Your tooth consists of two main parts: the crown, which is that part of the tooth above the gum and visible in your mouth; and the root or roots, which is that part of the tooth that lies beneath the gum and is surrounded by bone. Inside each root is a channel that runs the length of the tooth. This channel is the root canal and contains the pulp (nerves, blood vessels, and soft tissue), which is often referred to as the “nerve” of the tooth. The pulp may be irreversibly damaged by bacteria associated with decay, very deep restorations, fractures, trauma, or periodontal disease.
In order to preserve a tooth in which this has occurred, it is necessary to remove the diseased pulp tissue. This procedure is known as endodontic therapy. Since endodontic therapy is concerned with removing only the pulp from the root canal, the root will continue to function normally because the supporting tissues remain intact. It is advisable to remove the injured pulp because it may become infected or act as an irritant to the tissues surrounding the tooth.
Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or “root canal” contains a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontic specialist, such as Drs. Hymovitch, Lally, Ahmed, Sather, Colorado, Gano, Elseed, Sadykov and Salazar, removes the diseased pulp to save the tooth and prevent further infection and inflammation. After successful endodontic treatment, the tooth continues to perform normally.
No. While x-rays will be necessary during your endodontic treatment, we use an advanced non-film computerized system, called digital radiography, that produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to cotherapists via e-mail or CD-ROM. For more information contact Sirona Dental Systems, Inc.
Again, there’s no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.
When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact his office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.
In addition to digital radiography, we utilize special operating microscopes. Magnification and fiber optic illumination are helpful in aiding the doctor to see tiny details inside your tooth. Also, a tiny video camera on the operating microscope can record images of your tooth to further document the doctor’s findings.
Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and Drs. Hymovitch, Lally, Ahmed, Sather, Colorado, Gano, Elseed, Sadykov and Salazar 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 with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.
Root Canal Treatment
What is a root canal?
A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
At the center of your tooth is pulp. Pulp is a collection of blood vessels that helps to build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, 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 treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. Root canal therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 90% of cases. 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. Drs. Hymovitch, Lally, Ahmed, Sather, Colorado, Gano, Elseed, Sadykov and Salazar use local anesthesia to eliminate discomfort. In addition, we will provide nitrous oxide analgesia, if indicated. You will be able to drive home after your treatment, and you probably will be comfortable returning to your normal routine.
What happens after treatment?
When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond. To prevent further decay, continue to practice good dental hygiene.
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. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.
What should I expect after an apicoectomy?
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 demonstrate many types of symptoms, including pain when chewing, temperature sensitivities, or even the release of biting pressure. It is also common for tooth 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 when 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.