.

That’s followed by implant surgery or the placement of a bridge, and although these are common treatments nowadays, endodontic treatment should be your first consideration.

If you’re told by Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants that you need a root canal or endodontic treatment, you will probably have some questions. We'll try to answer some of them here.

What is endodontic treatment?

The most common type of endodontic treatment performed at our Worcester office is called an apicoectomy. In this procedure, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will surgically open the gum tissue, remove infected or inflamed material from the underlying bone, and remove the tip of the root.

Who needs endodontic treatment?

Usually, endodontic treatment is recommended for patients who have persistent pain or symptoms that can’t be detected by other, non-surgical means such as X-rays or a visual examination. This means typically the tooth has a hairline fracture or a small canal that’s causing discomfort. There are also cases where a patient may have a canal that has become calcified.

Why do I need surgery?

By performing a root canal, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can examine the entire root of the tooth to learn what is causing the discomfort and address it. So it’s not just a treatment but a means of diagnosis too. After the problem has been addressed, you will be able to keep your natural tooth and use it as you always have.

What’s the benefit of root canal treatment as opposed to getting an implant or a bridge?

A root canal allows patients to keep their natural tooth. Nothing comes close to how a natural tooth looks and functions, no matter how advanced implant technology or bridges may become. Often, a tooth that’s undergone a root canal can last patients their entire lifetime without any need for further treatment.

What if I’ve had a root canal but still have pain?

In rare cases, it’s possible that a tooth that has undergone a root canal could become inflamed or infected again. If this is the case, other surgical options may be able to save your tooth.

Crushing the Ice-Chewing Habit

April 14th, 2021

It's a habit many people have and not only can it be annoying to the people around you, it can be detrimental to your dental health. Chewing ice is so common that it even has its own name, pagophagia. We're not talking about a slushy or shaved ice (although those artificially sugary treats should be avoided too!) but more like the hunks of ice rattling around in the bottom of your glass.

Ice chewing can be a sign of emotional problems like stress or obsessive-compulsive disorder, but it can also be a marker for iron deficiency anemia and other physical problems. Then again, some people just like to have something to chew on. For whatever reason you find yourself chewing on it, it's a habit you need to break.

Chewing on ice can cause:

  • Chipped and cracked teeth
  • Damaged enamel
  • Sore jaw muscles
  • Damage to dental work such as crowns, fillings, or other appliances

If chewing on ice is becoming a problem in your life, don’t hesitate to speak with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about it. But if you find yourself still wanting to chew on something, here are a few alternatives to ice:

  • Baby carrots
  • Celery sticks
  • Sugar-free (xylitol) gum

We know you need to chill sometimes, but chomping down your entire glass of ice is not the way to do it. If you have any other questions on the topic, feel free to talk with a member of our Worcester team. It may be beneficial in solving the issue and helping to remediate any damage to your teeth.

April is Oral Cancer Awareness Month

April 7th, 2021

What is oral cancer?

April is Oral Cancer Awareness Month. If you have been putting off a visit to our Worcester office, now is an excellent time to schedule one. Regular visits to Central New England Endodontics and Implantology can be the first line of defense against oral cancer, by identifying early warning signs of the disease, or helping you with preventive care tips to lower your chances of developing it.

Oral Cancer Rates in America

Nearly 40,000 people in the U.S. will be diagnosed with oral cancer this year, and more than 8,000 die every year from this disease. It is a devastating illness: most people who are diagnosed with it do not live more than five years beyond their diagnosis. Oral cancer has a higher death rate than many other common cancers, including cervical cancer, testicular cancer, Hodgkin’s lymphoma, and thyroid or skin cancers. The high death rate results from the fact that most oral cancers go undiagnosed until the disease is well advanced and has spread to another part of the body—most often, the lymph nodes in the neck.

What causes oral cancer?

While there is no way to predict exactly which individuals will get oral cancer, there are some potential causes you should know about—because in some cases, you can minimize these risk factors.

  • Age (most patients diagnosed with oral cancer are over the age of 40)
  • Tobacco use, either from cigarettes or smokeless chewing tobacco
  • Excessive alcohol consumption (especially in combination with tobacco use)
  • Persistent viral infections, such as HPV16
  • A diet low in fruits and vegetables

In addition, oral cancer tends to occur at a rate six times greater in men than in women, and more often for African Americans than other ethnic groups. No genetic links have been identified to explain the higher incidence in these populations, so lifestyle choices remain the likeliest cause.

Oral Cancer Treatments

Once a diagnosis has been made, treatment of oral cancer usually involves a multi-disciplinary team that includes surgeons, oncologists, dentists, nutritionists, and rehabilitation and restorative specialists. Our team will decide on the best approach for each patient, depending on the risk factors and how far the cancer has progressed. The strategy will be different in every case. Some of the most common methods include chemotherapy, radiation, and potential surgery.

Finding out you have cancer can be devastating news. If you are concerned that you might be at risk for developing oral cancer, talk to us about screenings and other things you can do to reduce your risk.

Help! My gums hurt when I floss!

March 31st, 2021

By no stretch is it rare for your gums to hurt during and after flossing. Even some bleeding is to be expected. This is especially true if you have not flossed in a long time. However, if your gums do indeed hurt when you floss, and unbearably so, there are some things you can do.

Be Gentle

Perhaps the most obvious way to combat gum soreness and bleeding is to be gentle. One of the most common occurrences of these gum problems is over-aggressive flossing. In other words, if you are too rough on your gums while flossing, either because you are out of practice or because you are in a hurry, soreness and hurting is to be expected. Instead, try taking your time and be gentle. Also, if you are just starting out, be patient and consistent, your gums will become more conditioned over time.

Use an Alternative Method

If being consistent and gentle does not work, there are other alternative methods of flossing that you can try. You can also try a water floss machine, or what is sometimes called a water pick. The device essentially shoots water into the crevasses between your teeth, and in other areas of your mouth, in order to dislodge food and plaque. These oral instruments also come with different attachments that allow you to reach many of the hard to see and reach areas of your mouth. And lastly, you can always buy floss that is not as abrasive to your gums. There is floss that comes with soft and gentle coatings that will do less harm to your gums while they are adjusting to the good oral hygiene habit you are creating.

Flossing is one of the easiest parts of oral hygiene to overlook. When you first start out, it is common that you may want to stop because of the pain it can initially cause. However, if you try one, or all, of the above mentioned methods, you will give yourself the best chance of being success with your flossing, and it won't hurt as much.

For more flossing tips, schedule an appointment at our Worcester office and askDrs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or a member of our team!

What do I do if I fall and loosen my teeth?

March 24th, 2021

Although teeth are strong enough to tear through food, they are also fragile. An accident such as a fall may loosen teeth or knock a tooth out entirely. When a child loses a baby tooth in this manner, no permanent damage is usually done. However, adults who loosen permanent teeth may need to visit our Worcester office.

The Anatomy of a Loose Tooth

The hard external layer of teeth covers a more vulnerable interior. The center of a tooth consists of the pulp, which contains blood vessels and nerves. The entire tooth extends below the surface of the gums into the jaw. Special tissue called cementum and the periodontal ligament hold teeth in place, preventing them from moving.

When a fall or blow to the face loosens a tooth, the tissues anchoring a tooth to the jaw may be damaged. This results in a loosened tooth that wiggles in place. There may be inflammation or bleeding of the gums, which signals dental damage.

Dental Treatments for a Loose Tooth

The range of dental treatments for loose teeth varies by the severity of the problem. If your teeth are just slightly loose following a fall, it may be fine to wait a few days. Teeth often retighten on their own. Simply avoid chewing with that tooth and enjoy softer foods for a few days.

If a tooth is very loose or nearly falling out, call Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants immediately. Immediate placement of the tooth back into the socket is needed to ensure its survival. In general, a tooth must return to its socket within two hours or it may be lost.

In some cases, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may recommend splinting, in which teeth are joined together to strengthen them and reduce strain on an individual tooth. Tightening or straightening the tooth can restore your ability to chew regularly without stressing the loosened tooth.

Regardless of the extent of the problem, it is essential to keep the tooth clean to prevent decay. Brush carefully with a soft-bristled brush, and use mouthwash regularly to kill bacteria.

St. Patrick's Day

March 17th, 2021

On March 17, everyone has a little Irish in them. St. Patrick’s Day is a joyous celebration of Irish heritage. The holiday originated as a commemoration of Saint Patrick, who brought Christianity to Ireland. The saint arrived in Ireland in 432 and earned the reputation of a champion of Irish Christianity. March 17th, the day of St. Patrick’s death, has been commemorated by the Irish for over 1,000 years. St. Patrick’s Day is still observed as a religious feast day by several Christian denominations, but it is better known in the public imagination as a rich celebration of Irish culture.

St. Patrick’s Day has been an official public holiday in Ireland since 1903. Each year, the Irish celebrate with a several-day festival that includes theater performances, music, fireworks, and festive parades. The celebration is also a public holiday in Northern Ireland, Montserrat, and Newfoundland and Labrador. In other parts of the world with heavy Irish populations, it is an unofficial celebration of Irish heritage. Parts of Great Britain, Canada, Argentina, South Korea, Switzerland, New Zealand, the United States, and Australia commemorate the holiday each year. Typical celebrations in these countries include drinking green beer, wearing green, eating traditional Irish foods, parades, and shamrock decorations.

