Dental Health - Brainard Duncan, DDS

Ask A Doctor
Brainard Duncan, DDS
Dental Health

Q: What is a root canal?
A: Root canal therapy is generally performed due to a damaged, diseased or traumatically involved pulp, the area inside the tooth where the nerves and blood supply are contained. After an examination and review of X-rays, your dentist will determine if a root canal is needed. One or more appointments will be scheduled during which the pulp will be removed and the pulp chamber and canal will be shaped, cleaned, sterilized, and filled with a permanent material. Your root canal treated tooth will also need an appropriate restoration such as a filling or crown after the treatment is complete. The most common comment after a root canal is, “That wasn’t nearly as bad as I thought it would be.”

Often patients will refer to their root canal treated tooth as “dead.” Contrary to this popular notion, after the root canal treatment the tooth will receive blood supply from the surrounding tissue. The tooth will be functional for biting but will not have hot or cold sensation. Modern root canal therapy is more than 90 percent successful. With proper care, root canal treated teeth may last just as long as other teeth.

Q: Why do we need fluoride?
A: The history of using fluoride as a supplement to control tooth decay dates back to the 1930s. In 1945, the U.S. National Institutes of Health began a controlled experiment with Grand Rapids, Michigan, being the first city to have fluoridated water. After seeing positive results with the prevention of tooth decay, fluoridation became an official policy of the U.S. Public Health Service in 1951 and by 1960 fluoride was in wide use. The Centers for Disease Control and Prevention indicate water fluoridation to be one of the ten great public health achievements of the 20th century. Opponents to fluoridation, while relatively few, are organized and present a disproportionate objection and misleading view of water fluoridation.

With all the controversy, I want you to know I consider fluoride to be safe and essential to healthy teeth formation and maintenance when used with professional guidance. My friends and family use fluoride to good advantage.

For the Foothills, water fluoridation would not appear feasible with our several water sources. To calculate the fluoride dose needed, a current fluoride analysis for your water source needs to be available. For families without fluoridated water, your dentist may want you to have fluoride treatments which come in several forms – gels, foams, mouthwashes, or varnishes.

Q: What can I do about my husband’s bad breath?
A: Particles of food remaining in the mouth after meals is the most common source of bad breath. The small particles accumulate on the tongue, around the gums and between teeth. The trapped food particles cause an unpleasant odor just as they begin to interact with the bacteria in your mouth.

Persistent bad breath or a bad taste in your mouth may be warning signs of gum disease. Gum disease may be caused by the same food particles that accumulate in the mouth and form plaque and calculus.

Xerostomia, or dry mouth, is sometimes caused by certain medications and medical conditions and can result in bad breath. Consult a dental professional who can diagnose xerostomia and help you alleviate dry mouth symptoms.

Bad breath can also be temporarily caused by certain foods; raw onions, garlic and cabbage produce sulfur-containing gasses when they are digested. These sulfur compounds are absorbed into the bloodstream, carried to the lungs and exhaled with breathing. Tobacco products can cause bad breath, in addition to staining teeth, irritating gum tissue and contributing to oral cancer.

Proper daily tongue scraping, brushing and flossing are good ways to prevent gum disease. Brush your teeth twice a day with fluoride toothpaste. Carefully and thoroughly floss once a day to clean between your teeth (before bed is best). Drink plenty of water. Most conventional mouthwashes only mask odors temporarily. Ask your dentist for recommendations.

Q: Do I have to get my wisdom teeth pulled?
A: A healthy tooth in proper alignment with healthy gum tissue does not need to be removed. Frequently, there is not enough space for wisdom teeth to grow and they just push their way around to find space. Other teeth may also have difficulty finding a good space to grow into, but wisdom teeth have a reputation.

When wisdom teeth obviously are growing into a bad position, dentists often recommend they be removed when the patient is 16 or 17 years of age. Young bone is less rigid and the roots are not fully formed allowing for a less traumatic surgery. Impacted teeth have nowhere to grow. They are in unhealthy positions and sometimes covered completely with bone. In these cases they should be removed as conveniently as possible.

Prior to surgery, it is common to have a consultation with your oral surgeon. At this point a decision is made for the most appropriate setting for your procedure – office, surgery center or hospital operating room. The majority of these procedures are performed in an office setting. We are fortunate to have excellent facilities and trained professionals in the Sonora area.

Bio:
Brainard Duncan, D.D.S, studied dentistry at Loma Linda University and worked in private practice in Bakersfield and in the Sacramento area for many years. He left private practice to work with the prison system and, in 2003, began working to establish Tuolumne General’s rural health clinic dental services. In 2006 he joined the rural health clinic full time as dental director. Sonora Regional Medical Center took over the clinic in 2007 as a service of the Forest Road Health and Wellness Center. Dr. Duncan and most of the dental services staff moved to the new location on Fairview Lane where they provide dental care for Medi-Cal and CMSP patients.

Dr. Duncan is a NASCAR fan and enjoys all things automotive. At the age of 16 he built his first hot rod. Still a hot rod enthusiast, he hopes to someday build a Cobra. He also owns a 1931 Model A Ford Victoria, which he bought in 1975.