Posts for: September, 2018
You’ve recently learned one of your teeth needs a root canal treatment. It’s absolutely necessary: for example, if you have decay present, it will continue to go deeper within the tooth and it will spread to the roots and bone and could ultimately cause you to lose your tooth. Although you’re a little nervous, we can assure you that if we’ve recommended a root canal treatment, it’s the right step to take for your dental health.
There’s nothing mysterious — or ominous — about a root canal. To help ease any fears you may have, here’s a step-by-step description of the procedure.
Step 1: Preparing your mouth and tooth. We first take care of one of the biggest misconceptions about root canals: that they’re painful. We completely numb the tooth and surrounding tissues with local anesthesia to ensure you will be comfortable during the procedure. We isolate the affected tooth with a thin sheet of rubber or vinyl called a rubber dam to create a sterile environment while we work on the tooth. We then access the inside of the tooth — the pulp and root canals — by drilling a small hole through the biting surface if it’s a back tooth or through the rear surface if it’s in the front.
Step 2: Cleaning, shaping and filling the tooth. Once we’ve gained access we’ll clear out all of the dead or dying tissue from the pulp and root canals, and then cleanse the empty chamber and canals thoroughly with antiseptic and antibacterial solutions. Once we’ve cleaned everything out, we’ll shape the walls of the tiny root canals to better accommodate a filling material called gutta-percha, which we then use to fill the canals and pulp chamber.
Step 3: Sealing the tooth from re-infection. Once we complete the filling, we’ll seal the access hole and temporarily close the tooth with another filling. Later, we’ll install a permanent crown that will give the tooth extra protection against another infection, as well as restore the tooth’s appearance.
You may experience some mild discomfort for a few days after a root canal, which is usually manageable with aspirin or ibuprofen. In a week or so, you’ll hardly notice anything — and the tooth-threatening decay and any toothache it may have caused will be a distant memory.
If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-by-Step Guide to Root Canal Treatment.”
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”