Many people, Irish and non-Irish alike, take part in the “wearing of the green” on St. Patrick’s Day. In fact, the color originally associated with Saint Patrick was blue. His use of shamrocks to explain the Holy Trinity to the Irish made the green clover emblematic of the holiday, leading to the traditional green attire worn by thousands on St. Patrick’s Day. Other little-known facts about St. Patrick’s Day include the following:

  • Each year, the United States and Ireland face off in a rugby competition called the “St. Patrick’s Day Test.”
  • Montreal celebrates the holiday with an annual parade, which has been held each year since 1824. The Montreal city flag even features a shamrock in its corner, as a nod to its Irish heritage.
  • The Guinness World Records named St. Patrick’s Day the “Friendliest Day of the Year.”
  • Along with Valentine’s Day, St. Patrick’s Day is one of the most widely celebrated saint’s day in the world.

No matter your cultural heritage, St. Patrick’s Day is a great time to let loose and celebrate your inner Irish-ness! Don your greenest attire and exclaim “Erin go Bragh!” (Ireland forever!) to everyone you meet. From Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants - have a great St. Paddy’s day!

Symptoms That Could Mean You Need a Root Canal

March 10th, 2021

Every tooth packs a lot of layers in a very small area. The outer, visible part of our tooth, the crown, is covered in protective enamel, and the lower root area is protected by a similar substance called cementum. Inside these very hard layers is dentin, a hard but more porous tissue which surrounds the pulp. In this central pulp chamber, we have the blood vessels which nourish the tooth and the nerves which send our bodies signals from the tooth. And if one of those signals is persistent tooth pain, you may need a procedure called a root canal.

There are a number of reasons that a tooth may cause you pain, including:

  • Fracture—a cracked or broken tooth can allow bacteria to enter the pulp chamber and cause inflammation and infection
  • Cavity—an untreated cavity can leave an opening where bacteria can reach the pulp of the tooth, and again lead to infection
  • Gum Disease—bacteria can attack from the root area of the tooth if gum disease has become serious
  • Injury—an accident or injury to a tooth can damage the nerve or the blood supply which nourishes the pulp
  • Abscess—if infection is left untreated, an abscess may form under the root

While a damaged tooth may sometimes be symptom-free, usually there are signs that the pulp has been injured or infected. What symptoms should lead you to give Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants a call?

  • Persistent pain in the tooth
  • Long-lasting sensitivity to heat or cold
  • Gum tissue adjacent to the tooth that is sore, red or swollen
  • A cracked, broke, darkened or discolored tooth
  • A bump on your gums that persists or keeps recurring—this might indicate an abscess

A root canal is performed by a trained dentist or endodontist. After an anesthetic is used to numb the area, the damaged tissue, including pulp, blood vessels and nerves, is removed from the pulp chamber and each root. The inside of the tooth is then cleaned and shaped, and filled and sealed with a temporary filling. The tooth is filled again permanently, usually on a second visit, and might require a crown in order to protect it from further damage.

The most painful part of a root canal is far more often the time spent suffering before the procedure than the procedure itself. Delaying action when a root canal is necessary can lead to infection, abscess, and even tooth loss. If you experience any of the symptoms mentioned above, please give our Worcester office a call!

 

Types of Endodontic Treatment

February 24th, 2021

Endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, are dentists who specialize in the treatment of the inside of the tooth. The type of treatment an endodontist performs is designed to go deep into the tooth where the infection or inflammation resides, and to remove that tissue to alleviate pain. Obvious signs that you need to seek endodontic treatment include pain, swelling, and tenderness in the area around the gum, bone, lymph nodes, or elsewhere on the face. Tenderness to the tooth area, discomfort and sensitivity to hot and cold, chewing, and tooth discoloration are also indications that you should seek endodontic treatment.

Reasons to Seek Endodontic Treatment

Endodontic treatment (a root canal) is necessary when the pulp within the tooth becomes inflamed or infected. Many factors can contribute to the infection or inflammation, including cracked or chipped teeth, deep decay, and even repeated treatment (such as the replacement of fillings). Teeth can also incur pulp damage from injuries that don't cause visible damage to the tooth. Without treatment, an inflammation or infection can turn into an abscess.

What is a root canal?

A root canal allows Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to literally get to the "root" of the problem and treat it. A hole is drilled to allow access to the pulp within the tooth. The pulp and any infected and/or inflamed tissue are removed. The exposed area is then thoroughly cleaned. At this point, the open canal is filled with gutta-percha, which is cemented to the canal with adhesive. The hole is then covered with a temporary crown that is removed once the permanent crown, which is typically made of porcelain and metal, is installed. The tooth then functions normally.

Other Types of Endodontic Treatment

Other types of treatment that endodontists perform to save teeth include an apicoectomy. In this procedure, the gum is opened near the tooth to allow the endodontist to explore the area near the bone. Any impacted tissue, either inflamed or infected, is then removed. The end of the root is also removed. The rest of the procedure involves cleaning the area, packing it with protective material, and then covering the tooth with a permanent crown.

Endodontists also perform procedures on abscessed teeth. An abscess contains pus and/or other infected material. It usually occurs when an infected or inflamed tooth pulp isn't treated. Sometimes, the absence of pain or other symptoms prevents a patient from knowing they have an infection or inflammation. Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will remove the infected area and perform a procedure much like the root canal, and patients recover quickly.

At Central New England Endodontics and Implantology, it's our goal to help you sustain excellent oral health so that you can keep all of your natural teeth! Our Worcester office staff is always here to answer all of your questions and help you feel comfortable about your endodontic treatment.

How do I know if I need a root canal?

February 17th, 2021

Tooth decay affects everyone, with studies reporting that 92% of adults have had a cavity at one point in their lifetime. In more serious instances of tooth decay, however, the nerve of the tooth may become infected. This type of infection requires a root canal, in which the affected nerve is removed, and the interior of the tooth is cleaned and filled.

Tooth Anatomy

Although each tooth is covered by a hard outer shell, the interior of a tooth consists of dental pulp. This pulp is soft, containing blood vessels that bring nutrients to the tooth. Each tooth also has an associated nerve, which resides within a root canal passing from the tooth’s root into the dental pulp. This nerve provides information about temperature, allowing teeth to sense heat or cold.

Symptoms of Nerve Infection

Damage to the dental pulp or nerve tissue leads to a rapid multiplication of bacteria within the interior of the tooth. The result may be an abscess, a small pocket near the root of the tooth that becomes full of pus. This infected area commonly causes the following symptoms:

  • Intense pain or sensitivity when pressure is applied to the tooth
  • Sensitivity to hot or cold temperatures, even after the heat or cold has been removed
  • Darkening or discoloration of the affected tooth
  • A small, persistent pimple that forms on the gums
  • Swollen or tender gums
  • Swelling in other areas of the face, neck, or head

Nerve infection may occur due to deep decay, although repeated dental procedures, facial trauma, chipping or cracking of a tooth, or large fillings may also contribute to an abscessed tooth.

What to Do if You Think You Need a Root Canal

Only a visit to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can confirm whether a tooth’s nerve has become infected. We will perform an oral examination and X-rays to confirm whether the tooth is abscessed. If a root canal procedure is needed, a small hole will be placed in the tooth. The pulp and nerve tissue are removed from the tooth, which is thoroughly cleaned and filled. Then, the hole is sealed with a special compound to prevent bacteria from entering the tooth’s interior. The entire procedure is performed under local anesthesia to numb pain.

If you think you may have tooth or nerve decay, call our Worcester office today to schedule a diagnostic appointment.

The Transformation of Valentine's Day

February 10th, 2021

Did you know the actions leading to the beginnings of Valentine's Day were actually centered on the avoidance of war? A Catholic priest named Valentine defied the orders of the Emperor Claudius II and secretly married young men and their brides after the emperor had declared it illegal because only single, young men could be sent to war. Rather than lose potential soldiers to fight his war, Claudius attempted to hoard them by proclaiming marriage illegal.

Valentine continued to marry young couples anyway and, eventually, was put to death for it in 270 AD. Before his death, he sent a letter to a secret love and signed it “From your Valentine”. Nearly 1,800 years later, people are still signing letters and cards in this manner. This year, carry on the tradition started long ago, while adding your own twist. Here are a few suggestions.

Simple and Creative Valentine's Day Ideas

  • Memorialize it with a Photo. Couples often have photos taken around Christmas, but Valentine's Day photos allow you to capitalize on romance. Famous couple Julia Child and her husband, Paul, had their picture taken together every Valentine's Day and included their sense of humor with silly props.
  • Return to Your First Date Location. Even if your first date together was at a local hotdog stand, its sentimental value can make it a fun part of your Valentine's Day agenda. Be creative and make a treasure hunt with clues that lead your partner to the original date location, where you can express your love with flowers or a gift.
  • “From Your Valentine” Messages. Deliver your message in a creative way to make this Valentine's Day stand out from the others. Bake your partner's favorite treat and write a message on it with a tube of icing, or draw a note on the steamed up mirror so it shows up when your partner takes a shower.

