Endodontics is a specialized branch of dentistry that deals with the complex structures found inside the teeth. Dr. Sadjadi is trained to perform both complex and simple procedures, including root canal therapy.
Historically, a tooth with a diseased nerve would be removed immediately, but endodontists are now able to save the natural tooth in most cases.
Generally, extracting the inner tooth structures, then sealing the resulting gap with a crown restores health and functionality to damaged teeth.
Signs and symptoms of endodontic problems:
Inflammation and tenderness in the gums.
Teeth that are sensitive to hot and cold foods.
Tenderness when chewing and biting.
Unexplained pain in the nearby lymph nodes.
Endodontic treatment (or root canal therapy) is performed to save the natural tooth. In spite of the many advanced restorations available, most dentists agree that there is no substitute for healthy, natural teeth.
Here are some of the main causes of inner tooth damage:
Bacterial infections – Oral bacteria is the most common cause of endodontic problems. Bacteria invade the tooth pulp through tiny fissures in the teeth caused by tooth decay or injury.
Fractures and chips – When a large part of the surface or crown of the tooth has become completely detached, root canal therapy may be required. The removal of the crown portion leaves the pulp exposed, which can be debilitating painful and problematic.
What does an endodontic procedure involve?
Root canal therapy usually takes between one and three visits to complete. Complete X-rays of the teeth will be taken and examined before the treatment begins.
Initially, a local anesthetic will be administered. An opening will be created in the surface of the tooth, and the pulp will be completely removed using small handheld instruments.
The space will now be shaped, cleaned and filled with gutta-percha. Gutta-percha is a bio-compatible material that is somewhat similar to rubber. Cement will be applied on top to ensure that the root canals are completely sealed off. Usually, a temporary filling will be placed to restore functionality to the tooth prior to the permanent restoration procedure.
During the final visit, a permanent restoration or crown will be placed.
If you have questions or concerns about endodontic procedures, please ask your dentist.
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ROOT CANAL THERAPY
Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp, nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting a tooth will ultimately be more costly and cause significant problems for adjacent teeth.
Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy:
An abscess (or pimple) on the gums.
Sensitivity to hot and cold.
Severe toothache pain.
Sometimes no symptoms are present.
Swelling and/or tenderness.
What does root canal therapy involve?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).
While the tooth is numb, an access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.
Once the tooth is thoroughly cleaned, it will be sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.
After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.
Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.
Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer, the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth.
When tooth enamel is cracked, pain can become momentarily debilitating. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.
Symptoms of a cracked tooth may include:
Unexplained pain when eating.
Sensitivity to warm and cold foods.
Pain with no obvious cause.
Difficulty pinpointing the location of the pain.
Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.
Root amputation is a specialized dental procedure, whereby one root is removed from a multi-root tooth. The tooth is then stabilized and rendered fully functional with a crown or filling.
The multi-root teeth best suited to the root amputation procedure are the molars at the back of the mouth. These large flat teeth have either two or three roots depending on whether they are situated on the upper or lower jaw.
The general purpose of root amputation is to save an injured or diseased tooth from extraction. Generally, root amputation and the necessary crown work are less expensive and can be completed in 1-3 short visits.
When is root amputation necessary?
It is important to note that root amputation can only be performed on an otherwise healthy tooth. Even in the case of a “key” tooth, extraction will be performed if the tooth is diseased, badly fractured or otherwise injured. Suitable teeth for root amputation have a healthy tooth surface, strong bone support and healthy underlying gums.
There are several problems that may lead to root amputation including:
Broken, fractured or injured teeth and roots.
Embedded bacteria within the structure of the root.
Severe bone loss in a concentrated area due to periodontitis.
Tooth decay in a concentrated area of the tooth.
What does root amputation involve?
Prior to root amputation, it is necessary to perform root canal treatment. The amputation itself involves cutting deep into the tooth where blood vessels and nerves are located. For this reason, the pulp of the tooth including these vessels and nerves needs to be removed before re-sectioning the roots.
During the root amputation procedure, a small incision will be created in the gum to fully expose the roots of the affected tooth. The root will be sectioned off from the rest of the tooth and then removed. To kill any remaining bacteria, the whole area will be cleansed with saline solution, and then sutures will be applied to seal the incision.
Finally, a temporary crown or filling will be placed to secure the tooth. Depending on the specific situation, painkillers, antibiotics and a medicated anti-microbial mouthwash may be prescribed. Arrangements can now be made to place the permanent crown or filling.
ROOT CANAL RE-TREATMENT
In rare cases, root canal therapy fails to work as expected. The treated tooth might not heal properly or a patient might experience post-surgical complications that jeopardize the tooth. In short, root canal re-treatment is almost identical to the original procedure, aside from the structural removal. The success rate for a root canal re-treatment runs at around 75%.
Though the prospect of more endodontic surgery might not be pleasant, root canal re-treatment is fairly simple. In general, the whole treatment can be completed in 1-3 visits.
If you have any questions or concerns about root canal re-treatment, please ask your dentist.