Online Dental Education Library

Dr. Goldman and his staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions, please contact us.

Oral and maxillofacial surgeons are unique among dentists in that they all have completed an additional four years of hospital-based training alongside medical residents, and can administer all types of anesthesia. If you have a diseased or impacted tooth that needs to come out, implants to be placed, a suspicious lesion that needs a biopsy, or any other oral health condition requiring surgical diagnosis or treatment, we can help. Learn more about Oral Surgery.

Snoring & Sleep Apnea

Chronic loud snoring is a common symptom of Obstructive Sleep Apnea (OSA), which occurs when the upper airway is blocked to the point of causing significant airflow disruption, or even no airflow whatsoever for 10 seconds or more. This can be a dangerous situation. Learn more about Snoring & Sleep Apnea.

Tooth Extractions

There are times when it is in your best interest to have a tooth extracted (removed). This could be the case for a variety of reasons, including: damage or trauma to the tooth; an impacted wisdom tooth that may cause trouble for you later on; or overcrowding. Learn more about Tooth Extractions.

Implant Dentistry

Dental Implant Video

If you are missing one or more teeth, dental implants offer the comfort and security of a permanent replacement that looks and functions just like your natural teeth. Dental implants also help preserve the tooth-supporting bone in your jaw that deteriorates when even one tooth is lost.

Oral Diagnosis & Biopsies

When it comes to detecting certain oral or systemic (whole-body) diseases, a thorough dental exam may be your first line of defense. Learn more about Oral Diagnosis & Biopsies.

Bone Grafting

Bone grafting, a minor in-office surgical procedure, is commonly used in dentistry to correct deficiencies in bone quality and to build support for teeth or dental implants. Learn more about Bone Grafting.

Sedation Dentistry & Anesthesia

We want you to have the most comfortable dental treatment experience possible. That's why we offer sedation, to help you relax, and/or anesthesia, to block your sensations of pain. Learn more about Sedation Dentistry.

Facial Trauma & Reconstructive Surgery

Oral and maxillofacial surgeons are capable of treating the full scope of injuries to the structures of the face, mouth or jaws — including the teeth, the bones of the jaws and face, and the tissue of the skin and gums. We can also treat congenital defects such as cleft palate.

TMJ Disorders

If you have chronic pain in or around your jaw, or find the movement of your jaw is restricted, you may be suffering from a temporomandibular joint (TMJ) disorder. Learn more about TMJ Disorders.

Treating Dental Emergencies

We can treat a variety of traumatic dental injuries, including teeth that have been moved or knocked out entirely. Please call our office for assistance, or click here to learn more about what to do in a dental emergency.

Tooth pain.When you experience pain in your mouth, it's sometimes abundantly clear which tooth is causing it. At other times, the sensation of discomfort is more diffuse, generalized or hard to pinpoint. On occasion, it can even be challenging to determine exactly what problem or combination of problems is causing the symptoms you're experiencing. This may be the case when an infection exists in the root canals of a tooth as well as the gum tissue adjacent to it.

In this situation, the infection may have begun in the pulp of the tooth itself; or, it may have started in the gums. Over time, it has spread from one location to the other — and now it's causing a confusing set of symptoms that are difficult to sort out. Regardless of where the problem started, a thorough analysis will be necessary before treatment can begin, to give you the best chance of saving the tooth.

Confusing Symptoms

Root canal infection leading to gum disease.

From time to time, many people experience oral discomfort that's dull or intermittent. Occasionally, a more insistent pain may be triggered by a stimulus like temperature (from hot or cold foods or beverages) or pressure (from biting down on something). Sometimes, it may feel as though the ache is coming from a group of teeth rather than one single tooth — or even from the sinus area above the back teeth.

These symptoms can indicate a number of dental issues, including root canal and gum problems, and shouldn't be disregarded. However, if you manage to ignore the acute pain, in many cases it will fade in time. But this isn't good news: It generally means that the infected tissue in the pulp of your tooth has died, and the nerve is no longer functioning. That's when the problem may become more serious.

Chicken or Egg?

Gum disease leading to root canal infection.

When the pulp tissue inside your tooth becomes severely infected, it's possible for the disease to move through openings at the end (apex) of the root, and outside of the tooth. It can then spread to the periodontal ligament, which anchors the tooth to the surrounding bone and gum tissue. From there, the infection may extend to the gum tissue and cause periodontal disease, or even result in a painful gum abscess. At that point, you may have pain — even severe pain that will let you know exactly which tooth is affected.

But it's also possible for the infection to be spread by the exact opposite pathway. In this case, an infection that originated in the gums (commonly due to periodontal disease caused by a buildup of plaque) may have has traveled through small passageways called accessory canals, which are located in between a tooth's roots, or on the sides of the roots. The infection can then extend into the tooth's pulp. If your teeth are fractured, it's even easier for disease to spread.

Treatment Methods

When dental problems involves both root canals and gum disease, saving the affected tooth can prove challenging. This is when it matters where the infection started: If it's primarily a root-canal problem that later moved into the gums, the outlook for the tooth is reasonably positive if it receives immediate treatment. If gum disease came first, however, the prospects often aren't as good; by the time the infection has moved into the tooth, it's possible that much bone has already been lost, making the tooth's long-term prognosis poor.

In either case, the cause of the tooth pain will need to be diagnosed and an effective treatment plan developed. The sooner that happens, the better: Root canal and gum problems simply don't get better on their own.

Related Articles

Confusing Tooth Pain - Dear Doctor Magazine

Confusing Tooth Pain It is occasionally difficult to pinpoint the origin of tooth pain, which can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Nevertheless, it's always important to sort out what's going on so that the right treatment can be selected and the tooth saved... Read Article


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