These points cover the main issues surrounding Root Canal Treatment.
Many people have a deep-seated fear of root canal (endodontic) treatment. They
will say gnot as bad as a root canalh - as if it is one of the worst human experiences.
Such fears are unfounded. In professional hands, root canal treatment is the best
way to keep your natural teeth and preserve good dental health. By having better
information about this treatment, you will understand why it is often called ethe
Why do teeth need root treatment?
The nerve and blood vessels in the tooth (known as edental pulpe) are there to
help the tooth grow to maturity. They protect against bacteria within the body.
Bacteria play a defensive role in the general mouth area, but can become destructive
when they attack the body via the dental pulp or through gum disease. Bacteria
cause decay in teeth. When the decay is deep, it can allow bacteria to invade
the dental pulp - the living tissue inside your teeth. Your dentist removes the
decay in the tooth to protect the pulp and to restore the function and appearance
of the tooth. However repeated bacterial attacks can weaken the pulp to such an
extent that the nerve can no longer recover, and so the pulp dies.
Is there an alternative to endodontic treatment?
If you choose not to have root treatment, your affected tooth will be extracted.
Should you fill the space? That depends on functional and aesthetic grounds. People
today are aware of their mouth and smile, so someone displaying unaesthetic black
gaps between their teeth may feel self-conscious about speaking or smiling. Back
teeth may not be immediately noticed in a smile, but they are very important in
terms of chewing function. Every tooth stabilizes the teeth adjacent to it and
those immediately above or below. If it is removed and not replaced, other teeth
may well shift from their natural positions. This will stimulate problems with
gum disease, food packing (leading to further decay) and bite problems.
How long does treatment take?
This will depend on the complexity of the root canals and any problems that are
encountered. To achieve success it is important that the procedure is not rushed.
A one, to one and a half hour appointment is usually required on the first visit;
further time required can be gauged at the end of this appointment. Often it is
possible to complete treatment in one visit. Re-treatment cases usually take a
little longer than first time treatments. It may be necessary to follow up on
the treatment on a regular basis to monitor healing.
If a tooth
needs extracting, what next?
Teeth can be replaced with bridges, implants or removable dentures and the possibilities
should be discussed with your own dentist. Implants have revolutionized restorative
dentistry and can be an excellent substitute for the natural tooth. The dental
root has often been described as nature's implant, so wherever possible existing
teeth should be kept in place. However there are situations when it is neither
feasible nor cost- effective to keep the tooth. The options have to be considered
carefully either by your general dental practitioner, or by an endodontics specialist.
How successful is endodontic treatment?
Nobody can guarantee success. However when the endodontic treatment and the restorative
treatment that follows it are both carried out to a high standard, long-term success
is very likely. Failure would be caused by the leakage of bacteria into the root
canal system or by mechanical failure i.e. fracture of the remaining tooth.
Should endodontic treatment fail, it may be possible to re-treat the tooth. If
further treatment is impossible, the tooth may require extraction. Endodontic
re-treatment may be carried by your own dentist or by an endodontist, depending
on the particular problems and reasons for the failure.
General dentist or root canal specialist?
General dentist are trained to carry out root canal treatment and many of them
do this to a very high standard. Whether root canal treatment is carried out by
your regular dentist or an endodontics specialist will depend on many factors.
Is your dentist skilled, experienced and confident in performing these kinds of
procedures? Is it a straightforward treatment or are there complications? The
molar teeth have a more complicated root canal system than the front teeth (incisors
and canines), are harder to access and may require more specialized equipment.
Is there an alternative to a dental implant ?
Your dentist may have told you that your tooth has to be extracted and can be
replaced with an implant. Is there an alternative? Although a dental implant is
recognised today as an excellent long-term solution, keeping original teeth is
What is Endodontist?
The Endodontist is a root canal specialist
With the lengthy education that an endodontist receives, they are able to perform
all aspects of root canal therapy including routine as well as complex root canals,
retreatments and endodontic surgery.
What is endodontic treatment?
gEndoh is the Greek word for ginsideh and godonth is Greek for gtooth.h Endodontic
treatment treats the inside of the tooth. Root canal treatment is one type of
To understand endodontic treatment, it helps to know something about the anatomy
of the tooth. Inside the tooth, under the white enamel and a hard layer called
the dentin, is a soft tissue called the pulp. The pulp contains blood vessels,
nerves, and connective tissue and creates the surrounding hard tissues of the
tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it
connects to the tissues surrounding the root. The pulp is important during a toothfs
growth and development. However, once a tooth is fully mature it can survive without
the pulp, because the tooth continues to be nourished by the tissues surrounding
Why do I need another endodontic procedure?
