Root Canal Therapy
Root canal treatment is performed when the tissues within the tooth become inflamed or diseased. A small access is made through the top of the tooth and the diseased tissue is removed through a microscope. This procedure requires a lot of precision to conservatively remove an infection from inside the roots while preserving as much tooth structure as possible. This treatment is performed under a local anesthesia. Once the tooth is anesthetized, the procedure is painless and takes about 60-90 minutes to complete. At times the amount of infection will dictate how many appointments will be needed to completely clean the tooth. Once the canals are completely cleaned and confirmed with a microscope, the canals are filled with a permanent filling and the tooth is temporarily sealed at the top. After the root canal treatment, you will be instructed to return to your dentist to restore the tooth with a permanent restoration such as a crown.
The most common question is how do tissues inside a tooth become diseased. There are several factors that can contribute to this:
-Deep tooth decay
-Trauma to the tooth
-Parafunctional habits such as grinding or clenching at night or during the day
-Ice chewing or chewing on hard nuts
-Repeated irritation to the tooth
-Cracks and tooth fractures
Root Canal Retreatment
Retreatment is performed when the tooth has already had a previous root canal therapy. This usually happens because:
-The initial root canal was done a long time ago and the filling is degrading causing leakage of bacteria into the tooth
-The tooth needs a new crown but the tooth has developed decay on top of the existing root canal
-The canals became contaminated through tooth decay
-Tooth shows evidence of infection on a radiograph
-Tooth became symptomatic
-Bone loss around the roots is evident on x-rays
During retreatment, a small access is made at the top of the tooth. Old root canal filling is removed and the canals are recleaned. More than one appointment may be required to fully clean the canals before a final root canal filling is placed. Once retreatment is complete a temporary seal is placed at the top of the tooth. After the root canal retreatment, you will be instructed to return to your dentist to restore the tooth with a permanent restoration such as a crown.
Endodontic surgery can be used to locate small fractures or hidden canals previously undetected on X-rays during the initial treatment. Surgery may also be needed to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth.
There’s no need to worry about surgery if your endodontist prescribes this additional measure. Advanced technologies like digital imaging and operating microscopes allow these procedures to be performed quickly, comfortably and successfully. There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which may be needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure.
Whether your tooth cracks from an injury or general wear and tear, you can experience a variety of symptoms ranging from erratic pain when you chew your food to sudden pain when your tooth is exposed to very hot or cold temperatures. In many cases, the pain may come and go and your dentist may have difficulty locating the tooth causing the discomfort. If you experience these symptoms or suspect a cracked tooth, it’s best to see an endodontist as soon as possible. The sooner your tooth is treated, the better the outcome. Once treated, most cracked teeth continue to function as they should, for many years of pain-free biting and chewing.
Traumatic dental injuries often occur as a result of an accident or sports injury. The majority of these injuries are minor - chipped teeth. It’s less common to dislodge your tooth or have it knocked completely out but these injuries are more severe. Treatment depends on the type, location and severity of each injury. Regardless of the extent of the injury, your tooth requires immediate examination and a proper treatment by a dentist or an endodontist. Sometimes, your neighboring teeth suffer an additional, unnoticed injury that can only be detected by a thorough dental exam.
3D Diagnostic Imaging
We use Cone Beam CT to help us in diagnosis. Unlike two dimensional x-rays, Cone Beam CT allows us to rotate the tooth in different planes and examine the anatomy of the tooth and to determine how much of the disease has spread into surrounding bone. The amount of information we can get from the Cone Beam CT image is not comparable to the routine x-rays. With that information, we can diagnose and treat better than ever before.