Root Canal Treatment

What is non-surgical endodontic treatment?
This is a method of treating the inside of the tooth, also known as a root canal treatment. It is one of the most common dental procedures that can be performed to prevent tooth loss.
To help you understand endodontic treatment, we would like to familiarize you with the anatomy of your tooth. Inside your tooth, under the white tooth enamel and the hard layer of tooth, called dentin, is a soft tissue known as the pulp. The pulp consists of blood vessels, nerves and connective tissue which help to create the surrounding hard tissues of the tooth during development.
The pulp can be found in the center of the tooth and can extend all the way to the tip of the roots where it connects to the tissues surrounding the root. The pulp has a very important role during a tooth’s development. However, a tooth that has reached full maturity can survive without the pulp, because it continues to receive nourishment by the surrounding tissues.

Why do I need endodontic treatment?
If the soft tissue inside the root canal of a tooth becomes inflamed or infected, then a root canal treatment is necessary. There can be a variety of factors that cause the inflammation or infection such as: repeated dental procedures on the tooth, deep decay, crack s or chips in tooth.

What are the signs of needing endodontic treatment?
Indication signs to look for include pain, tenderness to touch and chewing, prolonged sensitivity to hot or cold, discoloration of the tooth, swelling of the surrounding tissue, and drainage. Symptoms may not always be present.

How does endodontic treatment save the tooth?
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, a channel inside the root, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full functions. After restoration, the tooth continues to function like any other tooth.

Will I feel pain during or after the procedure?
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontic's instructions carefully. Your tooth may continue to feel slightly different from your teeth for some

time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.

Root Canal treatment Procedure 1. A Deep Infection Root canal treatment is needed when an injury or a large cavity hurt the tooth's root.The root becomes infected or inflamed. 2. A Route to the Root The dentist numbs the tooth. An opening is made through the crown of the tooth to the pulp chamber. 3. Removing the Infected/Inflamed Tissue Special files are used to clean the infection and unhealthy pulp out of the canals. Then they shape the canals for the filling material. Irrigation is used to help clean the canals and remove debris. 4. Filling the Canals The canals are filled with a permanent material. Typically this is done with a material known as gutta-percha. This helps to keep the canals free of infection or contamination. 5. Rebuilding the Tooth A temporary filling material is placed on top of the gutta-percha to seal the opening. The filling remains until the tooth receives a permanent filling or a crown. A crown, sometimes called a cap, looks like a natural tooth. It is placed over the top of the tooth. 6. Extra Support In some cases, a post is placed into the root next to the gutta-percha. This gives the crown more support. 7. The Crowning Touch The crown is cemented into place. How much will the procedure cost? The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat, the fee is usually more. Most dental insurance policies provide some coverage for endodontic treatment. Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting.These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money. Will the tooth need any special care or additional treatment after endodontic treatment? You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings. Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing theendodontic procedure can save the tooth. What causes an endodontically treated tooth to need additional treatment? New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure. Can all teeth be treated endodontically? Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost.When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

Why is my front bottom tooth dark?

Q:
Via email from Amit

I have noticed over the past two years my lower front tooth has become darker than the teeth beside it. The tooth almost looks grey. When I was 17 (I am now 26) I fell on my face off a skateboard. At that time I cut up my lips a lot and banged my bottom teeth, but nothing happened at the time and I haven't thought of it since until I noticed my tooth was going grey. I don't have any pain, but I do not like how it looks at all.and wondering what to do.

A:

I cannot comment specifically on your tooth as I haven't examined it, but I can give you some broad answers that may help guide you in what to do next.

First, a tooth that darkens overall and has a greyish appearance typically is one in that the nerve and pulp is dying or dead. A healthy tooth has a rich vascular network within the pulp which nourishes the tooth, when trauma occurs that blood supply overtime can coagulate like a bruise and the nerve of the tooth ceases having sensation. This is when the grey colour appears and unfortunately stays.

The solutions to this may vary, in most cases a root canal can be performed which takes the dead nerve and pulp out of the tooth and replaced with an inert material which fills the space. After the root canal is performed a dental crown or cap may be recommended to protect the remaining tooth structure and prevent fracture. This new dental crown can be matched to your existing adjacent teeth to look as natural as possible.

In select cases where a dental crown or cap is not the choice, dental bleaching may be done on the inside of the tooth to remove the staining on the inside of the tooth. After this bleaching is completed a permanent filling would be put on the tooth to cover the hole where access was made to perform a root canal.

I hope this has helped. Your next step is to visit a Dentist to assess your particular dental situation.

Thanks for the great question!

Should I avoid dentistry while I am pregnant?

Q:
via email April 9, 2010 from Yasmin J

I am 8 weeks pregnant and I am wondering when I can get my teeth cleaned as I have noticed that my gums are bleeding and sore. My last dental cleaning was over 1 year ago so I am definitely due.

