New techniques in anesthesia make root canal treatment virtually painless for patients.
Patient Information
In order to understand endodontic treatment,
it helps to know something about the anatomy
of a tooth. Teeth have several layers. The
outside layer of the tooth is composed of a
hard layer called enamel. Enamel is supported
by an inner layer called dentin, which has at its
center a soft tissue known as the pulp.
The pulp contains blood vessels, nerves, and
connective tissue that are responsible for
forming the surrounding dentin and enamel
during tooth development. The pulp receives its
nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.
Root Canal Therapy
Root canal therapy is one of the most common
dental procedures performed in a dental office.
Root canal therapy can save your natural teeth
and prevent the need for dental implants or
bridges. Infection or inflammation of the pulp can
be caused by trauma to the tooth, deep decay,
cracks, or dental restorations. The infection or
inflammation can sometimes be identified
sometimes visibly by swelling and sometimes only
by symptoms, such as sensitivity to temperature
or pain in the tooth and gums.
If you experience any of these symptoms, your dentist will most likely recommend non-surgical root canal therapy to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned, shaped, and sealed. This procedure may be completed in one or more visits depending on the type of treatment required. If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment.
We use profound local anesthesia to eliminate discomfort. In addition, we may provide oral sedatives, nitrous oxide sedation, and or intravenous anesthesia with the aid of an anesthesiologist. If you are treated with just local anesthesia you will be able to drive home after your treatment, and you will most likely be able to return to your normal routine. If you have taken oral sedatives or intravenous anesthesia, you will need to arrange transportation to and from the office, as you will not be able to drive yourself home.
Endodontic Retreatment
Teeth that have had endodontic treatment can last as long as natural, untreated teeth. However, a tooth that has received treatment may not heal or may continue to have painful symptoms. Sometimes, pain or other signs of failure may occur months or even years after treatment. If so, Endodontic Retreatment may be necessary.
Teeth that have had endodontic treatment can last as long as natural, untreated teeth. However, a tooth that has received treatment may not heal or may continue to have painful symptoms. Sometimes, pain or other signs of failure may occur months or even years after treatment. If so, Endodontic Retreatment may be necessary.
Inadequate healing may be due to:
-Curved or calcified canals that were not cleaned during the initial treatment.
-Additional canals were undetected and untreated during the initial treatment. -The crown or restoration was not placed within the appropriate amount of time following the initial root canal procedure.
-The crown or filling did not prevent bacteria from leaking inside the tooth and resulted in contamination of the previous root canal filling.
-Additional canals were undetected and untreated during the initial treatment. -The crown or restoration was not placed within the appropriate amount of time following the initial root canal procedure.
-The crown or filling did not prevent bacteria from leaking inside the tooth and resulted in contamination of the previous root canal filling.
-New decay resulted in exposure of the root canal filling material, causing infection.
-A cracked or loose filling or crown lead to exposure of the tooth to new infection.
-A cracked or loose filling or crown lead to exposure of the tooth to new infection.
Surgical Root Canal Therapy
Apicoectomy: An overview of endodontic surgery.
Generally, a root canal is all that is needed to save teeth with an injured pulp from extraction. Occasionally, though, this non-surgical procedure is not sufficient and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated during this procedure. The most common surgery used to save damaged teeth is called an apicoectomy or root-end resection.
Apicoectomy: An overview of endodontic surgery.
Generally, a root canal is all that is needed to save teeth with an injured pulp from extraction. Occasionally, though, this non-surgical procedure is not sufficient and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated during this procedure. The most common surgery used to save damaged teeth is called an apicoectomy or root-end resection.
What is an Apicoectomy? An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. If needed, a root-end filling is placed to prevent reinfection of the root and the gum is sutured closed. The bone naturally heals around the root over a period of months restoring the tooth back to full function.
Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.
Cracked Teeth
Cracked teeth manifest with many types of symptoms. Some symptoms include pain when chewing, temperature sensitivities, or pain with the release of biting pressure. It is also common for pain to come and go, making it difficult to diagnose the cause of discomfort.
Cracked teeth manifest with many types of symptoms. Some symptoms include pain when chewing, temperature sensitivities, or pain with the release of biting pressure. It is also common for pain to come and go, making it difficult to diagnose the cause of discomfort.
