Posts for tag: root canal treatment
Tooth decay can wreak more havoc than just producing cavities. It can work its way into the innermost parts of the tooth — the pulp and tiny passageways called root canals that lead to the tooth's connection with the bone.
If that happens, you'll need more than “drilling and filling.” Without intervention, your tooth could be lost. That intervention is a root canal treatment, a procedure that removes the infection from within the tooth and preserves it from re-infection.
You've probably heard the old belief that root canal treatments are painful. With modern anesthetic techniques to deaden pain, that's not true. In fact, root canal treatments stop the pain caused by infected nerves within the pulp and root canals. More importantly, it saves your tooth.
Root canals can be performed by a general dentist. More extensive decay or complex root canal networks may require the services of an endodontist, a dentist who specializes in root canal anatomy and treatments. Endodontists have advanced techniques and equipment to handle even the most difficult case.
Regardless of who performs it, the basic procedure is the same, as is the goal: to completely remove all diseased tissue within the tooth and seal it with a special filling to prevent re-infection. To access the diseased pulp, we first drill an access hole, usually in the biting surface of a back tooth or the back of a front tooth. We then use specialized instruments to remove the infected tissue and flush out the space with antibacterial solutions.
We then insert a filling called gutta percha into the empty pulp chamber and root canals, seal off the filling with adhesive cement, and close the access hole with filling. These fillings and sealants prevent bacteria from reentering the tooth. For added protection against infection and fracturing, we also recommend placing a full-coverage dental crown. This also enhances the appearance of the tooth, which must be modified during the root canal procedure.
The end result: your once endangered tooth has been preserved for hopefully many years to come. So if we recommend you undergo a root canal treatment, don't wait — the tooth you save may be your own.
A root canal treatment is a commonly known but often misunderstood procedure. Contrary to popular belief, these treatments aren't painful — in fact, they often stop a toothache. More importantly, a “root canal” can give a tooth on the verge of loss another lease on life.
Still, if you've never experienced a root canal treatment before, you probably have questions. Here are the answers to a few of the most common.
Why do they call it a “root canal”? This is the popular shorthand term for a procedure that removes diseased tissue from a decay-infected pulp, the innermost part of a tooth and the actual root canals themselves. Root canals are the narrow, hollow channels that run from the tip of the root to the pulp and are also involved in the procedure.
Why do I need one? Once infected, the pulp's bundles of blood vessels, nerves and other tissues become diseased. This often results in a painful toothache that can also suddenly disappear once the nerves within the pulp die. But there's still a problem: If we don't clean out the diseased and dead pulp tissue, the infection could spread through the root canals to the bone and endanger the tooth's survival.
What happens during the procedure? After deadening the tooth and surrounding gums with local anesthesia, we enter the pulp through an access hole we create. Using special instruments we remove the diseased tissue and shape the root canals to seal them with a filling material called gutta percha. Sealing the access hole is then necessary to prevent re-infection. Later we'll cap the tooth with a porcelain crown to restore its appearance and add further protection against fracture or cracking of the tooth.
Who can perform a root canal treatment? In many cases a general dentist can perform the procedure. There are some complex situations, however, that require a root canal specialist with additional training, expertise and equipment to handle these more difficult cases. If your tooth is just such a case it's more than likely your general dentist will refer you to an endodontist to make sure you get the right kind of care to save it.
If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment: What You Need to Know.”
Children have a lot of energy that's often channeled through physical activities and sports. Unfortunately, this also increases their risk of injuries, particularly to their teeth.
Injuries to the mouth can endanger permanent teeth's survival. For an older tooth, a root canal treatment might be in order. Not so, though, for a pre-adolescent tooth, even if it is permanent.
A young permanent tooth is still developing dentin, the large layer just below the enamel. This growth depends on the connective tissue, blood vessels and nerves within the pulp in the center of the tooth. Because a root canal treatment removes all of this tissue, it could stunt dentin and root growth and endanger the tooth's future.
Instead, we may need to treat it with one of a number of modified versions of a root canal, depending on what we find. If the tooth's pulp is unexposed, for example, we may need only to remove the damaged dentin, while still leaving a barrier of dentin to protect the pulp. We then apply an antibacterial agent to minimize infection and fill in the area where we've removed tooth structure.