A:

Thank you for your question Yasmin and congratulations on your pregnancy! Dental care during your pregnancy is very important both for yourself and for your baby. Typically my personal recommendation is as minimal dental treatment possible within the first trimester when the fetal organ's are developing. While dental treatment may not harm this development, it is best to limit potential risk. I recommend dental treatment be done in the second trimester and third if need be (after fetal development is complete). Dental treatment in these latter trimesters should allow for flexibility of movement for the mother as laying on the back for an extended period of time can place pressue on the interior vena cava, so movement during the appointment is necessary.

A dental cleaning in the second trimester and a subsequent one prior to the birth of the baby is important to remove bacterial plaque and tartar to help prevent pregnancy gingivitis-pregnancy hormones and increased blood flow cause the gums to become increasingly sensitive to bacterial plaque, thus inflammation of the gums occurs. Brushing and flossing at home to remove the bacterial plaque is vital to maintaining a healthy mouth during pregnancy, while visiting the dentist assists in removal of both bacterial plaque and tartar both above and below to prevent gingivitis and allowing it to heal.

Pregnancy and your teeth

X-rays are normally not taken during a check-up at your dentist while pregnant so being aware of any warning signs of dental problems is very important, for example a new area of sensitivity, ache/pressure or bad taste/pus should be thoroughly checked to ensure no dental issues are occurring.

Great question, thank you!

Dentures

Even though complete or partial dentures are not the ideal treatment to replace missing teeth (Dental implant supported restorations are), they can provide many people with a very acceptable restoration that will last and function for many years.

Complete dentures are used when all the teeth have been lost in either your upper or lower arch. They allow you to smile, speak and masticate (a big word that means “chew”) your food so you maintain proper nutrition. While not the ideal restoration these days, they are necessary and will allow you to function far better than if you didn’t replace your missing teeth and had to mash up all your food.

One version of a complete denture is called an IMMEDIATE DENTURE. An immediate denture is a complete denture that is placed at the same time as your last remaining tooth is removed. It allows you to instantly have a full set of teeth and walk out of the office wearing your new denture.

Another version of a complete denture is called an OVERDENTURE. An overdenture is a complete denture that is partially supported by some remaining roots or implants. These roots or implants usually have some type of attachment that allows an insert placed in the denture to snap the overdenture in place. Overdentures are a very effective form of complete denture therapy and far more desirable than a normal complete denture.

A PARTIAL DENTURE is a tooth replacement appliance that replaces one or more missing teeth. It is held on by ‘clipping’ on to some of your existing natural teeth or crowns. They are two types of partial dentures- conventional and precision.

A CONVENTIONAL PARTIAL DENTURE is a tooth replacement appliance that stays in place by ‘hooking’ or ‘clipping’ on to some of your existing natural teeth or crowns. You can generally identify a conventional partial denture by a small metal clasp around one or more teeth.

A PRECISION PARTIAL DENTURE is a tooth replacement appliance that stays in place by attaching to one or more permanent crowns. Generally, precision partial dentures show no metal when you smile and attach to crowns using a number of different precision devices that are very long lasting.

Dental Implants

A dental implant is an artificial tooth root that a dentist places into your jaw to hold a replacement tooth or bridge. Dental implants are an ideal option if you have good general oral health and have lost a tooth or teeth due to periodontal disease, an injury, or some other reason.

While high-tech in nature, dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.

Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth. You know that your confidence about your teeth affects how you feel about yourself, both personally and professionally. Perhaps you hide your smile because of spaces from missing teeth. Maybe your dentures don't feel secure. Perhaps you have difficulty chewing. If you are missing one or more teeth and would like to smile, speak and eat again with comfort and confidence, there is good news! Dental implants are teeth that can look and feel just like your own! Under proper conditions, such as placement by a dentist and diligent patient maintenance, implants can last a lifetime.

Crowns & Bridges

Bridges
A dental bridge is a device used to fill the space where a tooth has fallen out or been removed. A typical dental bridge consists of a pontic (a filler tooth) that is attached to two surrounding crowns (abutments). Once complete, this bridge structure is bonded into the mouth. Without the use of a bridge, spaces in the mouth from missing teeth can cause multiple teeth to shift, lead to occlusion (biting) and/or jaw problems, and may spur periodontal disease. Dental bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.

Crowns
When a tooth is cracked, decayed, or damaged, a dental crown may need to be fitted onto the tooth. A dental crown is a permanent covering that fits over the original tooth. Crowns can be made of porcelain, gold and other metals, acrylic resin, or an amalgam (a mix) of these materials. Porcelain crowns typically have the most realistic appearance, although they tend to be less durable than other materials. Dental crowns can whiten, reshape, and realign existing teeth, adding to a healthy and vibrant smile.

How many teeth should an adult have?

Q:

Received via email March 9, 2010 from *******.
How many teeth should an adult have?

A:

Thank you for your question Anthony. This is a question I am asked quite frequently from both adults and children alike.
An adult who has his/her full set of teeth, including their wisdom teeth should have 32 teeth. Exceptions can always occur though, some people these days do not form all four wisdom teeth thus they may have less than 32 teeth. As well, occasionally a person may either be missing a tooth (it does not form) or form an extra tooth, these are exceptions to the rule.