Posts for tag: root canal
It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.
Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.
Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.
Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.
For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.
If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.
As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.
If you would like more information on caring for primary teeth, 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 for Children’s Teeth.”
Which would you rather have — the flu or a root canal procedure? Nearly 80 percent of people recently surveyed by the American Association of Endodontists wisely chose the root canal. If this takes you by surprise, then let us bring you up to date on root canal treatment today. It’s nothing like the experience that once made it the butt of jokes and a benchmark against which other “undesirable” experiences were measured.
The term “root canal” actually has two meanings. It is part of the pulp-filled chamber at the center of every tooth containing nerves and blood vessels that keeps teeth vital (alive). It’s also the endodontic (endoÂ = inside; dont = tooth) procedure that treats inflammation and infection in this tissue. Common causes of pulp problems are traumatic damage (for example a crack, chip, or root fracture), deep decay, or gum disease.
The first sign of a problem is typically pain — ranging from acute and intense pangs when biting down, to lingering discomfort after consuming hot or cold foods, to a chronic dull ache and pressure, or tenderness and swelling in nearby gums. The primary pain may abate as the nerves in the pulp die, but the infection will continue, compromising the affected tooth, jeopardizing the health of the surrounding tissues, and often triggering secondary pain.
Pain-Relieving, Tooth-Saving Treatment
Endodontic treatment, by contrast, is no more uncomfortable than having a cavity filled. The tooth and surrounding area are numbed with a local anesthetic before the procedure begins. In order to access the diseased pulp, a small opening is made in the biting surface of the tooth. Tiny instruments are used to remove the pulp, clean and disinfect the root canal(s) and pulp chamber, and prepare the empty tooth interior to receive a biocompatible filling material to prevent bacteria from returning. A permanent crown may be placed over the tooth at that time, or a second visit may be needed. A crown (cap) is important to the tooth's long-term strength and functionality.
For a day or two following treatment you may experience temporary sensitivity, which often responds to an over-the-counter medication like ibuprofen. Occasionally, prescription medications, including antibiotics, may be needed.
All in all, doesn’t saving a tooth sound easier and more constructive than coming down with the flu?
If you would like more information about root canal treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “A Step-By-Step Guide To Root Canal Treatment.”
As a new permanent tooth develops, the roots undergo a process of breakdown and growth. As older cells dissolve (a process called resorption), they’re replaced by newer cells laid down (deposition) as the jaw develops. Once the jaw development ends in early adulthood, root resorption normally stops. It’s a concern, then, if it continues.
Abnormal root resorption most often begins outside of the tooth and works its way in, beginning usually around the neck-like (or cervical) region of the tooth. Also known as external cervical resorption (ECR), the condition usually shows first as pink spots where the enamel is being undermined. As these spots continue to erode, they develop into cavity-like areas.
While its causes haven’t been fully confirmed, ECR has been linked to excessive pressure on teeth during orthodontic treatment, periodontal ligament trauma, teeth-grinding or other excessive force habits, and bleaching techniques performed inside a tooth. Fortunately, ECR is a rare occurrence, and most people who’ve had these problems won’t experience it.
When it does occur, though, it must be treated as quickly as possible because the damage can progress swiftly. Treatment depends on the size and location of the resorption: a small site can often be treated by surgically accessing the tooth through the gum tissue and removing the offending tissue cells. This is often followed with tooth-colored dental material that’s bonded to the tooth to replace lost structure.
A root canal treatment may be necessary if the damage has extended to the pulp, the tooth’s interior. However, there’s a point where the resorption becomes too extensive to save the tooth. In these cases, it may be necessary to remove the tooth and replace it with a dental implant or similar tooth restoration.
In its early stages, ECR may be difficult to detect, and even in cases where it’s been diagnosed more advanced diagnostics like a CBCT scanner may be needed to gauge the extent of damage. In any case, it’s important that you have your teeth examined on a regular basis, at least twice a year. In the rare chance you’ve developed ECR, the quicker it’s found and treatment begun, the better your chances of preserving the tooth.
Tooth preservation is the ultimate aim of a root canal treatment. But how long should you expect a treated tooth to last? The answer will depend on a few different variables.
A root canal treatment is necessary when a tooth’s pulp — the inner tissue made of nerves, blood vessels and connective tissues — becomes infected with disease. As the pulp dies, the infection spreads into the adjacent bone; this can eventually lead to loss of the tooth.
To stop this process, we enter the tooth and remove all of the pulp, disinfect the pulp chamber and the root canals, and then fill the chamber and canals. Depending on the type of tooth and level of decay, we seal the tooth with a filling or install a crown to prevent re-infection. it’s then quite possible for a treated tooth to survive for years, decades, or even a lifetime.
There are a number of factors, though, that may affect its actual longevity. A primary one depends on how early in the disease you receive the root canal treatment. Tooth survival rates are much better if the infection hasn’t spread into the bone. The earlier you’re treated, the better the possible outcome.
Tooth survival also depends on how well and thorough the root canal is performed. It’s imperative to remove diseased tissue and disinfect the interior spaces, followed by filling and sealing. In a related matter, not all teeth are equal in form or function. Front teeth, used primarily for cutting and incurring less chewing force, typically have a single root and are much easier to treat than back teeth. Back teeth, by contrast, have multiple roots and so more root canals to access and treat. A front tooth may not require a crown, but a back tooth invariably will.
These factors, as well as aging (older teeth tend to be more brittle and more susceptible to fracture), all play a role in determining the treated tooth’s survival. But in spite of any negative factors, a root canal treatment is usually the best option for a diseased or damaged tooth. Although there are a number of good options for replacing a lost tooth, you're usually better in the long run if we can preserve your natural tooth for as long as possible.
If you would like more information on root canal treatments, 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: How Long Will it Last?”