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Endodontics

A tooth is composed of three layers

Enamel

Enamel

The outer layer, whose hard surface helps grind food and protect the tooth from decay
Dentin

Dentin

The slightly softer middle layer, composed of calcium, collagen, water, and other organic materials
the Pulp

the Pulp

The softest and innermost later: the pulp, holding connective tissues, blood vessels, and nerves

Endodontics

Endodontics is the study of these inner layers of the tooth, in particular, the pulp. Endodontics has evolved tremendously in the past decade and its applications have immensely improved the quality of dental treatment for our patients.

What is a Root Canal Treatment, and when is it necessary?

When the nerve of a tooth becomes infected, root canal treatment can save the tooth. You may realize you have an infected tooth because it’s sensitive to hot or cold, it causes swelling and pain, or it gives you a bad taste in your mouth. Occasionally, you may be completely unaware that you have an infected tooth because you experience no symptoms at all. 

A root canal is necessary when infection has reached the pulp of the tooth. The presence of nerves, arteries, and veins inside the pulp accounts for the pain many people experience with a bad infection. 

The pulp extends from the pulp chamber down through a narrow channel, which is the root canal, all the way to the tip of the root. In general, teeth in the front of the mouth have one or two root canals, while teeth in the back of the mouth have two, three or four root canals. 

How do teeth become infected?

Though some teeth without cavities can become infected, deep cavities are the main cause of infection. Cavities first wear away the enamel, creating a small hole in the outer surface of the tooth which can eventually allow germs to infect the inner layers of the tooth. Deep cavities can allow germs to get into the pulp chamber. These germs create infection, causing the pulp to die. If left untreated, the infection can eventually build up at the root tip and create a hole in the jaw bone. This is called an abscess. A severe blow to a tooth may also cause the pulp to die and then become infected. 

An infected tooth will never heal on its own, and as it gets worse, it will continue to be a source of infection that drags down your immune system, and can affect your entire body. This damage to the bone and the swelling inside the bone can be excruciatingly painful, and even life threatening. Years ago, an infected tooth would simply have to be extracted, but today, we can save your tooth with root canal treatment.

Why might a chipped tooth need a root canal treatment?

Any time a tooth has been damaged and needs a restoration, including a crown or a filling, there’s a possibility that the tooth pulp has been injured and will eventually die, resulting in the need for a root canal to save the tooth.

While a crown for example, is necessary to protect the outside of the tooth, it doesn’t do anything to protect the pulp inside. If after any procedure the pulp becomes infected, only a root canal can save your tooth.

Can a root canal be performed when a crown is in place?

If you’ve had a crown placed on your tooth, it’s been permanently cemented in place. There are a few options to choose from. In some cases, a small hole can be made in the crown to get at the infection, and the root canal can be performed through the crown. We use dental files to carefully clean out the infected tissue and shape the canals to receive the filling material. We take X-rays to make sure that all of the infected pulp is removed. After placing the filling material, we then simply place a filling in the hole in the crown. In other cases, we need to remove the crown to properly perform the root canal. We then seat a new crown on the newly root-canaled tooth.

Root canal treatment at 7Dental is as easy as 1..2..3!

We want the entire root canal procedure to be comfortable for you, so the first thing we’ll do is make sure you’re thoroughly numb. Root canal treatment and restoring the tooth usually involves three steps. We place a rubber dam around your tooth to isolate it from the rest of your mouth. It protects you like a safety net; nothing can fall to the back of your throat, while also keeping the tooth dry and accessible so we can do a better job. First, we remove the infection to promote healing. Next, we place filling material in the root canals, and then we crown the tooth to protect it. To get at the infection, we make an opening through the top of the tooth down into the pulp chamber. To accomplish this, we use a tool called a dental file. We use it to carefully clean out the infected tissue and shape the canals to receive the filling material. We take an X-ray to make sure that all of the infected pulp is removed. Then we place filling material to fill the root canals.

In some cases your root canal treatment may require two visits to complete. In that case, we place a medicine in the tooth and place a temporary filling, and schedule another appointment to complete the procedure. On the second appointment, we remove the temporary filling and place filling material into the root canals.

Apicectomy

An apicoectomy is a minor surgical procedure, necessary when root canal treatment hasn’t completely healed an infected tooth. After root canal treatment, an abscess, which is a hole in the bone at the tip of the root, sometimes continues to grow. To stop the infection, we make a small incision in the gums. We remove the infection and then seal the tip of the root. Once this has been done, the infection will heal, new bone will grow in, and the tooth will be healthy again.

Post and Core Procedure

Sometimes, when a tooth has broken off due to fracture or decay, there’s simply not enough tooth remaining to place a crown. Fortunately, there is a way to replace the missing portion and save the tooth by placing a post and using it to anchor a buildup, which is also called a core.

The first step in placing a post is performing root canal therapy on the tooth. The nerve of the tooth is removed and replaced by a filling material. The top of the root canal is then shaped. A post is selected, tried in, and then cemented or bonded in place. Depending on the situation, we may use posts made of metal, fiber-reinforced plastic, or carbon fiber.

After the post is in place, the next step is the placement of the new core material. Once hardened, the core material is prepared and shaped, and an impression is taken. The placement of the temporary crown completes the first appointment. On the second appointment, the temporary crown is removed. The permanent crown is tried in and then cemented in place.  When a tooth is severely broken down, a post and core procedure is an excellent way to save the tooth.

Possible Alternatives to root canal treatment

Once the pulp of a tooth has become infected, your choices are limited. You could choose to have the tooth extracted, or you could choose to save your tooth with root canal treatment. The problem with delaying treatment is that an infected tooth will NEVER heal on its own, and this can lead to some very serious problems.

As the infection spreads down the tooth and into your jawbone, the pain may become excruciating. It could even put you in the hospital and threaten your life. An extraction is only a short-term solution. While it does remove the source of infection, it may off a chain reaction of shifting teeth and other dental problems. The only way to save your tooth and keep it in your mouth is to remove the infection with a root canal treatment.

If you have any questions or concerns about root canal treatments, please do not hesitate to speak with our friendly and compassionate dentists. We are here for your comfort, and to give you as much information as possible about any procedures you may require.

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