Although Valentine's Day is a day to celebrate love, it doesn't have to be a special day only for couples. If you're single, use this special day to shower yourself with love, because you're worth it! After all, the priest Valentine believed so strongly in the sanctity of love that he was willing to risk his life for it. Whether you're in a relationship or single, young or old, romantic or not, Valentine's Day is for you. Happy Valentine’s Day from the dental office of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

February is Heart Month

February 3rd, 2021

The American Academy of Periodontology stresses the importance of good oral health since gum disease may be linked to heart disease and stroke. Thus far, no cause-and-effect relationship has been established, but there are multiple theories to explain the link between heart disease and periodontal disease. One theory suggests that oral bacteria may affect heart health when it enters the blood and attaches to the fatty plaque in the heart's blood vessels. This can cause the formation of blood clots. Another theory suggests the possibility that inflammation could be a contributing link between periodontal disease and heart disease. Gum disease increases plaque buildup, and inflamed gums may also contribute to the development of swollen or inflamed coronary arteries.

What is coronary artery disease?

Coronary artery disease is caused in part by the buildup of fatty proteins on the walls of the coronary arteries. Blood clots cut off blood flow, preventing oxygen and nutrients from getting to the heart. Both blood clots and the buildup of fatty proteins (also called plaque) on the walls of the coronary arteries may lead to a heart attack. Moreover, periodontal disease nearly doubles the likelihood that someone will suffer from coronary artery disease. Periodontal disease can also worsen existing heart conditions, so many patients who suffer from heart disease need to take antibiotics before any dental procedures. This is especially true of patients who are at greatest risk for contracting infective endocarditis (inflammation of the inner layer of the heart). The fact that more than 2,400 people die from heart disease each day makes it a major public health issue. It is also the leading killer of both men and women in the United States today.

What is periodontal disease?

Periodontal disease is a chronic inflammatory disease that destroys the bone and gum tissues around the teeth, reducing or potentially eradicating the system that supports your teeth. It affects roughly 75 percent of Americans, and is the leading cause of adult tooth loss. People who suffer from periodontal disease may notice that their gums swell and/or bleed when they brush their teeth.

Although there is no definitive proof to support the theory that oral bacteria affects the heart, it is widely acknowledged better oral health contributes to overall better health. When people take good care of their teeth, get thorough exams, and a professional cleaning twice a year, the buildup of plaque on the teeth is lessened. A healthy, well-balanced diet will also contribute to better oral and heart health. There is a lot of truth to the saying "you are what you eat." If you have any questions about you periodontal disease and your overall health, give our Worcester office a call!

Avoid Brushing After Every Single Meal!

January 28th, 2021

Here is some surprising yet worthwhile advice you might be hearing for the first time: Brushing after a meal can be incredibly bad for your teeth if you do it after eating certain foods.

Enamel is an extremely hard mineral on the exterior of each of your teeth. It’s actually the hardest substance in the human body: It’s even stronger than your bones! Its only weakness is that acids in the food we eat can easily destroy enamel.

Healthy teeth thrive in an environment that has the proper pH balance. That ensures your mouth doesn’t start the process of demineralization. That’s what happens when alkaline turns into acid, which attacks and softens the enamel on the surface of your teeth. Pores and fissures form, and that’s when the harmful bacteria go to work.

Our mouth’s pH level fluctuates depending on what we eat throughout the day. Examples of the most common highly acidic foods include citrus fruits, soda, and sugary foods. Highly acidic foods tip the balance of pH in your mouth from a healthy alkaline to a dangerous acid.

Can brushing your teeth immediately after a meal lead to even more damage? The answer is yes!

Eating highly acidic foods causes your teeth to be more susceptible. If you brush your teeth when they have been weakened by acids, even more destruction can happen to your enamel. Your toothbrush’s bristles will actually wear away some of your enamel. So it’s healthier to wait at least an hour after eating or snacking to brush.

Good preventive measures to take instead of brushing after you eat include:

  • Rinsing or drinking water
  • Chewing sugarless gum
  • Consuming dairy or non-acidic foods to conclude your meal

These practices help produce saliva, which in turn restores a healthy pH level in your mouth and coats the teeth with minerals they need.

Once you’ve allowed time for your mouth to be restored to a healthy pH level, you may brush your teeth as you normally would. Keep in mind that acidic foods can weaken the enamel on your teeth and take the right measures to prevent spiking pH levels.

Most important, don’t forget to wait to brush at least one hour after you eat!

Still have questions? Call our Worcester office and schedule an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

What to Expect at Your First Endodontic Appointment

January 20th, 2021

Your first endodontic appointment at our Worcester office establishes an essential foundation between you, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, and our endodontic staff. It involves completing paperwork, discussing your condition, and may include treatment.

Paperwork

The first visit begins with obtaining important contact, insurance, and medical history information. There is paperwork to complete in the form of a medical history, and various consent forms. In addition, we ask that you bring a list of all the medications you take on a regular basis, whether prescriptions or over-the-counter, you are taking with you. Further, if you have a referral document or X-rays that your primary dentist gave to you, please bring them with you as well.

Meet with Assistant

Once all the required paperwork is completed, you’ll meet with an assistant who will ask you about your pain and dental issue that prompted a visit to us. The assistant will take a set of X-rays for the endodontist to review.

Meet with the Endodontist

After the x-rays are complete, your endodontist will review them with you, in addition to talking to you about your symptoms. The endodontist will test the affected tooth or teeth, along with adjacent teeth. This will often include mild tapping which patients tolerate well.

Once all of the testing is done, your endodontist will make a diagnosis, and discuss the treatment options with you. These may include a root canal and a crown to protect the treated tooth. As with any treatment, your endodontist will discuss the benefits and risks along with each option.

The goal of endodontics treatment is to:

  • Relieve your pain
  • Save your tooth
  • Protect surrounding teeth and gums from further damage

Endodontic Treatment

If you decide to receive the endodontic treatments, in many cases, the treatment is started that same day. However, prior to beginning the treatment, a local anesthesia is applied to numb your tooth, gums, and nerves to any painful sensations you might otherwise feel without local anesthesia.

While a root canal, which is a common endodontic procedure, has received a bad rap for being extremely painful, the reality is that with modern dental technology and medications, most patients report no significant discomfort during a root canal.

In order to determine the results of the treatment, further X-rays will be taken once the treatment is complete. You will receive post-endodontics treatment instructions and you learn what you might feel or see in your treated area over the next several days to a week. This may include tooth sensitivity and mild swelling in the gums and jaw.

Patients are typically able to drive after their procedure, and go back to work, or resume regular activities immediately following their endodontic treatment.

Root Canal FAQs

January 13th, 2021

Most people hear the word root canal and panic. With today’s state of the art equipment and improved local anesthetic devices, and some knowledge, a root canal does not have to cause panic. Root canals are a common dental procedure, done quite often at our Worcester office.

Why do I need a root canal?

There are several reasons why Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may suggest a root canal including:

  • An infection in your tooth that has reached the nerves
  • A deep cavity that cannot be filled because the pulp and nerves are also effected
  • Injury to the tooth
  • A deep cracked tooth
  • Broken tooth
  • Repeated fillings of the effective tooth

What is a root canal?

A root canal is a dental procedure that is used to prevent the loss of a tooth and relieve pain. Inside your teeth is pulp which consists of soft tissue blood, connective tissue, blood vessels, and nerves. When the pulp becomes infected, swollen or diseased a root canal is necessary to save your tooth. During a root canal, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will remove the infected pulp. The tooth’s root canals and pulp chamber of your tooth will be cleaned, so all the diseased pulp is removed and then your tooth will be sealed.

What to Expect During a Root Canal

Your root canal will start out just like any other dental procedure. We will go over any questions you may have, and then numb the area surrounding the tooth. After the area is numb the root canal will begin.

The amount of time it takes to do your root canal varies depending on number of roots that need to be cleaned. Most teeth have one root canal, while others have between two and four. For a single canal, the procedure usually lasts less than an hour. The more canals your tooth has the longer amount of time it will take and in some cases, you will require more than one visit.

How much pain will I have after a root canal?

Once the local anesthesia wears off, your pain can be controlled by over the counter pain medications such as Ibuprofen, Naproxen, or Acetaminophen. In some cases, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may prescribe a prescription dose of pain medication. Within two days you should be feeling much better and able to return to your regular lifestyle.

Root Canal Procedure

January 6th, 2021

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 Worcester 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!

Understanding Dental Insurance Terminology

December 23rd, 2020

If you have a hard time understanding your dental insurance plan, particularly the treatments and services it covers, you’re not alone. That’s why Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have put together a cheat sheet to help you through them.

It’s common for patients to get lost in the morass of the terms and phrases that surface when you’re dealing with a dental insurance plan. Knowing the commonly used terms can help speed up the process and enable you to get the most out of your coverage.