Initial Treatment may be completed in one or more visit depending on the treatment
required .Success for this type of treatment occurs in about 90% of cases , however
it sometimes fails when treatment falls short of acceptable standards . The reason
many teeth do not respond to root canal treatment is because of procedural errors
that prevent the control and prevention of intracanal endodontic infection . Undoubtedly,
the major factors associated with endodontic failure are the persistence of microbial
infection in the root canal system and/or the periradiculararea . In addition
, that procedural errors, such as broken instruments, perforations, overfilling,
underfilling, ledges and so on are the direct cause of endodontic failure.
A procedural accident often impedes or makes it impossible to accomplish appropriate
intracanal procedures. Thus, there is potential for failureof root canal treatment
when a procedural accident occurs during the treatment of infected teeth. So root
canal retreatment make it difficult in our clinical practice . Scientific evidence
indicates that some factors may be associated with the unsatisfactory outcome
of well-treated cases. They include microbial factors, comprising extraradicular
and/or intraradicular infections, and intrinsic or extrinsic nonmicrobialfactors
What will happen during retreatment?
First, the endodontist will discuss your treatment options. If you and your endodontist
choose retreatment, the endodontist will reopen your tooth to gain access to the
root canal filling material. In many cases, complex restorative materials-crown,
post and core material-must be disassembled and removed to permit access to the
After removing the canal filling, the endodontist can clean the canals and carefully
examine the inside of your tooth using magnification and illumination, searching
for any additional canals or unusual anatomy that requires treatment.
After cleaning the canals, the endodontist will fill and seal the canals and place
a temporary filling in the tooth. If the canals are unusually narrow or blocked,
your endodontist may recommend endodontic surgery. This surgery involves making
an incision to allow the other end of the root to be sealed.
After your endodontist completes retreatment, you will need to return to your
dentist as soon as possible to have a new crown or other restoration placed on
the tooth to protect and restore it to its full function.
retreatment the best choice for me?
Whenever possible, it is best to save your natural tooth. Retreated teeth can
function well for years, even for a lifetime.
Advances in technology are constantly changing the way root canal treatment is
performed, so your endodontist may use new techniques that were not available
when you had your first procedure. Your endodontist may be able to resolve your
problem with retreatment.
As with any dental or medical procedure, there are no guarantees. Your endodontist
will discuss your options and the chances of success before beginning retreatment.
What are the alternatives to retreatment?
If nonsurgical retreatment is not an option, then endodontic surgery should be
considered. This surgery involves making an incision to allow access to the tip
of the root. Endodontic surgery may also be recommended in conjunction with retreatment
or as an alternative. Your endodontist will discuss your options and recommend
What are the alternatives to endodontic
retreatment and/or endodontic surgery?
The only other alternative is extraction of the tooth. The extracted tooth must
then be replaced with an implant, bridge or removable partial denture to restore
chewing function and to prevent adjacent teeth from shifting. Because these options
require extensive surgery or dental procedures on adjacent healthy teeth, they
can be far more costly and time consuming than retreatment and restoration of
the natural tooth.
No matter how effective tooth replacements are-nothing is as good as your own
natural tooth. Youfve already made an investment in saving your tooth. The payoff
for choosing retreatment could be a healthy, functioning natural tooth for many
years to come.
Why would I need endodontic surgery?
Surgery can help save your tooth in a variety of situations. Surgery may be used
in diagnosis. If you have persistent symptoms but no problems appear on your x-ray,
your tooth may have a tiny fracture or canal that could not be detected during
nonsurgical treatment. In such a case, surgery allows your endodontist to examine
the entire root of your tooth, find the problem, and provide treatment.Sometimes
calcium deposits make a canal too narrow for the instruments used in nonsurgical
root canal treatment to reach the end of the root. If your tooth has this gcalcification,h
your endodontist may perform endodontic surgery to clean and seal the remainder
of the canal.
Usually, a tooth that has undergone a root canal can last the rest of your life
and never need further endodontic treatment. However, in a few cases, a tooth
may not heal or become infected. A tooth may become painful or diseased months
or even years after successful treatment. If this is true for you, surgery may
help save your tooth.
Surgery may also be performed to treat damaged root surfaces or surrounding bone.
Although there are many surgical procedures that can be performed to save a tooth,
the most common is called apicoectomy or root-end resection. When inflammation
or infection persists in the bony area around the end of your tooth after a root
canal procedure, your endodontist may have to perform an apicoectomy.
What is an apicoectomy?
In this procedure, the endodontist opens the gum tissue near the tooth to see
the underlying bone and to remove any inflamed or infected tissue. The very end
of the root is also removed. A small filling may be placed in the root to seal
the end of the root canal, and a few stitches or sutures are placed in the gingiva
to help the tissue heal properly.Over a period of months, the bone heals around
the end of the root.
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