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    Hershey Dentist – Bhargav Patel, DMD - Family, Cosmetic and Implant Dentistry

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    Root Canal Treatment

    A root canal is the space within the root of a tooth. It is part of a naturally occurring space within a tooth that consists of the pulp chamber (within the coronal part of the tooth), the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or  the surface of the root. The smaller branches are most frequently found near the root end (apex) but may be encountered anywhere along the root length. There may be one or two main canals within each root. Some teeth have more variable internal anatomy than others. This space is filled with a highly vascularized, loose connective tissue, the dental pulp. The dental pulp is the tissue which forms the dentin portion of the tooth. The formation of secondary teeth (adult teeth) is completed by 1-2 years after eruption into the mouth. Once the tooth has reached its final size and shape, the dental pulp’s original function ceases for all practical purposes. It takes on a secondary role as a sensory organ.

    Fundamentals For A Root Canal Therapy

    RCT is one name that gives many patients shivers when told about it. However, in reality, it is not that bad. In fact, it is an instant pain reliever and the best treatment to retain the original teeth. A Root canal treated tooth serves its purpose and function just as a healthy tooth.
    A root canal is a capillary, which runs from the base of the root of the tooth to the middle of the crown (the visible part of the tooth). The root canal carries the pulp (a network of blood and nerve cells), which brings the tooth to life.
    The nerve of the tooth gets damaged due to many reasons. One of the main causes is a cavity in the tooth that grows deeper and touches the nerve. Since the cavity is filled with bacteria, the root canal gets inflamed and causes pain. Other reasons that may damage the teeth are accidental cracks or infection from gums reaching to the base of roots. In such cases, root canal treatments can easily stabilize the position.
    There are two ways to get relief from the pain: perform the root canal therapy, or pull the tooth, clean the gum below, and replace the tooth with a denture or bridge. We advise removing teeth as a last resort; natural teeth are the ones best suited for the mouth.
    It’s important to have root canal therapy done quickly. The bacteria will travel down the canal to the root and into the jawbone. If this happens, the pain of your toothache will spread to your jaw. Even more important, the infection can cause your jawbone to deteriorate and weaken the structure that holds your teeth.
    The best way to avoid root canals is to take good daily care of your teeth to prevent the growth and spread of bacteria. Brushing and flossing are important. Just as important, are regular trips to the dentist, to check for the first sign of decay or cracks that could eventually lead to an infected tooth. In this case, an ounce of prevention really is worth a pound of cure!

     

    Symptoms Of Endodontic Disease

    Common Symptoms requiring a Root Canal Treatment:

    • Severe tooth pain, typically relieved by cold water and increases with the intake of hot liquids.
    • Pain worsens when you lie down and reduces when you sit up.
    • The Pain stays for a long time after consuming cold things.
    • Swelling around the tooth.
    • Constant tooth pain
    • Pain when chewing.
    • Tooth pain referred to head and ears as well.
    • Tooth sensitivity on consuming sweets.

    If you have any of the above- stated symptoms, it would be advisable that you visit your dentist, since he is the best person to judge whether you have a root canal disease or not, as some of these symptoms may be due to other problems as well.

    Why May Endodontic Disease Cause Swelling?

    When the pulp tissue becomes severely diseased and necrotic, the resultant infection can spread from inside the tooth into the adjacent bone and soft tissues. As a result, swelling can occur in the tissues immediately surrounding the tooth. If this situation is not treated and the disease process is not kept under control by the body’s defenses ; the infection can begin to spread into other tissue spaces, such as those around the eye or in the neck. In some situations, this can become a serious medical emergency

    Root Canal Retreatment

    Can an Endodontically Failing Tooth Be Re-treated?

    Even when pain and/or swelling is present, the majority of failing endodontically-treated teeth can be successfully re-treated in today’s world of clinical possibility. By using scientific information gathered from research and clinical studies, clinicians have developed better endodontic concepts, materials, and techniques. Additionally, there are now better-trained general dentists and specialists alike. All of these factors translate into improved care for patients. The significant technological breakthroughs that benefit both doctors and patients in endodontic retreatment include:

    1. Magnification glasses, fibre optic lighting sources, and headlamps- have significantly improved vision and hence , elevated treatment success.
    2. Ultrasonic devices allow doctors to more efficiently and completely remove old root canal filling materials and other intracanal obstructions so that teeth may be successfully re-treated.
    3. Computer digital radiography technology allows the doctor to better diagnose, visualize, and treat root canal disease. Additionally, this technology significantly reduces radiation exposure to the patient.
    4. Improved instruments, better materials for filling and repairing canals, and innovative new technologies have all contributed to significantly improved retreatment success.

    Today, well-trained general dentists and specialists alike can often perform non-surgical endodontic retreatment in a very predictable, cost-effective, and time saving manner when compared to other treatment alternatives. At times, however, re-treatment cannot be managed with non-surgical efforts alone. In these situations, and as an alternative to extraction, a surgical approach may be necessary.

    What Is Non-Surgical Root Canal Treatment (NSRCT)?

    Non-surgical root canal treatment is a procedure directed towards saving an endodontically failing tooth. At times, the patient’s existing artificial crown must be removed. In other instances, access through the crown may be possible. The access opening is created  to give the dentist non-surgical access into the root canal space through the biting surface of the tooth. Once this has been           accomplished, a non-surgical re-treatment procedure often requires:

    • Locating and treating previously missed canals.
    • Removing old filling materials from the root canal space.
    • Removing posts and broken instruments.
    • Enhancing existing root canal treatment.
    • Negotiating blocked canals and bypassing canal ledges.
    • Repairing mechanical and pathological perforations in the root.

    Once these objectives have been accomplished, the root canal system is re-cleaned, re-shaped, disinfected, and three-dimensionally sealed. A protective restoration can then be placed and the tooth restored to a state of health and function.

    What Is Surgical Root Canal Treatment (SRCT)?

    Surgical root canal treatment is a procedural effort in which it is necessary to elevate a small flap of tissue adjacent to the involved tooth in order to gain access to and treat root canal disease. Surgical root canal treatments are usually minor, in-office procedures performed under local anesthesia. Once the pathological area is exposed, the doctor performs a “curettage” to remove the diseased tissue from around the root. This is usually followed by an “apicoectomy,” a procedure in which the diseased portion of the root is removed. A small filling is then usually placed to seal the remaining portion of the root. Surgical root canal treatment will often result in a good long-term prognosis for the tooth if the cause of pathology can be effectively eliminated.
    Unfortunately, on occasion, re-treatment efforts may not be possible or cost-effective and extraction may be the only alternative. However, saving a tooth that has been previously treated endodontically and is failing is usually possible, can be very predictable, and is typically the most conservative option for the patient.