Common Terms

Annual Maximum: The most your policy will pay per year for care at Central New England Endodontics and Implantology. It is often divided into cost per individual or per family.

Co-payment: Typically, a small amount the patient has to pay at the time of service before receiving care, and before the insurance pays for any portion of it.

Covered Services: A list of all the treatments, services, and procedures the insurance policy will cover fully under your contract.

Deductible: An amount you must pay out of pocket each year before the insurance company will contribute for any treatments or procedures. The amount can vary according to your plan.

Diagnostic Services: A category of treatments or procedures that most insurance plans will cover before the deductible, which may mean services that occur during preventive appointments with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, including X-rays or general screenings.

Exclusions: Dental services not covered under a dental benefit program.

In-Network: An insurance company will usually cover a larger portion of the cost of the care if you see an in-network provider for treatment.

Out-of-Network: If you visit someone who is not a part of your provider’s network, the insurance company may pay for a portion of the care, but you will be responsible for a significantly larger share out of your pocket.

Lifetime Maximum: The most that an insurance plan will pay toward care for an individual or family over the entire life of the patient(s).

Limitations: A list of all the procedures the insurance policy does not cover. Coverage may limit the timing or frequency of a specific treatment or procedure, or exclude some treatments altogether.

Member/Insured/Covered Person/Beneficiary/Enrollee:  A person who is eligible to receive benefits under an insurance plan.

Premium: The regular fee charged by third-party insurers and used to fund the dental plan.

Provider: Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants or other oral-health specialist who provides treatment.

Waiting Period: A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments.

It’s essential to understand the various insurance options available to you. Knowing what your insurance covers can save you major costs in the future.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our dental staff hope this list of terms will help you understand your dental insurance plan better. Be sure to review your plan and ask any questions you may have about your policy the next time you visit our Worcester office.

Do You Have an Injured Molar?

December 16th, 2020

Fortunately, most of our dental work is fairly straightforward. You have an exam and a cleaning, or a cavity gets filled, or a crown might be used to protect a fragile tooth. But sometimes, a more complex dental problem affects one of your molars. In this case, it could be the right time to call in an endodontist like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants—a dental professional skilled in saving at-risk teeth.

Endodontists have two or more years of specialized training in the diagnosis and treatment of the inner tooth and the tissue surrounding it. An endodontist has the knowledge and experience to treat complex molar issues, and modern endodontics provides a number of options to protect the health and appearance of your natural teeth even when they have suffered an injury.

The inside of each tooth contains the vital (living) pulp, which includes blood vessels, nerves, and connective tissue. Once the pulp has suffered injury or infection, a root canal is almost always necessary to save the tooth. The bone and connective tissue surrounding the tooth can also suffer trauma or infection.

In the case of serious molar trauma or infection that goes beyond root canal treatment, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants might be able to save part or even most of your tooth with endodontic surgery. Two of the surgical procedures which can save such a molar are hemisection and bicuspidization.

When might an endodontist consider hemisection or bicuspidization?

  • A root canal is a common endodontic procedure in which the damaged pulp is removed, and the tooth is cleaned, shaped, and sealed. Sometimes, though, an infection persists. In this case, part of the tooth might be removed to save the remaining natural tooth.
  • When a traumatic vertical fracture occurs, a tooth is split from top to bottom. Depending on the location of the fracture, part of the tooth may be saved with surgical intervention.
  • Serious decay or injury can damage a limited area of the tooth, while leaving another part of the tooth intact. Surgery can save the healthy part of the tooth.
  • When periodontitis (serious gum disease) attacks the bone around the roots, severe bone loss can take place between the roots or around a single root. Surgery might be necessary to repair the damage.

In each of these procedures, the goal of Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is to preserve as much of your molar as possible. How is this done?

  • Hemisection

In a hemisection, the injured tooth is split into two parts, and the part of the crown and the root that cannot be restored are removed. The remaining healthy crown area and root will be cleaned and treated, and a temporary crown will be put in place to protect the tooth. A permanent crown will then be designed to custom-fit the tooth.

  • Bicuspidization

In this procedure, the damaged tooth is separated into two parts, each with a crown section and a root. The divided portions are cleaned and shaped, and temporary crowns will protect each section. A custom crown or crowns will be needed to cover and protect each segment of the tooth.

Why should you consider a hemisection or a bicuspidization? These procedures are alternatives to tooth extraction, and allow Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants to preserve as much of your natural tooth as possible. While an implant or a bridge is certainly an option, we always prefer saving your natural teeth. If your dental problem involves the inner tooth or the tissue around it, ask us about your treatment options when you visit our Worcester office. It’s not only worth your while—it’s worth your smile!

How the Specialty Practices of an Endodontist Can Help

December 9th, 2020

What Is an endodontist?

If you have been to the dentist lately, you may have been directed to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for additional care. You may be asking, “What exactly is an endodontist?” The answer is pretty simple: An endodontist is a dental specialist who has completed two or more extra years of specialty training in endodontics (which is the field of dentistry that focuses on root canals), as well as the four basic years of dental school. Put simply, an endodontist is a root canal specialist. If you have been referred to an endodontist, you are probably in need of special root canal treatment.

What exactly does an endodontist do?

An endodontist is able to perform all kinds of root canal therapy. Because of their extensive training, endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, can do routine root canals, complex root canals, retreatments, endodontic surgery, and more. Endodontists concentrate on these types of treatments, and therefore possess extensive experience performing root canals and other root procedures.

What are the benefits of seeing an endodontist?

While many regular dentists are capable of performing root canals, there are added benefits to seeing an endodontist when you have root problems with your teeth. The endodontist can give you more precise, specialized care, which typically means less pain and stronger teeth in the future. Some of the many benefits of seeing an endodontist include:

  • Advanced anesthesia: If you are nervous about experiencing pain during your root canal, most endodontists offer more advanced forms of anesthesia than regular dentists. Whether it is general or local anesthesia, an endodontist can ensure your comfort during the procedure.
  • Cosmetics: Endodontists can generally help you avoid an extraction and save your natural tooth. Fake teeth can be painful and costly, and sometimes less attractive. If you are interested in saving your natural teeth, an endodontist can help.
  • Comfort after the procedure: Because of the advanced methods used by endodontists, the recovery time for your root canal will most likely be shorter and less painful than if you had received the same treatment from a general dentistry practice.
  • Better long-term results: Seeing an endodontist can help you prevent future problems. Because of the precise care that an endodontist puts into root canal treatment, you are less likely to experience the same problems with that tooth in the future.

In terms of time, money, and comfort, there are many benefits to seeing an endodontist. If you are in need of a root canal, consider calling our Worcester office to schedule an appointment. We're looking forward to answering all of your questions and helping you achieve your optimal oral health here at Central New England Endodontics and Implantology!

Electric Toothbrushes vs. Regular Toothbrushes

December 2nd, 2020

Convertible or sedan? Downtown or suburbs? Electric or manual toothbrush? As life decisions go, it’s certainly not choosing your next car, or deciding where you want to live. But, even when you are selecting a toothbrush, it helps to make a list of the pros and cons of the contenders before you make that final selection.

  • Efficiency

The most important factor in choosing a toothbrush is finding out which model works best to eliminate bacteria and plaque. And studies have shown that, used properly, both electric and manual toothbrushes do a great job of removing plaque. Some electric models can reach the backs of teeth and the gumline more easily, some manual head designs work better for your individual mouth and teeth, so your particular needs should dictate which style of toothbrush you use. Talk to us about the best methods to brush with your preferred toothbrush, and we’ll let you know if one type of toothbrush or the other might work better for you.

  • Health Considerations

Brushing too energetically can actually harm teeth and gums, causing sensitivity and damage to the enamel and gum tissue. An electric toothbrush should provide a continuous brushing motion without needing any pressure from the brusher. This might be the model for you if you have a too-vigorous approach to brushing, or sensitive teeth and gums.

An electric toothbrush can also be more efficient for older and younger brushers, those with limited mobility, and those with health conditions or injuries that make brushing with a regular toothbrush more difficult.

  • Cost

An electric toothbrush is not a one-time investment. You should change the removable head as often as you change your manual toothbrush (every three to four months, please). But this cost is offset if an electric toothbrush is more efficient in removing your plaque, easier to use, or even if you just prefer it to manual brushing. If you find that you brush better and more often with an electric toothbrush, the added expense is well worth it.

Whichever brush you decide on, the most important part of the brush is the person holding it! A regular appointment with your toothbrush for two minutes of thorough brushing in the morning and two in the evening, daily flossing, and regular visits to our office for checkups and cleanings will keep your teeth healthy and strong no matter which toothbrush you choose.

Questions about your toothbrush choices? Don’t hesitate to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office.

Thanksgiving Trivia

November 25th, 2020

At Central New England Endodontics and Implantology we love learning trivia and interesting facts about Thanksgiving! This year, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants wanted to share some trivia that might help you feel a bit smarter at the holiday dinner table and help create some great conversation with friends and family.

The Turkey

There is no historical evidence that turkey was eaten at the first Thanksgiving dinner. It was a three-day party shared by the Wamponoag Indians and the pilgrims in 1621. Historians say they likely ate venison and seafood.

