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Posts for tag: root canal treatment

By Don Fortner, DMD
September 23, 2019
Category: Dental Procedures
TheBeforeDuringandAfterofRootCanalTreatments

Root canal treatments have suffered a bad rap over the years—and undeservedly. While we applaud root canal therapy for the millions of decayed teeth the procedure has saved, the worn-out cliché that it's painful still lingers on.

So, let's set the record straight: a root canal treatment doesn't cause pain, it most often relieves it. Let's look a little closer at what actually happens before, during and after this tooth-saving treatment.

Before: a tooth in crisis. Tooth decay can damage more than a tooth's outer enamel. This aggressive bacterial infection can work its way into a tooth's interior, destroying the nerves and blood vessels in the pulp, before moving on to the roots and supporting bone through the root canals. Untreated, this devastating process can lead to tooth loss. A root canal treatment, however, can stop the invading decay and save the tooth.

During: stopping the disease. The dentist first numbs the tooth and surrounding gum tissues with local anesthetic—the only thing you might normally feel during treatment is a slight pressure. They then drill into the tooth to access the inner pulp and root canals and remove all diseased tissue. Once the interior spaces of the tooth have been disinfected, the dentist then fills the empty pulp chamber and root canals with a pliable filling called gutta percha to prevent future infection.

After: preventing re-infection. With the filling complete, the dentist then seals the access hole. There may be some minor soreness for a few days, similar to the aftermath of a routine filling, which can usually be managed with over-the-counter pain relievers like ibuprofen. Sometime later, the dentist will normally finish the treatment with a new crown on the tooth. This accomplishes two things: It helps strengthen the tooth against stress fracturing and it provides another layer of protection against future decay.

Root canal treatments have an exceptional track record for giving diseased teeth a second chance. There's nothing to fear—and everything to gain for your troubled tooth.

If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment: What You Need to Know.”

DespiteSomeOnlineSourcesRootCanalsDontCauseDisease

The internet has transformed how we get information. Where you once needed to find an encyclopedia, telephone directory or library, you can now turn to your handy smartphone or tablet for the same information.

But this convenience has a dark side: A lot of material online hasn’t undergone the rigorous proofreading and editing published references of yesteryear once required. It’s much easier now to encounter misinformation—and accepting some of it as true could harm your health. To paraphrase the old warning to buyers: “Viewer beware.”

You may already have encountered one such example of online misinformation: the notion that undergoing a root canal treatment causes cancer. While it may sound like the figment of some prankster’s imagination, the idea actually has a historical basis.

In the early 20th Century, a dentist named Weston Price theorized that leaving a dead anatomical part in the body led to disease or major health problems. In Price’s view, this included a tooth that had undergone a root canal treatment: With the vital pulp removed, the tooth was, in his view, “dead.”

Price amassed enough of a following that the American Dental Association rigorously investigated his claims in the 1950s and found them thoroughly wanting. For good measure, a Journal of the American Medical Association (JAMA Otolaryngology—Head & Neck Surgery) published a study in 2013 finding that not only did canal treatments not increase cancer, but they might even be responsible for decreasing the risk by as much as forty-five percent.

Here’s one sure fact about root canal treatments—they can save a tooth that might otherwise be lost. Once decay has infiltrated the inner pulp of a tooth, it’s only a matter of time before it spreads through the root canals to the bone. Removing the infected pulp tissue and filling the resulting empty space and root canals gives the tooth a new lease on life.

So, be careful with health advice promoted on the internet. Instead, talk to a real authority on dental care, your dentist. If they propose a root canal treatment for you, they have your best health interest—dental and general—at heart.

If you would like more information on root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Safety: The Truth About Endodontic Treatment and Your Health.”

WhyAlfonsoRibeiroIsGratefulforRootCanalTreatment

As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."

The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"

Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.

Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.

Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.

Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!

If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”

WemayStillbeAbletoSaveYourToothwithaRootCanalAlternative

Your tooth is in peril if its innermost layer, the pulp, becomes infected and inflamed. Deep tooth decay, repeated dental procedures or fractures can all expose the pulp and ultimately the roots to infection and lead to tooth loss.

But that scenario isn't inevitable — we can often save the tooth with a root canal treatment. By accessing the tooth's interior through a prepared hole, we're able to clean out the infected tissue in the pulp chamber and root canals, and fill the empty space with a special filling. We then cap the tooth with a custom crown to protect it from a re-infection.

Root canal treatments have a very high success rate — chances are good your tooth will survive for many years afterward. But there's a slight chance the tooth may become re-infected; in that case, a second root canal treatment may be in order.

In a few cases, though, a second root canal may not be advisable, and could even accelerate damage to the tooth. For example, if past dental work resulted in an extensive crown restoration, accessing the root canals the conventional way will require disassembling that restoration. This could weaken the tooth significantly.

We can approach the problem from a different route: instead of accessing the tooth's interior through the crown (the visible part of the tooth), we instead perform a surgical procedure called an apicoectomy, which accesses the tooth at the root end through the gums.

In this procedure we numb the area with local anesthesia and then make a small incision through the gums at the level of the affected root. After access, we remove any diseased tissue around the root and a few millimeters of the root tip itself. We then insert a small filling in its place to seal the canal and prevent further infection. In some cases we may also insert a graft to encourage bone growth and aid in healing.

Over time, the affected area will heal and return to normal function. Even if a traditional root canal treatment can't be used, an apicoectomy could be another option for saving your tooth.

If you would like more information on your options for preserving a problem tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Apicoectomy.”

WhatHappensinaRootCanalTreatmentandHowitCanSaveYourTooth

Along with periodontal (gum) disease, tooth decay poses one of the two greatest threats to your teeth. Cavities are just the start: if decay invades the pulp, the tooth’s innermost layer, the infection created can continue to advance through the root canals to the supporting bone. This worst case scenario could cost you your tooth.

But we can stop this advanced decay in its tracks with a procedure called a root canal treatment. A root canal essentially removes all the infected tissue within the tooth and then seals it from further infection. And contrary to its undeserved reputation for being painful, a root canal can actually stop the severe tooth pain that decay can cause.

At the beginning of the procedure, we deaden the affected tooth and surrounding tissues with local anesthesia—you’ll be awake and alert, but without pain. We then isolate the tooth with a dental dam of thin rubber or vinyl to create a sterile environment around it to minimize contamination from bacteria found in saliva and the rest of the mouth.

We then drill a small hole through the enamel and dentin to access the interior of the tooth. With special instruments, we remove and clean out all the diseased or dead tissue in the pulp chamber and root canals. After disinfecting the empty spaces with an antibacterial solution, we’ll shape the root canals to make it easier to perform the next step of placing the filling.

To fill all the root canals and pulp chamber, we typically use a rubber-like material called gutta-percha. Because it’s thermoplastic (“thermo”—heat; “plastic”—to shape), we can compress it into and against the walls of the root canals in a heated state to fully seal them. This is crucial for preventing the empty tooth interior from becoming re-infected. Afterward, we’ll seal the access hole with its own filling; later, we’ll bond a permanent crown to the tooth for additional protection and cosmetic enhancement.

After the procedure you may have some temporary minor discomfort usually manageable with aspirin or ibuprofen, but your nagging toothache will be gone. More importantly, your tooth will have a second chance—and your dental health and smile will be the better for it.

If you would like more information on treating tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”