Chewing can cause movement of the cracked pieces of your tooth, and the pulp within the tooth becomes irritated. At the same time, when biting pressure is released, the crack can close quickly, resulting in sharp pain. Eventually, the pulp will become damaged and tooth will consistently hurt, even if you are not chewing. It is possible that cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.
Types of Cracks
-Craze lines:
These are tiny cracks that only affect the outer enamel of the tooth. These cracks are more common in adults. These types of cracks are superficial and are usually of no concern.
-Craze lines:
These are tiny cracks that only affect the outer enamel of the tooth. These cracks are more common in adults. These types of cracks are superficial and are usually of no concern.
-Fractured Cusp:
When a cusp becomes weakened, a fracture may result. The cusp may break off or be removed by a dentist. A fractured cusp rarely damages the pulp, so root canal is not necessary. Your dentist will usually restore the tooth with a full crown.
When a cusp becomes weakened, a fracture may result. The cusp may break off or be removed by a dentist. A fractured cusp rarely damages the pulp, so root canal is not necessary. Your dentist will usually restore the tooth with a full crown.
Dental Trauma
Luxation, Intrusion, or Extrusion -
Injuries to the mouth can cause teeth to be dislodged from their natural position in their sockets. Your endodontist or dentist may reposition and stabilize your tooth. Root canal treatment is usually started within a few weeks of the injury and a medication will be placed inside the tooth. Eventually, a permanent root canal filling will be placed. Sometimes a tooth may be pushed partially out of the socket. Again, your endodontist or dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. Yet, if the pulp becomes damaged or infected, root canal treatment will be required.
Injuries to the mouth can cause teeth to be dislodged from their natural position in their sockets. Your endodontist or dentist may reposition and stabilize your tooth. Root canal treatment is usually started within a few weeks of the injury and a medication will be placed inside the tooth. Eventually, a permanent root canal filling will be placed. Sometimes a tooth may be pushed partially out of the socket. Again, your endodontist or dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. Yet, if the pulp becomes damaged or infected, root canal treatment will be required.
Avulsed Teeth
If an injury causes a tooth to be completely removed from your mouth, it is important that you are treated immediately! If this happens, keep the tooth moist. If possible, put it back into the socket immediately. A tooth can be saved if it remains moist. You can even put the tooth in milk or a glass of water (add a pinch of salt). Your Endodontist may start root canal treatment based upon the stage of root development. Several factors influence the type of treatment that you receive, including the length of time the tooth was out of your mouth and the way the tooth was stored.
Injuries in children
An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:
An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:
Apexogenesis
This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth. Root canal treatment may be necessary in the future.
This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth. Root canal treatment may be necessary in the future.
Apexification
In this case, the unhealthy pulp is removed. Medication is placed into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures, so it is important to have the tooth properly restored by your dentist
In this case, the unhealthy pulp is removed. Medication is placed into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures, so it is important to have the tooth properly restored by your dentist
Post-Operative Instructions:
Endodontic treatment has now been completed. The root canal system has been permanently sealed. However, the outer surface is sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay. Please telephone your restorative dentist for an appointment. A complete report of treatment will be sent to your restorative dentist.
Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation during treatment and previous condition of your tooth. This tenderness is normal and is no cause for alarm. This mild discomfort will be relieved by Aspirin, Tylenol, Advil, or the like. Occasionally moderate to severe discomfort may occur. If medication has been prescribed, use it according to the directions. If you do not have a prescription for pain medication, please call the office. Some swelling is possible. Call the office if more than a slight puffiness occurs. If antibiotics have been prescribed, please take them according to directions until they are used up. If any other problems develop, please notify the office as soon as possible.
In order to protect the tooth against fracture during or immediately after treatment, avoid chewing on the tooth until the final restoration has been placed by your general dentist. You may continue your regular dental hygiene regimen.
Root Canal Therapy
Root Canal Retreatment
Cracked Teeth
Dental Trauma
Surgical Endodontics
Specialist in Endodontics
Phone: 310-855-0444
8920 Wilshire Boulevard, Suite 403
Beverly Hills, CA 90211