According to National Geographic, the dinner at the Plymouth colony was in October and included about 50 English colonists and 90 American Indian men. The first Thanksgiving dinner could have included corn, geese, and pumpkin.

Today, turkey is the meat of choice. According to the National Turkey Association, about 690 million pounds of turkey are consumed during Thanksgiving, or about 46 million turkeys.

The Side Dishes

The green bean casserole became popular about 50 years ago. Created by the Campbell Soup Company, it remains a popular side dish. According to Campbell’s, it was developed when the company was creating an annual holiday cookbook. The company now sells about $20 million worth of cream of mushroom soup each year, which is a major part of the recipe.

While there were likely plenty of cranberries for the pilgrims and Indians to enjoy, sugar was a luxury. What we know today as cranberry sauce was not around in those early Thanksgiving days. About 750 million pounds of cranberries are produced each year in the US, with about 30 percent consumed on Thanksgiving.

The Parade

Since Thanksgiving did not become a national holiday until Lincoln declared it in 1863, the annual parades were not yearly events until much later. The biggest parade that continues to draw crowds is the Macy's Thanksgiving Day Parade. Beginning in 1924 with about 400 employees, they marched from Convent Avenue to 145th Street in New York City. Famous for the huge hot-air balloons today, it was actually live animals borrowed from the Central Park Zoo that were the stars of the show then.

However you choose to spend your Thanksgiving holiday, we wish you a safe, happy and healthy holiday with those you love.

Just What Is Plaque?

November 18th, 2020

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

  • It’s an unappealing film that sticks to your teeth
  • It causes cavities
  • It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

  • It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

  • Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

  • A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

  • What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

  • The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

  • The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria that don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

  • Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

  • Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

  • Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gum line, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

  • Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gum line.
  • Floss to remove plaque from between the teeth and near the gum line.
  • See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to your dentist about the best way to keep plaque at bay. And if deep cavities or damage to the roots or the bone surrounding them have put you at risk for tooth loss, call Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office. Endodontists are specialists in saving teeth when the health of a tooth’s pulp or roots is compromised.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

Bite Pain? It Might Be Time to See Your Endodontist

November 11th, 2020

Whether it’s a constant ache when you chew food or a sharp, jolting pain every time you bite down, if bite pain has you considering a permanent liquid diet, a trip to see Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is definitely in order!

What causes bite pain? You might feel an ache because of a cavity, a loose filling, bruxism (grinding the teeth) or a malocclusion (bad bite). Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will be able to help you get to the root of this type of tooth pain and provide treatment that will leave you smiling again.

But sometimes, pain is caused by damage or infection located in the inner chamber of the tooth. In this case, pain caused by biting or pressure on the tooth might indicate:

  • Pulp Infection

The pulp of a tooth contains blood vessels, nerves, and connective tissue. Because it is composed of living tissue, pulp can be subject to injury, inflammation, and infection. If bacterial infection sets in, the pulp will need to be removed and the site cleaned, shaped, and filled. This is something that should not be postponed, because without treatment infection can spread to the surrounding bone and tissue.

  • An Abscess

An abscess forms when pus collects into a pocket at the site of an infection. When tooth pulp suffers bacterial infection, the infection spreads through the interior of the tooth. An abscess can form at the tip of the root, or appear in the surrounding tissue. If the abscess finds a path to drain, you might feel some temporary relief, but treatment is essential. Unless the infected pulp is removed and the inner tooth cleaned, shaped, and filled, pain can not only recur, but the infection can spread to other parts of the body—sometimes with serious results. Endodontists are trained to treat infection in the tissues surrounding a compromised tooth.

  • A Cracked or Injured Tooth

When a tooth suffers a significant crack or fracture, the pulp can become infected or damaged. An endodontist is trained to discover and diagnose cracks and fractures that might not appear on an X-ray. If the crack is treatable, there are a variety of procedures, including oral surgery, which can preserve a tooth even if some of the root area needs to be removed.

Of course, bite pain is not the only symptom of a damaged or infected inner tooth. Any redness, swelling, fever, or prolonged sensitivity to heat and cold are signs that your tooth should be examined as soon as possible.  If you are suffering from discomfort because the pulp of the tooth has been injured, endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants are experts in treating your pain.

Whether the answer is a root canal or more complex oral surgery, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team have the training and experience to relieve pain, protect you from further infection, and save injured teeth.

If you are avoiding biting or chewing because of tooth pain, call our Worcester endodontic office. We can let you know how we can help give you back your happy—and healthy—smile.

Has Your Endodontist Recommended an Apicoectomy?

November 4th, 2020

If Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our team recommend an “apicoectomy” to save your tooth, you probably have a few questions about the procedure. Here are some of the basics you might discuss when you visit our Worcester office:

  • What is an apicoectomy?

The tip of a root is also called its “apex.” An apicoectomy means the removal (“ectomy”) of the apex (“apico”) of the tooth. This is a surgical procedure performed by a specialist in the treatment of the inner tooth.

  • Who performs apicoectomies?

Your endodontist is a specialist in tooth-saving surgical procedures. Endodontists like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants diagnose and treat problems of the inner tooth and its surrounding tissue. They have two or more additional years of study in the field of endodontics, and have the experience, knowledge, skill, and specialized equipment needed to perform delicate endodontic surgeries.

  • Why choose this procedure?

Usually, a root canal is all that you need to treat any damage or infection in your inner tooth. But when inflammation or infection returns at the tip of the root, or in the bone surrounding the tip, or a tooth can’t be treated with a conventional root canal, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants may recommend an apicoectomy both to save your natural tooth and to prevent further infection or damage to the surrounding bone and teeth.

  • How does the procedure work?

Often local anesthesia is all that is needed. (But if you have concerns, talk to us about your anesthesia and sedation options. We will have suggestions for you.) After the area is numb, an incision is made in the gum tissue to allow access to the root and any affected bone tissue.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will carefully remove a few millimeters from the tip of the tooth as well as any infected tissue from the area. Because the tip of the tooth is small, and cracks or extra canals in a root are often difficult to discover even with an X-ray, we might make use of microscopic technology to be sure there are no additional canals or large cracks or breaks in the root. Using specialized instruments, the end of the tooth will be cleaned and sealed.

Stitches or sutures will be used to close the incision, and will either dissolve on their own or might need to be removed on a follow-up visit. We will let you know just how to take care of the site after surgery.

In general, any pain or sensitivity after the procedure can be treated with over-the-counter anti-inflammatory pain relief such as ibuprofen. Follow post-op instructions carefully to reduce any swelling, and be sure to follow any dietary suggestions and restrictions. If pain or swelling are a problem, or if you have any other concerns, call our Worcester office.

Apicoectomies are a common procedure used by endodontists to save a compromised tooth.  If you have recurring or new pain or infection after a root canal, if you have an undetected extra canal, if there is a crown and post in place that would make it impractical to reach the root or pulp chamber area with conventional treatment, and if you want to preserve your natural tooth, an apicoectomy is an option well worth discussing.

Five Common Reasons for Emergency Care Visits

October 28th, 2020

A dental emergency can strike anywhere, anytime, and without warning. Perhaps you’re playing a game of touch football on Thanksgiving and your brother-in-law decides to up the ante and tackles you, accidentally knocking out your two front teeth. Or maybe you’re on vacation somewhere in the tropics and decide to go deep-sea fishing, but when you’re climbing onto the boat you slip on the dock, fall, and chip three of your teeth. From misplaced fly balls to bagel seeds causing a painful bout of inflammation, there are all kinds of dental emergencies.

Here are the five most common reasons for emergency care visits.

  1. Somehow you've managed to knock out a tooth. Whether it's the result of a sports injury or because of decay, when you lose a tooth, you need emergency dental care. If the tooth is salvageable, then it can be reattached to the socket, but this needs to be done within a one- or two-hour window.
  2. A chipped tooth is the most common dental emergency. Small chips can be caused by food (chicken bones and nuts have sent many people to the dentist); however, it's usually some sort of accident or injury that more often causes a chip. While you might be embarrassed to walk around with a gaping chip in your front tooth, it is easily fixed with a bond, crown, or veneer.
  3. A broken tooth is more severe than a chipped tooth. When a tooth breaks, it might be due to a small or hidden chip. However, chances are the pain and discomfort will be more severe.
  4. It might seem comical, but getting a piece of food lodged in the wrong place can result in a dental emergency. If something gets stuck deep in a crevice, it can cause pain and inflammation.
  5. The loss of a filling happens more often than you think. When you lose a filling, you need to receive emergency care immediately. If you don’t, you risk further damage to your tooth.

When you injure your teeth or mouth, you need to seek emergency care as soon as possible. In the event of a suspected emergency, don't wait. Contact Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants immediately.

Good Dental Hygiene Impacts Overall General Health

October 21st, 2020

There are many ways in which your oral health has an impact on your overall general health. There are naturally occurring bacteria in the mouth. Some of those bacteria, including strep and staph, are harmful, while other bacteria are essential for the balance of intestinal flora. The healthier your mouth is, the less likely it is the harmful bacteria will travel to other parts of your body to infect it and make you sick. There is much more to good dental hygiene than brushing and flossing.

