Endodontic Treatment_02
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The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a "dental dam" over the area to isolate the tooth and keep it clean and free of saliva during the procedure. Some dentists depending on the case, do not put rubber dam on every patient. |
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The endodontist makes an opening in the crown of the tooth. Very small instrument are used to clean the pulp from the pulp chamber and root canals and to shape the space for filing. |
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After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called "gutta-percha". The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling will be removed by your dentist before the tooth is restored. |
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After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function. |
How much will the procedure cost?
The cost varies depending on how severe the problem is and which tooth is affected. Molars are more difficult to treat and usually cost more. Most dental insurance policies provide coverage for endodontic treatment. Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration.
Most edodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment fails to heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this happens, another endodontic procedure (retreatment) can save the tooth.
What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover very narrow or curved canals that could not be treated during the initial procedure.
Can all teeth be treated endodontically?
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 endodontic treatment is not effective, endodontic surgery may be able to save the tooth.
What is endodontic surgery?
The most common endodontic surgical procedure is called an apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after endodontic treatment, your endodontist may perform an apicoectomy. In this procedure, the endodontist opens the gum tissue near the tooth to expose the underlying bone, and the infected tissue is removed, and a small filling may be placed to seal the root canal. Local anesthetics make the procedure comfortable, and most patients return to their normal activities the next day.
What are the alternatives to endodontic treatment?
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 require 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 matter how effective modern tooth replacement are- and they can be very effective - nothing is as good as a natural tooth. Every attempt should be made to salvage natural tooth.
Treatment for Failed root canal treatment
Once the root canal treatment fails, that may not be the end of the road.
In root canal treatment, a dentist cleans the inside part of the tooth i.e. pulp chamber and nerve in the roots. This nerve may be damaged due to caries (tooth decay), trauma to the tooth or gum diseases. Dentists disinfect the canal and fill it up, for a life long seal to avoid future growth of bacteria.
But due to various reasons, a dentist may not be able to clean the canal completely or fill up the complete root canal. Hence bacteria start growing in the incompletely filled space and the treatment fails. Signs and symptoms recur. One can diagnose the root canal treatment by radiograph and confirm the success of root canal treatment by radiograph after every 3 months.
Due to difficult anatomy of the root or curved roots, many times, root canal treatment becomes challenging to the dentist. That is why a skilled dentist or endodontist is the best clinician to perform a root canal treatment.
If the root canal treatment fails, one should not opt for extraction. Every attempt should be made to salvage the natural tooth.
Microscope in dentistry has opened a new vision to tackle all the difficulties during dental treatment. Routine root canal treatment is a blind procedure but microscope helps clinician to see inside the canal so that he can treat the difficult anatomy of the root or curved canals. When you see better, you can perform better!
Due to microscope, repeat root canal treatment has become more predictable and successful.
Routine check ups (yearly) with the help of radiograph is mandatory after every endodontic treatment.
So if a root canal treatment fails in your case, there is microendodontics for you!
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