Endodontics (Root canal treatment)

Endodontics is a specialized branch of dentistry that deals with the disease of complex structures found inside the tooth. A Root canal specialist (Endodontist) is trained to perform both simple and complex procedures, which range from root canal therapy to root canal microsurgeries. In the past, a firm tooth with diseased nerve was immediately removed, but now we are able to save such teeth – thanks to advances in Endodontics.

What are the signs and symptoms of root canal problem?

  • Pain or sensitivity to hot, cold and sweet foods
  • Tenderness on chewing or biting
  • Pain and swelling in the gums around the affected tooth
  • Pus around the roots of the tooth
  • Tooth discolouration
  • Unexplained pain in the jaws, head and neck

Please contact us, if you have questions or concerns about endodontic procedures.

Root canal therapy

Root canal therapy is needed when the nerve of a tooth is affected by decay, infection or injury.  In order to save the tooth, the living tissues inside the tooth along with bacteria and toxins are removed and the resulting space is sealed with special fillings materials. Root canal therapy is the treatment of choice to save a tooth that would otherwise need removal. Many people believe that removing the diseased tooth is the best solution, without realizing that extracting the tooth will ultimately be more costly and can cause significant problems to the adjacent and opposite teeth. Root canal treatment have a high success rate and last for many years, although on occasion, a tooth may have to be retreated for new infections.

Signs and symptoms for possible root canal therapy:

  • Pain or sensitivity to hot, cold and sweet foods
  • Tenderness on chewing or biting
  • Pain and swelling in the gums around the affected tooth
  • Pus around the roots of the tooth
  • Tooth discolouration
  • Unexplained pain in the jaws, head and neck
  • Seldom there are no symptoms and a pulp vitality test might indicate the need for RCT

Reasons for root canal therapy:

  • Infection or pus has developed inside the tooth and around the root tip
  • Decay or bacteria has reached the tooth pulp
  • Severe injury or trauma that has damaged the pulp

What does root canal therapy involve?

A root canal treatment, depending on the case can be completed in one or multiple visits. While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to isolate it (keep it dry and free of saliva).  A cavity is made on top of the tooth to access the pulp and remove the contents of the root canal space. Once the tooth is thoroughly cleaned, it is sealed with special root canal filling materials and a temporary or permanent filling is placed on top. If the infection is extensive then a root canal medicament is placed with a temporary seal on top till a permanent filling can be done. Once the root canal treatment is completed, such teeth are further protected either with bonding, inlay, onlay or a crown. This added protection prevents the teeth from breaking and restores it to its full function.

Your tooth might be sensitive for a few days after the treatment. This is usually due to inflammation in the tissues around the root tip. But such pain or sensitivity can be easily controlled with proper medication and usually subsides as the inflammation diminishes.

Root canal retreatment

In rare cases, root canal therapy might not succeed due to improper healing or post-surgical complications. There are a number of reasons why root canal therapy might unexpectedly fail:

  • Undetected or complex root canal structures
  • Saliva or blood entering the restoration
  • Improper sealing of the curved or narrow root canals
  • Delay in placement of final restoration or crown following root canal therapy
  • Cracked crown
  • Leaking filling material
  • New fracture in previously treated tooth
  • New decay in previously treated tooth

However, root canal treatments and retreatments are a better alternative than extraction in most cases. Opting for root canal retreatment can be far less expensive than the alternatives. An extensive bridgework or dental implants cost far more and require higher maintenance than a natural tooth.

What does root canal retreatment involve?

A root canal retreatment, depending on the case can be completed in one or multiple visits. While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to isolate it (keep it dry and free of saliva). Whether the treatment can be completed in a single visit will depend on the extent of infection and the complexity of treatment.

The first step in a root canal retreatment is to gain access to the inside of the tooth. If a crown and post have been placed, these will be usually be removed. This is followed by the removal of the previous root canal filling. We might use loupes or microscopes for magnification during this process. The root canal space is then thoroughly cleaned and reshaped. If the root canals are complex then a medicament is packed inside the tooth and cleaning process is continued in the next appointment.

When we are confident that the infection has subsided and root canal is completely clean, it is sealed with a root canal filling material like gutta-percha or resilon in combination with a sealer. This prevents bacterial invasion in to the root canal space. Finally, such teeth are further protected either with bonding, inlay, onlay or a crown. This added protection prevents the teeth from breaking and restores it to its full function.

Your tooth might be sensitive for a few days after the treatment. This is usually due to inflammation in the tissues around the root tip. But such pain or sensitivity can be easily controlled with proper medication and usually subsides as the inflammation diminishes.

 

 

Endodontic surgery and microsurgery

Endodontic microsurgery combines magnification and illumination provided by the dental loupes and surgical operating microscope. Special microsurgery instruments are used during this procedure. Without these microsurgical devices and instruments, procedures such as apicoectomy, internal and external resorption repair, as well as the repair of iatrogenic and pathological perforations would not be possible. Endodontic microsurgery can be performed with great precision and predictability unlike conventional endodontic surgery. The main advantage of microsurgery is a smaller surgical field which results in quicker healing with less post-operative discomfort. At Smileoracles, our doctors are specially trained in all areas of conventional and surgical microendodontics. You can contact us to know more about the benefits of microsurgery.

Cracked tooth syndrome

Cracked and fractured teeth are common dental problems which usually go undetected as they are difficult to diagnose. There are many reasons why teeth may crack, for example, weakening of teeth due to decay or RCT, biting on hard food, trauma, grinding and clenching of teeth. All of these conditions put the teeth under extra strain and render them more susceptible to cracking. When tooth enamel is cracked, pain can become momentarily excruciating. When no pressure is exerted on the crack there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the pain subsides. 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 while eating or biting.
  • Sensitivity to warm and cold foods.
  • Difficulty in pinpointing the location of the pain.

How are cracks in the teeth treated?

Treatment of the cracked tooth depends on the severity of the crack as well as the location. In cases where only the root of the tooth is affected, root canal therapy is the treatment of choice. Restorations using bonding and crowns can also treat some of the cracked teeth. However, if the crack is too severe for the tooth to be saved, then extraction is the only available option.

Please contact us, if you have any questions or concerns about cracked teeth.