Historical Methods of Maintaining Oral Health

Ancient civilizations relied on natural remedies for maintaining oral health. Around 250 AD, the Kemetic Egyptians used myrrh and other herbs as antiseptics for treating infected gums. Two centuries later, the Nubians, who lived in the Nile River valley, drank beer to ease the pain of infected teeth. That probably sounds crazy, but their beer was effective because they used grains that were contaminated with the same bacteria that produce the antibiotic tetracycline.

Today's Biggest Dental Hygiene Challenge

In the past, tooth decay was more of an issue because there was no routine dental care, and problems that are routinely treated today went untreated. Thanks to fluoridated water, and toothpastes containing fluoride, tooth decay is far less problematic than it was a century or more ago. Gum disease has replaced tooth decay as the most serious dental problem facing people today. According to the American Dental Association, a staggering 80 percent of Americans over age 65 suffer from some form of periodontal disease.

Ironically, if that infection attacked any other part of your body, especially in a place where it was clearly visible, you would head to your doctor for treatment immediately. People tend to ignore gum tenderness and bleeding. When the tenderness and bleeding aren't treated, the inflammation can turn into periodontitis. The longer you allow the inflammation to go untreated, the greater the likelihood that it will affect other body parts. Make sure to visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at Central New England Endodontics and Implantology regularly to be proactive about dental health!

Researchers are now discovering that untreated inflammation in the mouth acts as a driving force for multiple chronic illnesses, including clogged arteries, heart attacks, arthritis, and even cancer. That inflammation is one of many hypotheses that may explain how chronic infections can trigger systemic diseases, and even intensify existing ones. Bacterial overgrowth in the inflamed gum tissue can enter the bloodstream through the food you eat, and from daily brushing.

Caring for your mouth at home is just as important as visiting our office for exams!

Oral Health during Pregnancy

October 14th, 2020

Pregnancy can be one of the most exciting times in a woman’s life, as you eagerly wait for the birth of the new addition. Needless to say, pregnancy comes with a lot of responsibilities. Everything you do to your own body can affect your baby’s health, so you eat right and try to avoid anything that could harm your baby.

You may not realize it, but even your oral health affects your baby. You have a lot to worry about during this time in your life, but it’s important not to let your oral health slide. Maintaining good routines before and during pregnancy can improve the health of your baby.

Gum Disease and Pregnancy

Gum disease includes gingivitis and the more severe condition called periodontitis. Pregnancy gingivitis is a condition that results from bacteria in your teeth. Symptoms include gum inflammation and bad breath. If it progresses to periodontitis, your baby is at higher risk for preterm delivery and low-birth weight. You can also develop pregnancy tumors, or pyogenic granulomas, which can interfere with speaking and eating. Throughout pregnancy, continue to visit Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at your regularly scheduled appointments to look for signs of gum disease.

Pregnancy and the Role of Our Office

Make an appointment with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants at our Worcester office when you first learn that you’re pregnant, especially if you have unresolved oral health issues. If possible, try not to schedule necessary treatment during the first trimester or second half of the third trimester.

Oral Health Care Habits to Follow

Maintain a normal good oral health care regimen, which includes brushing your teeth at least twice daily with a fluoride toothpaste and soft toothbrush, and flossing daily. If your regular regimen is not up to par, now is a good time to develop good habits. You can use an unflavored toothpaste if you have morning sickness and regular toothpaste makes you feel nauseous. Also, rinse your mouth with water or mouthwash if you experience morning sickness to prevent acid damage to your teeth.

Should Adults Continue Fluoride Treatments?

September 30th, 2020

Many adults wonder if they should continue to receive fluoride treatments. Our team at Central New England Endodontics and Implantology wants to set the record straight about the usefulness of fluoride treatment for adults.

There are several reasons fluoride treatments could be beneficial to you as a grownup. If you have a high risk for cavities, topical fluoride applications can cut down on that risk.

If you’re experiencing gum recession that’s softening your enamel, fluoride treatments can slow down that process. Fluoride treatments may also protect expensive restorative work on crowns or bridges that may be adversely affected by plaque.

In addition, fluoride can also protect teeth in adults who have orthodontic braces or who sometimes neglect to keep up with daily oral hygiene regimens such as flossing and using mouthwash.

Do you have sensitive teeth? Consuming foods that are highly acidic or using teeth-whitening products can lead to irritated gums. Fluoride treatments remineralize your enamel and reduce sensitivity.

If you’ve undergone radiation treatment for cancer, fluoride can help restore any dry-mouth damage that may have developed during that time. Saliva acts as a buffer against the foods we eat, and without enough of it you may be more likely to get cavities.

In general, fluoride treatments are not always necessary for adults, but they can be beneficial to your overall oral hygiene depending on your situation. If you fall into one of the general areas listed above, ask about a fluoride treatment during your next visit at our Worcester office.

We can also go over your options to treat other issues you may experience in terms of your oral health. Until then, make sure to take care of your teeth properly and use toothpaste or mouthwash that contains fluoride on a regular basis.

How to Choose the Best Mouthwash

September 23rd, 2020

As we all know, or should by now, the key to maintaining great oral health is keeping up with a daily plan of flossing, brushing, and using mouthwash. These three practices in combination will help you avoid tooth decay and keep bacterial infections at bay.

At Central New England Endodontics and Implantology, we’ve noticed that it’s usually not the toothbrush or floss that people have trouble picking, but the mouthwash.

Depending on the ingredients, different mouthwashes will have different effects on your oral health. Here are some ideas to take under consideration when you’re trying to decide which type of mouthwash will best fit your needs.

  • If gum health is your concern, antiseptic mouthwashes are designed to reduce bacteria near the gum line.
  • If you drink a lot of bottled water, you may want to consider a fluoride rinse to make sure your teeth develop the level of strength they need.
  • Generally, any mouthwash will combat bad breath, but some are especially designed to do so.
  • Opt for products that are ADA approved, to ensure you aren’t exposing your teeth to harmful chemicals.
  • If you experience an uncomfortable, burning sensation when you use a wash, stop it and try another!

Still have questions about mouthwash? Feel free to ask Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants during your next visit to our Worcester office! We’re always happy to answer your questions. Happy rinsing!

If You Have Dental Anxiety, Let’s Talk About Your Sedation Options

September 16th, 2020

Sometimes people feel a tiny bit nervous when they sit in the dental chair. And sometimes it’s more than a tiny bit. If your anxiety over dental procedures is leading you to postpone the root canal that can save your tooth, if worrying about an apicoectomy outweighs treating a recurring infection, if dreading endodontic surgery means you would rather live with tooth loss than give us a call—give our Worcester office a call! Sedation dentistry might be just the procedure you need to make dental anxiety a thing of the past.

Depending on your preferences, there are several levels of sedation Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can provide to make your visit more comfortable.

  • Minimal Sedation—this type of sedation leaves you calm and conscious, and you respond normally to verbal directions.
  • Moderate Sedation—sometimes called “conscious sedation,” this option will leave you awake, relaxed and able to follow directions, but you will probably have little memory of the procedure afterward.
  • Deep Sedation—a deeper level of sedation where you cannot be roused easily or respond to instructions. It is unlikely you will remember much or any of the dental treatment.

Our office is trained to administer and monitor all these forms of sedation. Because sedation in all its varieties is a regular part of our practice, we have the medical knowledge and skill to provide you with a safe and comfortable endodontic experience.

And we will prepare you with all the information you need to decide on any endodontic treatment, including sedation. We will describe the procedure in detail, and discuss any possible risks. If you have any health conditions or take any medications that might interfere with sedation, we can discuss your options with you and your doctor to make sure you are a good candidate. We will explain any preparations you should take, and let you know if there is a window of recovery time needed in our office while the sedation wears off.

Don’t let yourself suffer dental pain or discomfort because you suffer from dental anxiety! Please call us to discuss your sedation options. Whether you choose oral, inhaled, or IV sedation, we are trained to administer your treatment gently and safely. Above all, we want to help you keep your smile the heathiest it can be, and that only happens with proper dental care. Let us work with you to make that care as comfortable and stress-free as possible.

Does Your Child Need Endodontic Treatment?

September 9th, 2020

Baby teeth come with a built-in expiration date. That charming first smile is meant to make way for a healthy, beautiful adult smile. Unfortunately, before they are ready to make way for permanent teeth, primary teeth can be affected by decay, trauma, or infection—problems which can lead to damage to the pulp within the tooth. If your dentist tells you that your child’s tooth needs specialized endodontic treatment, is treatment really that much better for your child than losing a baby tooth prematurely?

Quite often, the answer is yes!

Baby teeth do much more than serve as temporary stand-ins for adult teeth. They are essential for:

  • Biting and chewing—a full set of baby teeth helps your child develop proper chewing, which leads to healthy digestion. And chewing also helps build face and jaw muscles.
  • Speech development—primary teeth help guide speech production and pronunciation.
  • Spacing—a baby tooth serves as a place holder for the adult tooth waiting to arrive. If a primary tooth is lost too early, the remaining baby teeth may drift from their proper location. This, in turn, can cause overcrowding or misalignment of the permanent teeth when they do erupt.

