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Root Canal       

Root Canal Treatment or Endodontic Treatment or Endodontic Procedure is the procedure involves removing inflamed or damaged tissue from inside a tooth and cleaning, filling and sealing the remaining space.

root canal, endodontic treatment,  root canal procedure, tooth decay, tooth crown

Your dentist uses root canal treatment to find the cause and then treat problems of the tooth's soft core (the dental pulp).

The dental pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.

Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment has given dentists a safe way of saving teeth.

When the infected or injured pulp is not removed, pain (toothache) or lead to an abscess and swelling can result. Certain byproducts of the infection can injure your jaw bones. Without treatment, your tooth may have to be extracted or removed.


Indication for Endodontic Treatment

Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected when
germs (bacteria) enter the pulp:
  • repeated dental procedures on the tooth
  • a crack or chip in the tooth
  • an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks
  • tenderness to touch and chewing
  • swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues
  • sometimes, however, there are no symptoms
  • left without treatment, pus builds up at the root tip, in the jawbone, forming a "pus-pocket" called an abscess
  • an abscess can cause damage to the bone around the teeth

Steps of Endodontic Procedure

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.
Endodontic treatment can often be performed in one or two visits and involves the following steps:
1. 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.
2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. 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 is placed to close the opening.

Instructions After Endodontic Treatment

1. You should not chew firm or bite hard on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible.
2. You need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.
3. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues.

Complications after Root Canal Treatment

For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.

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 additional very narrow or curved canals that could not be treated during the initial procedure.
Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.
Most teeth can be treated. Rarely, 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. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

Final Restorations of the Tooth

Most endodontically treated teeth last as long as other natural teeth.
In the final step, a gold or porcelain crown is usually placed over the tooth.
After the last visit with your endodontist, you must return to your dentist to have a filling, dental crown, dental bridge  or other restoration placed on the tooth to protect and restore it to full function.
The temporary filling will be removed by your dentist before the tooth is restored.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist may place a post inside the tooth.
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 dental bridge or dental implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.
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Looking forward to hearing from you

Aleksandr V. Melekhin, DDS


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