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Root Canal Treatment
Inside of a healthy tooth is live tissue called the dental pulp. This is commonly referred to as the nerve, but consists of connective tissue and blood vessels in addition to nerves. The pulp can become injured due to trauma or tooth decay. The pulp often becomes inflamed and causes pain but can often die and become infected with minimal pain. Once the pulp dies, it no longer has blood supply, and thus loses the protection of the body’s immune system. The only way to stop the infection is to either remove the pulp or remove the tooth. The purpose of root canal treatment is to remove inflamed or infected tissue without requiring a person to lose the tooth.
Root canal treatment involves accessing the inflamed or infected pulp and cleaning out the canal space, then filling it with a material (usually gutta percha) that helps prevent bacteria from growing in the canals. The tooth then needs to be restored with a permanent filling, and often a crown. In most cases, the pain resolves and any abscess heals and is replaced with healthy bone.
In most cases, root canal treatment resolves the pain and infection associated with diseases of the dental pulp. As with any dental or medical treatment, however, root canal treatment does not work as expected in some cases. If the initial treatment did not remove all infected tissue or if the filling material has become re-infected, endodontic retreatment is usually the best way to manage the problem.
Retreatment consists of entering the tooth again and removing all old root canal filling materials. At this time, the tooth is inspected under high magnification to see if there is a clear reason for the continued or recurrent infection, such as cracks or untreated canals. The canal system is then disinfected and refilled with clean filling material. The process of retreatment is often performed in two separate appointments. After treatment is completed, a new restoration, either a crown or a filling, is necessary to seal the tooth and prevent further infection.
In most cases, root canal treatment resolves the pain and infection originating from a diseased tooth. In some cases, however, an additional surgical procedure may be necessary to resolve the infection. Apicoectomy, or endodontic surgery, consists of removing the abscess, along with the infected portion of the root. The end of the root is then thoroughly cleaned and filled with a material that seals off the end of the root and prevents bacteria from growing in that canal space. This involves making an incision and placing sutures to allow the incision to heal.
Treatment of traumatic injuries to the teeth
Teeth can often be damaged due to impacts, such as falls, car accidents, and children crashing into each other while running. Various types of dental injuries can result. Common injuries include the following:
• Avulsions (teeth being knocked out)
• Fractured teeth
• Fractured bone in the jaw
For severe injuries, call 911 or go to the emergency department of a hospital. For injuries to the teeth and minor injuries to the mouth, the endodontist is often the provider of choice to provide treatment. We will evaluate the injury and treat as necessary in the way that will most predictably allow a person with a dental injury to keep the teeth for as long as possible, and hopefully for a lifetime.
Just remember that in most cases, the best place to store a tooth that has been knocked out is right back in the socket where it came from. The sooner the tooth is repositioned and treated, the better the chances that it will survive.
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