Baby teeth, like adult teeth, contain living pulp tissue. The pulp chamber inside the crown (the visible part of the tooth) and the root canals (inside each root) hold nerves, blood vessels, and connective tissue. When the pulp is damaged by trauma or infected, a baby tooth can still be saved with endodontic treatment. Endodontic treatment in baby teeth can take two forms.

  • “Vital” pulp is pulp that can be saved. Vital pulp therapy uses procedures to deal with damaged pulp inside the crown, or visible part, of the tooth. Pulp therapy can be used on teeth when only the top of the pulp has been affected by decay, limited exposure, infection, or trauma, but the root pulp remains healthy. Specific treatment will depend on the nature of the pulp injury, and a crown will usually be placed over the tooth after treatment to protect it.
  • With non-vital pulp, your dentist will probably recommend a traditional root canal procedure. All of the pulp tissue will be removed from inside the crown and the roots, and the pulp chamber and root canals will then be cleaned, disinfected, shaped, and filled. Finally, because the treated tooth will be more fragile, a crown will be used to protect the tooth from further damage.

There can be good reasons for extracting a seriously damaged baby tooth, and there are situations where preserving the tooth is the best and healthiest option for your child. Discuss your options with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants when you visit our Worcester office for the safest, most effective way to treat your child’s compromised tooth.

When Should I See an Endodontist?

August 26th, 2020

Your teeth generally give you no reason to complain. In fact, brushing and flossing regularly for tooth and gum health, getting good check-ups, and appreciating your beautiful smile in your latest selfie are all very positive experiences. But sometimes, a tooth demands attention in a less than positive way.

When exposure to hot and cold foods causes discomfort, or your gums are swollen and tender around a tooth, or when you can’t bite down without pain, it might mean that the pulp or roots of your tooth have been injured or infected. If your regular dentist suspects there is a problem inside your tooth, he or she might recommend that you see an endodontist, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants.

“Endodontic” means “inside the tooth,” and refers to the pulp and roots within each tooth that hold tissue, nerves, and blood vessels. While all dentists receive some endodontic training in dental school, to specialize in this field, endodontists receive two or three years of additional advanced training. Here they concentrate on the diagnosis and treatment of diseases and injuries that affect the inner tooth and its supporting tissue.

Damage to the tooth’s pulp can be the result of an injury, such as a blow to the mouth. A chip, a crack, or a deep cavity can leave an opening for infection. Whatever the cause of injury or inflammation, once the pulp and roots have been compromised, treatment needs to take place to prevent further infection, pain, and even tooth loss. Endodontists work to save injured teeth with a variety of procedures, including root canals, treatment of injuries caused by trauma, and endodontic surgeries.

If you have a compromised tooth, or if you have oral or facial pain that is difficult to find an explanation for, talk to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants about specialized endodontic treatment at our Worcester office. Saving a tooth is, after all, one of the most important ways to preserve our smiles. And that’s nothing but positive!

Hypersensitive Teeth

August 19th, 2020

It is common to experience dentine hypersensitivity, with symptoms ranging from moderate to severe. Why does it happen and how do you know if this sensitivity is something to be concerned about? The first step is to determine the cause.

The most common cause of the sensitivity is exposure of the dentin. Dentin is the layer immediately surrounding the nerve of the tooth. It is alive and usually covered by the gum tissue. When gum recession is present hypersensitivity is common. Other contributors to temporary tooth hypersensitivity include teeth whitening and dental procedures such as fillings, periodontal treatment, and braces placement or adjustment. These are temporary and should be of no concern.

Permanent hypersensitivity, however, may require treatment. To understand the cause of sustained hypersensitivity, let us explain the structure of dentin and why it serves as a ‘hot spot’.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When dentin tubes are exposed, there is a direct connection between the mouth and dental pulp, which houses the nerve and blood supply of the tooth. External stimuli, such as mechanical pressure (tooth grinding or clenching - bruising the ligaments holding the teeth in place), temperature changes, as well as chemical stimuli (sweet–sour) are transmitted to the pain-sensitive dental pulp and activate nerve endings. A short and sharp pain is the result. These external stimuli cause fluid movement in the open tube that is transmitted as pain sensations. Something needs to be placed into the dentin tube to plug it and stop this fluid movement.

The first step in doing something about dental hypersensitivity is to determine the cause; our professional team at Central New England Endodontics and Implantology can help you with this. Whether the sensitivity is due to exposed dentin or an underlying cause such as abscess or decay, corrective measures are needed. Contact us sooner rather than later so Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants can reduce the sensitivity, and provide you with some relief!

Can all teeth be treated endodontically?

August 12th, 2020

Advancements in dental treatment, and in dental training, have made it possible for specialized dentists, called endodontists, to treat inflammation and infection deep within the core of a tooth. Endodontists, like Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants, receive two additional years of specialized training beyond dental school, where they learn the sophisticated techniques needed to treat problems related to the inside of the tooth. Historically, the only solution for problems within the tooth was to extract the tooth. Today, people who eat a healthier diet have better oral health. They also take better care of their teeth and have regular dental checkups and twice yearly cleanings, all of which contribute to better oral health. Sometimes, however, unforeseen problems arise, and a tooth gets injured, or somehow becomes infected or inflamed. This leads to the need for endodontic treatment.

Understanding Tooth Anatomy

Understanding basic tooth anatomy will put things in proper perspective. The tooth is composed of several parts. The outer layer consists of the enamel and the hard layer called dentin. These layers protect the inside of the tooth, which has a canal that extends from the very top (crown) of the tooth all the way down to the roots. Surrounding that canal is soft tissue known as the pulp. The pulp contains the "guts" of the tooth — or the living parts. Those living parts include blood vessels, connective tissues, and nerves.

Importance of Tooth Pulp

The pulp is most important when your teeth are developing. It connects the area from the top of the tooth to the roots, and then to the supporting tissues around the roots (or gums). Once teeth are fully mature, they can still survive without the pulp because as long as the surrounding tissue is healthy, it continues to nourish the tooth.

Can all teeth be treated endodontically?

Most infections benefit from endodontic treatment. The only reason that a tooth can't be treated endodontically is when the tooth itself isn't salvageable. That might include the inability to access the root canal, a severe fracture of the tooth root, inadequate bone support, or a damaged tooth that can't be restored. Endodontic surgery might be a viable alternative treatment.

Although endodontic treatment is sometimes inevitable and unavoidable, good oral hygiene keeps the teeth, mouth and entire oral cavity in good health. If you experience pain, prolonged sensitivity, swelling, gum sensitivity, swollen lymph nodes, or fever, give our Worcester office a call or consult your general dentist. You may then be referred to Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants for specialized treatment at Central New England Endodontics and Implantology.

What are the alternatives to endodontic treatment?

August 5th, 2020

You have been recommended to Central New England Endodontics and Implantology for an endodontic treatment — commonly known as a root canal — and now you may be wondering if there are any alternatives to this procedure? Before discussing other options, it’s important to understand exactly what this common procedure accomplishes.

What is the purpose of an endodontic treatment?

Endodontic treatment is done when a tooth’s pulp — the inside of the tooth that houses the nerves and blood vessels — becomes infected or inflamed. In order to eliminate any pain and save the tooth, the damaged pulp is removed, the area is cleaned, and the tooth is sealed.

What are my other options?

According the American Association of Endodontics (AAE), the alternative to endodontic treatment is usually the complete removal the damaged tooth. If you have a tooth extracted, the AAE recommends replacing it with a dental implant, a bridge, or a removable partial denture. Failure to replace the extracted tooth could result in problems with chewing and biting, shifts in your remaining teeth, and self-consciousness.

Here are more details on the most common types of tooth replacements:

  • Dental implants – According to the American Dental Association, dental implants are effective and common options for replacing teeth. The implant is made from materials that are compatible with the human mouth and the device includes an artificial tooth. The placement of the implant and artificial tooth can be completed in one day, although some patients may need to wait up to several months before an artificial tooth can be added to the implant.
  • Bridges – Bridges do exactly what their name suggests: they bridge the space left by one or two missing teeth. Your dentist will bond the bridge to your remaining, natural teeth in order to keep it in place. Bridges can only be removed or put in place by a dentist.
  • Removable partial denture – Much like bridges, removable partial dentures are made up of replacement teeth that attach to your natural teeth. These, however, may be removed and replaced by the patient on a daily basis.

The AAE notes that dental implants have the same success rates as endodontic treatments. Even so, nothing can fully replace the look, capabilities, or the feel of your own teeth, which is why endodontic treatment (preserving the natural tooth) with Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants is an important decision!

Don't hesitate to contact our Worcester office if you have further questions!

