Endodontics (Nerve Treatment or Root Canal Treatment)

Root Canal Treatment

Our teeth not only have their own metabolism and blood circulation; they have their own nerve fibres as well. The blood and nerve network is in the inside of the tooth and various factors (for example deep tooth decay, knocks, breaking of the crown) can cause their inflammation.

Pulpal inflammation causes pain and destroys the living inner tissues. The inside of the tooth - the dental pulp - has to be totally cleaned out and filled in; this process is known as root canal filling.

In spite of all rumours and unpleasant experiences in the past, root canal filling can be done painlessly!Today's technical know-how ensures that the patient should not feel any pain during treatment.

Q&A

What is root canal treatment?

Root canal treatment (RCT) is also known as endodontic therapy is a dental procedure that replaces a tooth’s damaged or infected pulp tissue (nerve) with a artificial substance to prevent the spread of infection.

Why could it happen?

Nerve and pulp can become irritated, inflamed and infected due to deep decay, repeated dental procedures on a tooth and or large fillings, a crack or chip in the tooth, or trauma to the tooth.

What are the signs that I need a root canal treatment?

You know that you need a root canal treatment if you are experiencing severe toothache upon chewing or application of pressure, prolonged sensitivity or pain to heat and cold temperatures (after the stimuli as been removed), discoloration (darkening) of a tooth (caused by trauma), swelling and tenderness in the nearby gums and a persistent or recurring pimple on the gums.

What happens if I don’t get the treatment?

If the pulp becomes infected by bacteria (caused by decay or trauma) it will begin to die and become infection. The infection itself spreads down into the root canal all the way past the end of the roots of the tooth and may lead to the development of a painful dental abscess (a pus-filled swelling). The swelling may also spread to other areas of the face, neck or head. A hole can occur through the side of the tooth (pimple) with drainage into the gums or through the cheek with drainage into the skin.  If a root canal treatment is not done, the tooth may have to be extracted.

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How long will the procedure take and will it be painful?

A root canal treatment may require 3-4 visits depending on each case. On the first appointment an X-ray is taken to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Your endodontist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetize the area to make the patient more relaxed and at ease.

Who should I see for this treatment?

Root canal treatment is best performed by an endodontist, a superhero for the sensitive inner-tooth. This dentist has spent a minimum of two extra years in school focused on advanced training in root canal techniques and procedures. This is the type of dental work that needs finesse specialized skills and a gentle hand.

What will I be feeling after undergone a root canal treatment ?

After initial treatment, an amount of pain that was felt before will be diminished and you might instantly feel better. The treated tooth is commonly very tender to touch, you should not chew or bite on the treated tooth until you have had it restored because your tooth could fracture. Any discomfort usually subsides in a couple of days, improvement will be gradual. The treated tooth, injected sites as well as soft tissue will probably feel sore and tender.

Will I have a new tooth after RCT done?

It depends on the remaining tooth structure. Final restoration could be a simple filling, inlay/onlay (stronger&longer lasting alternatives to traditional fillings) or even a “crown”. Sometimes your dentist will put a "post" in those teeth which have extensive portions of natural tooth structure missing to build up the height of the tooth using dental filling material that will hold the crown.

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Endodontic / Root Canal Treatment

Retreatment

Endodontic retreatment describes a dental root canal procedure that is carried out on a tooth that has previously had root canal treatment. For this reason it is also called "repeat root canal treatment".

One reason for endodontic retreatment is failure of the initial endodontic procedure: Recurrence of symptoms, infection such as dental abscess may occur.

RCT may fail for many reasons:

  • Curved or narrow canals were not treated during the initial treatment.
  • Complicated canals went undetected during the initial treatment.
  • New decay can expose a root canal filling material, causing infection.
  • Unproper or loose filling or crown can expose the tooth to new infection.
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Once endodontic therapy is completed your tooth should be examined periodically, usually every 6 - 12 months.  This allows us to make sure the tooth has healed or is healing properly.  Since an abscess may take 2 years to heal, our office will reevaluate the tooth for at least 2 years

Is retreatment the best choice for me?

Retreated teeth can function well for years, even for a lifetime. It's always best to save the tooth if your endodontist believes retreatment is the best option for you.

Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may even be able to use a new technique that was not available when you had your first procedure. If your tooth has unusual anatomy that was not cleaned and sealed during the first procedure, your endodontist may be able to resolve this problem with a second treatment.

Of course, there are no guarantees with any dental or medical procedure. Your endodontist will discuss your options and the chances of success before beginning retreatment.

What are the alternatives to retreatment?

The only alternatives to retreatment are having the tooth extracted or having it treated surgically.

The extracted tooth can then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth.

 

Endodontic surgery is also an option. This surgery involves making an incision near the end of the root to allow the tip of the root to be sealed. Endodontic surgery may be recommended in conjunction with retreatment or as an alternative. Your endodontist will discuss your options and recommend the appropriate treatment.

 

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