The Root Reflections- A dental journey

  "Doc, my face is swollen, and it hurts. Can’t you just give me some antibiotics?” If you're a dentist, how many times have you heard that? And if you're a patient reading this — yes, that swelling and pain are real. But the truth is, not every swelling means infection . Sometimes, it’s your body’s way of reacting to something else — a mechanical insult, a chemical irritation, or even necrotic tissue from trauma. Welcome to the world of sterile abscesses .  What Exactly Is a Sterile Abscess? In simple words, a sterile abscess is a collection of pus-like fluid — a noninfectious dental abscess. It’s like your body saying: “Something is not right here. I don’t like this tissue or material, and I’m going to wall it off.” Now, in dentistry, we usually think of abscesses as infections — but not all of them are. And if there’s no infection , guess what? Antibiotics won’t help. What Causes a Sterile Abscess in the Mouth? Here are a few common culprits I see in pr...

  A Moment Before the Lecture      A few years ago, I was preparing to deliver an afternoon lecture at a professional gathering of dental specialists. Just before the session began, a young endodontist approached me, holding her phone with an IOPA image displayed. She looked a little unsettled but curious and asked if she could share a quick case with me. The Dilemma of Doing Right        She recounted a recent experience from her clinic: A patient had walked in, requesting a replacement for a crown that had been placed nearly a decade earlier. The patient was asymptomatic, with no pain or swelling, and just wanted a better-looking or perhaps better-fitting crown. As part of routine protocol, an X-ray was taken, which revealed something she hadn’t expected – the root canal filling done ten years ago was clearly underfilled. Ethically, she did what she had been trained to do. She explained the situation to the patient, informing him that the previ...

As dental professionals, we constantly strive to restore health and function to our patients’ teeth. But have we ever paused to consider what’s really happening beneath the surface when we prepare teeth for fillings or crowns? When we drill, we're not just shaping the tooth — we're creating heat and friction that could be silently damaging the very pulp that keeps the tooth alive. The Silent Dangers: Microcracks and Overheating It’s well-known that dental drills, even when water-cooled, can raise pulp temperature by 3–10°C during routine procedures (Zach & Cohen, 1965). That might not sound like much, but it’s enough to tip the balance and cause irreversible pulp damage . And don’t forget the microcracks — those invisible fractures in the enamel and dentin that can undermine a tooth’s strength. Studies have shown that these cracks can weaken the tooth over time, making it more susceptible to fractures (Shetty et al., 2016). Are we really helping by drilling and p...