If some of the pulp is exposed, we may perform a pulpotomy to remove just the affected pulp and any overgrown tissue. We then place a substance that encourages dentin growth and seal it in with a filling. If we go deeper toward the root end, we might also perform procedures that encourage the remaining pulp to form into a root end to stabilize the tooth.
If the entire pulp has been damaged beyond salvage, we may then turn to a procedure called an apexification. In this case we clean out the pulp chamber; at the root end we place mineral trioxide aggregate (MTA), a growth stimulator that encourages surrounding bone to heal and grow. We then fill in the root canals and chamber with a special filling called gutta percha to seal the tooth.
The deeper we must penetrate into the pulp, the higher the chances the young tooth's dentin and roots won't form properly, leading to later problems and possible loss. But by employing the appropriate one of these methods, we can minimize the risk and give your child's damaged tooth a fighting chance.
If you would like more information on children and dental injuries, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saving New Permanent Teeth after Injury.”
Most first-time root canal treatments achieve their purpose in saving an internally decayed tooth and extending its life to match those of the patient’s non-decayed teeth. Occasionally, though, a root canal-treated tooth may become re-infected by decay.
There are a number of reasons for this: the permanent crown meant to add further protection against decay may have been delayed, giving bacteria an opening to re-infect the tooth; it’s also possible the original seal for the pulp chamber and root canals after filling wasn’t sufficient to prevent bacterial contamination.
There‘s also another reason that’s very difficult to foresee — the presence of narrow, curved root canals in the tooth that can pose complications during the procedure. Some of these known as accessory or lateral canals branch off the main canals to create a complex network that’s difficult to detect during the initial procedure. If they’re not cleaned out and filled during the procedure any tissue trapped in them can remain infected and ultimately die. If these canals also open into the periodontal membrane at the attachment between the teeth and bone, the infection can spread there and become a periodontal (gum) infection that can trigger future tooth loss.
Fortunately, a reoccurrence of infection isn’t necessarily a death sentence for a tooth. A second root canal treatment can correct any problems encountered after the first treatment, especially complications from accessory canals. It may, though, require the advanced skills of an endodontist, a dental specialist in root canal problems. Endodontists use microscopic equipment to detect these smaller accessory canals, and then employ specialized techniques to fill and seal them.
If you encounter pain or other signs of re-infection for a tooth previously treated with a root canal procedure, contact us as soon as possible. The sooner we can examine and diagnose the problem, the better your tooth’s chances of survival by undergoing a second root canal treatment.
If you would like more information on tooth preservation through root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Accessory Canals.”
It’s absolutely critical to stop tooth decay and repair any damage to tooth structure. Hopefully, we’ve caught it early in the enamel and dentin where we’re able to repair any holes or “cavities” that might have developed by filling them.
But what if the decay has crept deeper into the interior of the tooth? In this case, you’re at a much higher risk of eventually losing the tooth. If the decay has spread into the bone, a root canal treatment is usually your best option.
The first sign that decay has invaded the pulp, the innermost layer of the tooth, and the root canals may be a severe toothache. It’s different from the wince of pain or discomfort caused by sensitivity to temperature or pressure. Inner decay pain is constant and often excruciating. This is because the infection is attacking the nerves bundled within the pulp chamber.
The pain can last for several days, and then suddenly stop altogether. No pain is good news, right? Wrong — the pain has stopped because the infected nerves have finally died and can no longer signal the brain. The infection, though, is very much alive and will continue to advance toward the root where the damage may eventually cause you to lose the tooth.
A root canal treatment removes decay in the pulp chamber and canals. We first drill an access hole to enter the pulp chamber. Once inside, we use special instruments to completely remove all tissue and disinfect the empty chamber. We then fill the chamber and root canals with a special filling and seal the access hole to prevent further decay. A few weeks later we install a custom crown to protect the tooth further.
If you have a toothache, or you’ve had one that suddenly went away, you should schedule an appointment for a dental examination as soon as possible: this is the only way to accurately determine the cause of the pain. If a root canal is deemed necessary, the sooner we perform it, the less chance the infection will cause you to lose your tooth.
If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Signs and Symptoms of a Future Root Canal.”