At the center of every tooth is pulp. Pulp is a collection of nerves and blood vessels that provides nourishment to the tooth. Pulp may become infected by trauma, deep decay, cracks or issues from a previous filling. The patient may then experience pain when biting and chewing, lingering sensitivity to hot or cold and swollen or tender gums. Your dentist will then recommend that you see an endodontist for treatment. During non-surgical root canal, the endodontist will remove the diseased pulp and thoroughly clean and seal the infected root canal. To ensure patient comfort, anesthesia will be provided as needed. The process is completed with a follow up visit to the general dentist for restoration and the tooth will function like any other tooth.
Sometimes, a tooth that has received treatment, may continue to cause pain. This may occur months or even years after treatment. This may be caused by complicated canals that were not treated during the initial treatment or restoration that either was not done in a timely manner or that did not prevent saliva from contaminating the inside of the tooth. In some cases, even teeth that were successfully treated by root canal therapy can be compromised by new problems that develop. New decay can expose the root canal to bacteria and cause infection in the tooth. A loose or cracked dental restoration can expose the tooth to a new infection. In all such cases, endodontic retreatment may be warranted. During this procedure, the tooth will be reopened through a small hole in the surface. Once the canals have been accessed, the previous root canal filling materials are removed and the canals are carefully cleaned, examined and sealed. To ensure patient comfort, anesthesia will be provided as needed. The process is completed with a follow up visit to the general dentist for restoration and the tooth will function like any other tooth.
In the case of a dislodged tooth, a dental injury may partially push the tooth into its socket. Immediate dental care is required to reposition and stabilize the tooth. Root canal therapy is usually initiated within a few days of the injury and Calcium Hydroxide is placed inside of the tooth. If the tooth is partially pushed out of its socket, immediate dental care to reposition and stabilize the tooth is also required. If the pulp of the tooth is unaffected, then no other treatment is necessary. If the pulp becomes damaged or infected, the patient will be referred for root canal therapy. In the case of an avulsed tooth, a dental injury has completely knocked the tooth out of the mouth. The tooth must be kept moist by placing it in milk or a glass of water with a pinch of salt. It must be brought to the dentist in a timely fashion for possible reimplantation. Root canal therapy will likely be performed at a later date as the pulp of the tooth has been damaged.
When an immature tooth of a child is irreversibly damaged, apexification is performed to induce the formation of a calcific barrier near the root tip that will provide closure and allow a root canal filling to be placed. The process is completed with a follow up appointment to the general dentist for restoration.
When an immature tooth of a child is diseased or injured, apexogenesis is performed to preserve the vitality of the pulp. A special medication is placed inside of the tooth to encourage physiological development and formation of the root end.
When a tooth is darkened or discolored and the stains will not respond to traditional external whitening on the outer surface of the tooth, internal bleaching is used to bleach the tooth from inside. Chemical whitening and endodontic treatment are part of the process. The tooth is opened to access its interior and a safe bleaching agent is placed inside.
A post is a thin metal rod that is cemented into the root of a tooth following root canal treatment. A post may need to be removed if the tooth needs to undergo endodontic retreatment due to decay or if the original post has fractured. Utilizing ultrasonic energy and specialized instruments, most posts can effectively be removed without causing damage to the root structure of the tooth. In many cases, this will make the difference between saving the tooth or requiring an extraction.
Treatment of a cracked tooth depends on the type of crack and the degree to which it has irritated the pulp of the tooth. Craze lines are shallow cracks that only affect the outer enamel of the tooth. These cracks are usually regarded as merely a cosmetic imperfection. Fractured cusps affect the elevated features of the tooth. When the cusp of a tooth becomes weakened, it can fracture. If the fracture does not extend deep into the tooth, restoration by a general dentist may be sufficient. If the fracture does extend deep into the tooth and causes pulpal involvement, then root canal therapy may be required. When a crack in the tooth extends vertically from the surface to the root, it is referred to as a cracked tooth. A cracked tooth is not completely separated into two pieces. This type of crack typically impacts the pulp of the tooth and necessitates root canal therapy. If a cracked tooth is not treated in a timely fashion, it will progressively worsen and may reach the stage of a split tooth. In a split tooth, the crack completely divides the tooth into two distinct parts. Only if sufficient tooth structure remains may it be possible to preserve the tooth with root canal therapy.
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