Endodontics is a special discipline in dentistry that deals with maintaining the health of the living tissues (pulp) inside a tooth and preventing or managing infection in the surrounding tissues. The most common endodontic procedure is known as root canal treatment (RCT). The aim of RCT is to eliminate the damaged pulp as well as the bacteria that are causing the infection, and to restore the tooth to a pleasing appearance and functional state. The procedure involves removing inflamed or dead nerves and blood vessels from the centre of the affected tooth, which is accomplished by creating an access through the top of the tooth to the root canals and removing the dead tissue. The empty root canal system is then cleaned, shaped, and filled with special materials, and finally, a permanent seal is put over the top of the tooth. The procedure may be carried out over one or two visits to a dentist.
At Sunrise Dental Clinic, your dentist will take an x-ray of the affected tooth and possibly administer a temperature sensitivity test before deciding if RCT is required. The x-ray image will reveal the number of roots on the tooth, the extent of the decay (if any), and presence of any abscess.
If you have a dead tooth or one with severely damaged pulp, RCT may be the only treatment option. Your dentist will discuss the diagnostic results and recommend possible treatment options to help you make the right decision to restore the health of your tooth.
Your teeth have a core of blood vessels and nerves at their centre. This tissue is referred to as pulp, and it occupies spaces called root canals. The number of root canals in a tooth varies, depending on the location of that tooth in your mouth. Front teeth often have just one root canal, while back teeth may have three or more. If your tooth is injured or severely decayed, the pulp can become damaged, and the blood vessels may die. This results in a “dead” tooth, which is prone to infection because it is no longer protected by your immune system. Sensitivity to hot and cold foods and drinks may be a warning sign of tooth decay. This symptom warrants a visit to your local Coquitlam dentist, who can evaluate the cause of discomfort and administer preventive or corrective measures.
A tooth’s pulp can be damaged by decay, injury, or even gum disease. All of these conditions can lead to bacterial infection, causing blood vessels and nerves to die. Without treatment, a collection of pus known as an abscess can form at the root tip, causing pain, swelling, and even damage to the surrounding jawbone. Failure to treat the infected tooth may worsen the damage and lead to the extraction (removal) of the tooth.
Root canal treatment is needed to remove the damaged tissue, disinfect the root canal system, and restore the tooth to function. Certain teeth may have complex anatomy or may be part of a bridge and require careful treatment. However, modern endodontic practices, such as the use of a microscope for greater visual access, allows for the completion of such cases to a high standard.
Occasionally, RCT is undertaken in a previously root-filled tooth in which the treatment is inadequate or has failed. The outcome for such cases can be very favourable and usually results in complete resolution and healing of extensive infections.
If you do need to have RCT, your dentist will give you a local anaesthetic, which will block all sensation within the treatment area without causing you to sleep. An anaesthetic may not be necessary if your tooth is dead, but your dentist will discuss this with you before starting the procedure.
During the procedure, your affected tooth will be separated from the rest of your mouth using a thin sheet of rubber called a rubber dam. This keeps your tooth dry and protects your airway. It also allows for effective cleaning of the root canal system and prevents re-contamination. Your dentist will first make a hole in the top of your tooth, through which the dead or diseased pulp is removed. The empty pulp cavity is then cleaned, and your dentist may also put in some medication to treat the bacterial infection.
If more than one visit is required to treat the affected tooth, your dentist will put a temporary filling on your tooth to keep it sealed until your next visit. However, if the infection has not caused serious problems or damage, your dentist may decide to fill the cavity immediately. If you have had a temporary filling, your dentist will remove this during your subsequent visit and then fill the root canals with a suitable material—usually a putty-like substance. A permanent filling or crown is then placed over the top of the tooth to protect your filled root canal and the vulnerable tooth structure. Your dentist will help you choose between a gold or porcelain crown. If your dentist thinks it is necessary, he or she may also place a metal or plastic rod inside the canal to help support the crown.
The management of traumatic injuries to the mouth, particularly in children, is an important aspect of endodontic practice. The front teeth (incisors) are often involved and may sustain fractures or chipped crowns. Such teeth require careful monitoring to ensure that they remain healthy and develop naturally. Our Coquitlam tooth repair experts may decide to perform RCT to avoid pulp death and infection. Even so, the teeth can be restored to normal appearance and function.
Endodontically involved or treated teeth may discolour over time. Where appropriate, bleaching of the tooth can restore the tooth to its original colour and normal appearance.
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