Endodontics is a branch of dentistry recognized by the American Dental Association involving diagnosis and 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, trauma, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontic specialist removes the diseased pulp to save the tooth and prevent further inflammation and infection. After successful endodontic treatment, the tooth continues to perform normally.
Endodontic treatment is necessary when the pulp of a tooth becomes inflamed or infected. The causes of the inflammation or infection include deep decay, repeated dental procedure on a tooth or a crack or chip in the tooth. In addition, a blow to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
Inflammation and infection spread down the root canal, often causing sensitivity to hot or cold foods, throbbing, aching, or pain when chewing. Pain may be prolonged, constant, or be intermittent and transient. Often nerve damage causes tooth pain, swelling, and sensitivity to hot or cold and a spontaneous wave of discomfort day and night. Also, the tooth may begin to darken in color. However, sometimes a root canal problem can only be diagnosed with an X-ray or other tests. Microscopes and digital X-rays are rapidly becoming invaluable and becoming the standard of care for correct diagnosis.
During root canal treatment, the endodontist cleans out the infected pulp tissue within the roots. After all the nerve has been removed, the canals are sterilized and filled.
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterwards the general dentist will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
The biggest criticism of the implant world today is that far too many teeth are being removed that could have been saved with a good long-term prognosis with correct endodontic treatment or re-treatment. Our observation over the years is that every single implant course shows cases where implant placement was unnecessary, and this is simply wrong. That is why it is important to consult with an endodontist who also does implants so you will receive the best possible advice before removing a tooth.
Implant technology, advancing both surgical and restorative aspects, has made dental implants the optimal tooth replacement in almost all clinical cases. The dental implant simply and predictably prevents bone loss and restores function and esthetics without impacting or involving adjacent teeth. Bridge replacement opens a Pandora’s box for future dental problems on adjacent abutment teeth and simply does not have as good a long-term prognosis as a dental implant replacement.
The bone socket resorbs away, adjacent teeth shift opposite teeth extrude out of the socket. A healthy bite will collapse with remaining teeth in the area, causing them to become crooked. All this deterioration is associated with lip and cheek wrinkling with time. Today, a dental implant is the ideal way to prevent these problems associated with early tooth loss when successful endodontic treatment is not possible.
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics most patients report that they are comfortable during the procedure. We pride ourselves in making all our office treatments a good experience.
For the first few days after treatment, a tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications.
A tooth may continue to feel slightly different from other teeth after endodontic treatment is completed. However, with severe discomfort or pressure that lasts more than a few days, please call the office. We need to monitor post-treatment healing with post-operative telephone calls and/or office visits if necessary.
One should not chew or bite hard on a treated tooth until it has been restored by the general dentist. The unrestored tooth is susceptible to fracture, so it is important to have a full restoration at the general dentist as soon as possible. Later, one needs only to practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.
Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. And, when root canal treatment is not effective, endodontic surgery may be able to save the tooth. After the root is fixed surgically, osseous grafting and guided bone regenerative procedures and tissue engineering have allowed us to save many more teeth than ever before because of our doctor’s ability to grow back a new socket around previously damaged roots.
When the pulp of a tooth is damaged, the only alternative to endodontic treatment is extraction of the tooth. To restore chewing function and to prevent adjacent teeth from shifting, the extracted tooth must be replaced with an implant or bridge. This requires surgery or dental procedures on adjacent healthy teeth and can be far more costly and time-consuming than endodontic treatment and restoration of the natural tooth.
No. While x-rays will be necessary during your endodontics treatment, we use an advanced non-film computerized system, called digital radiography, which 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 co therapists via e-mail or diskette. For more information contact Schick Technologies, 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, original radiographs and a record of your treatment will be sent to your restorative dentist. You may need to contact the 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.
Electric Apex Locators: In certain cases electric apex locators can minimize the number of x-rays needed to complete root canal treatment.
Ultrasonics: Ultrasonic instruments can be valuable to remove or loosen obstructions that would otherwise prevent reliable endodontic therapy.
For your convenience, we have four locations in Central New England to serve you:
67 Highland Street
Worcester, MA 01609
888-768-ROOT
55 Court Street
Keene, NH 03431
888-852-ROOT
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