How to Handle an Unexpected Dental Emergency

July 29th, 2020

Regardless of the type of dental emergency you experience, it is important that you visit Central New England Endodontics and Implantology for emergency dental care as soon as possible. A chipped or cracked tooth requires professional attention, as bacteria may gather in these areas, potentially causing infection that could require a root canal. Remember, you may be capable of managing pain, bleeding, and swelling at home, but by visiting our office for immediate treatment, you can fight infections and minimize lasting damage to your mouth, teeth, and gums under the expert care of our emergency dentist.

24/7 Emergency Dental Care

Central New England Endodontics and Implantology is proud to offer emergency dental care around the clock, seven days a week. Dental emergencies do not wait for regular business hours, and if you experience a serious dental emergency, you need immediate treatment. Whether you have a broken tooth or if you have bitten through your tongue, do not hesitate to visit us day or night. Until you arrive at our office, however, there are some helpful steps you can take if you encounter a serious dental dilemma.

Managing Your Dental Emergency

If a toothache is causing problems, you can probably keep the discomfort under control until our emergency doctor can treat you. Start by checking the gums that surround the affected tooth for inflammation, bleeding, or foreign objects. There may be food lodged in the gum that could be removed by flossing. You can control pain by placing a cold compress against your mouth, or by using an over-the-counter oral numbing agent.

More serious situations may be extremely time sensitive, and require immediate emergency attention. For example, if a tooth is completely knocked out, carefully clean it with water. Try to place the tooth back into its socket or briefly store it in a cup of milk if it will not fit back into the gum. Never pick up a tooth by the root or force it into the socket. Come straight to our office, as your tooth will need to be replaced within a short amount of time. Similarly, if you have bitten through your lip or tongue, the American Dental Association recommends carefully cleaning the area before coming as quickly as you can to our emergency dental office for treatment.

Remember, there is no reason you should live with discomfort. By visiting our Worcester office immediately in an emergency, you can take control of your oral health comfortably and safely.

Endodontists Can Save Teeth

July 22nd, 2020

An endodontist is a dental specialist who concentrates on root canals, or procedures involving the soft inner tissues of the teeth, otherwise known as the pulp. This type of doctor has gone through extensive training and extra years of schooling to be able to complete these procedures effectively.

You will be referred to an endodontist such as Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants if you’re in need of a root canal, or other specific procedures necessitated by a problem tooth. Nowadays, endodontists have the ability to avoid extraction altogether and save your natural tooth by restoring it to a healthy state.

Getting a root canal may not be on the top of your list of fun things to do, but it can make it possible for your endodontist to save a problem tooth if the pulp has become infected with bacteria. During this surgery, Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will remove the infection from the root of the tooth, clean and fill the area, then seal it so bacteria can no longer get inside. Finally, a crown is placed on top of the tooth to prevent damage from occurring down the road.

Sometimes, additional treatment is necessary after a root canal, if you continue to experience pain in the area where the root canal took place. Inflammation and pain that persists after an initial root canal may mean the infection has spread to the bony area that surrounds the tooth.

This can occur if the tooth has experienced trauma, decay, or the crown has been cracked since the surgery. A root-end resection will fix these issues by opening the irritated gum tissues, then removing the infection and filling in the space. It’s unlikely that you will experience more problems following a root-end resection.

Endodontists such as Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants have the ability to save and restore problem teeth. When it comes to your oral health, being able to avoid a tooth extraction can be extremely relieving. If you think you may need a root canal, or notice recurring pain in your mouth, don’t hesitate to schedule an appointment at our Worcester office.

Endodontic Surgery: Is There a Dress Code?

July 15th, 2020

If you’re scheduled for endodontic surgery at our Worcester office in the near future, you probably have a lot of very important questions:

  • Will it help? An endodontist has the skill and experience to diagnose and treat conditions affecting your inner tooth, the pulp of the tooth, and the tissues surrounding the root. Endodontists are the experts in this specialty, so you are in good hands!
  • Will it hurt? Your endodontist will offer you options for anesthesia, so you can choose the sedation experience which will make you most comfortable.
  • What should I do after surgery? Don’t worry! Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants will give you clear instructions on caring for the surgical site, selecting soothing diet options, cleaning your mouth, and all of the other practices that will enable a speedy and smooth recovery.
  • What should I wear? Wait—fashion questions?

Yes! Part of being prepared for your surgery is being as comfortable as you can be during and after the procedure. Happily, there is no strict dress code for endodontic surgery. It’s more a basic list of recommendations for what not to wear.

  • Don’t wear something you’re not comfortable in. Generally, loose fitting clothing is best.
  • Don’t wear clothing that might be difficult to clean. While you and your clothing will be well protected, blood, irrigation, and other staining hazards are all occasionally part of the surgical process.
  • Don’t wear something that will be difficult to remove after surgery. No one wants to struggle out of a tight turtleneck even at the best of times!
  • Don’t wear jewelry. And, by the way, this includes tongue and facial piercings.
  • Don’t be afraid to layer. While the office staff will try to make sure you are as warm or as cool as you would like to be, it’s a good idea to bring a jacket or sweater for extra warmth.
  • Don’t wear tight sleeves. Short sleeves or sleeves that can be rolled up easily allow access to your arm if you are having IV sedation or blood pressure monitoring.
  • Don’t wear contact lenses, especially if you are planning on IV sedation or a general anesthetic, because your eyes might be closed throughout the procedure.

If you have any questions in advance of your endodontic surgery, give our Worcester office a call. Planning ahead is always in fashion!

Meet Dr. Kaplan

July 14th, 2020

Central New England Endodontics and Implantology is excited to announce that we have a new doctor joining our team! Let us introduce you to Dr. Kaplan, specializing in Root Canal Therapy.

Dr. Kaplan has been practicing in Rhode Island and Massachusetts for over 22 years. He has had the honor of being selected as America’s top dentist in the field of endodontics for the past 16 years in a row. Dr. Kaplan also served as a clinical instructor and professor at Tufts University and Boston University School of Dental Medicine where he taught post-graduate residents. Currently, he runs the endodontics department and teaches the AEDG residents at U. Mass Memorial Hospital.

We can’t wait for you to meet Dr. Kaplan!

Our Latest Office Updates

July 13th, 2020

Happy July from Central New England Endodontics and Implantology. We hope everyone is having a safe and wonderful start to the summer. If you weren’t already aware our office reopened on May 18, 2020, so we are ready to see you.

Before you arrive at your appointment there are a few new health implementations to be aware of. If you are a new patient, you can access the new patient forms on our website and fill them out prior to coming in. We ask all patients to bring and wear a face covering. Additionally, standard COVID questions will be asked when scheduling an appointment and again upon checking in. Your temperature will be taken upon arrival.

We ask that patients come alone and if that is not possible, we kindly ask that any accompanying people present wait in their car or come back to pick up the patient after the appointment. This helps us limit the number of people in the office and stick to social distancing measures. We thank each and every one of you for your cooperation during this time!

So far, with the new health implementations, we have received positive feedback from patients regarding visits and our new procedures to keep everyone safe and healthy. We do everything in our power to make sure your time with us is safe and comfortable so that you leave our office feeling satisfied.

If you are experiencing tooth discomfort or have questions about our procedures please give us a call to learn how we can help you. We hope to see you soon!

Proper Brushing Techniques

July 8th, 2020

Brushing your teeth properly removes the food particles and bacteria that can lead to tooth decay and gum disease. However, you do not want to scrub your teeth or gums heavily. A heavy hand can lead to tooth and gum erosion, as Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our staff see all too often.

You should also use a soft bristle toothbrush to avoid damaging the surface of your teeth. Make sure the head of the brush fits in your mouth, because if it is too large you will not be able to reach all tooth surfaces. Follow these steps to ensure you are brushing properly.

  1. Use a small amount of toothpaste on your brush. The recommendation is a pea-sized amount or thin strip on the bristles.
  2. Hold your toothbrush at a 45-degree angle to the surface of your teeth, angling towards your gums. Use a circular motion on all exterior tooth surfaces, and avoid back-and-forth “scrub” brushing.
  3. Once you have cleaned the outer surfaces, hold the brush vertically and clean the inner teeth surfaces — the side of your teeth that face your tongue. Do not forget the inner surfaces of your front teeth.
  4. Finally, finish by cleaning all the chewing surfaces of your teeth. You need to maintain a gentle touch, but make sure you get into the full depth of your molars. The entire process should take about two minutes.

Drs. Manzoli, Russo, Pauk, Desrosiers, Sahakyants and our staff recommend changing your toothbrush every three to four months for best results. Do not forget to clean your tongue, which helps remove excess bacteria from your mouth. Special brushes are available just for cleaning your tongue, and they are easy to use.

Proper care of your teeth also requires flossing on a regular basis. Flossing can be performed before or after you brush. Following up with a quality mouthwash will provide you with even more protection. Do not be afraid to ask the Central New England Endodontics and Implantology team for tips on proper brushing and flossing.

Welcome to Our Blog!

June 25th, 2020

Thank you for taking the time to visit our blog. Please check back often for weekly updates on fun and exciting events happening at our office, important and interesting information about orthodontics and the dental industry, and the latest news about our practice.

Feel free to leave a comment or question for our doctors and staff - we hope this will be a valuable resource for our patients, their families, and friends!