Endodontics (Root Canal Therapy)
Our primary goal is to save your natural teeth whenever possible. Our practice specializes in Endodontics, commonly referred to as root canal therapy. Endodontics is the treatment of the pulp and surrounding tissues of a tooth. When root canal therapy is performed the pulp chamber of the tooth is removed and then filled with a suitable filling material. Root canals are most often necessary when decay has reached the nerve of the tooth or the tooth has become infected. People have anywhere from 1 to 4 canals in a tooth. Extra canals may branch out and are called “accessory canals.” The number of canals and anatomy of a tooth can vary. The word “endo” comes from the Greek language and means “inside” or within. Endodontists work with the “inside” of a tooth.
Occasionally a tooth that was treated months or years ago may develop new problems. In some cases a tooth that has received endodontic treatment fails to heal or continues to have pain. You may have another chance to save the tooth with a second endodontic procedure.
Endodontic or Apical Surgery
In some cases it may be necessary to remove the infected root tips or apex and the nearby tissue. This is known as a apical surgery or an apicoectomy. The area around the apex of the tooth that is infected is cleaned, and the tip of the root is resected and sealed. Sutures are placed and an ice pack is applied. Medication is prescribed to help alleviate any pain or discomfort and it is best to plan to rest for the remainder of the day. Most patients will have some minor swelling and occasional bruising with some numbness.
Symptoms of a cracked tooth are varied and may include pain when chewing, temperature sensitivity or pressure sensitivity or a combination of these. Because the pain often comes and goes, it can be very difficult to recognize what is causing the problem. It can sometimes even be difficult to identify exactly which tooth is causing the discomfort.
Even small movement of the cracked tooth pieces during chewing can cause irritation to the tooth’s pulp, which causes pain. Similarly, when the bite is released, the crack can close quickly, causing sharp pain. Over time, the tooth pulp will become damaged. As this happens, the tooth will hurt more consistently. Cracks can sometimes lead to infections in the pulp tissue and spread to the surrounding gum and bone.
Traumatic injuries can result in the need for dental treatment. Fractured or cracked teeth, a displaced tooth, or even a tooth that has been knocked out (avulsed) are common results of dental trauma. Each of these conditions requires specific treatment, dictated by the effect of the injury on the tooth, whether or not the tooth is deciduous (a baby tooth) or permanent (adult), and the time between the injury and treatment, among other considerations. Any dental trauma requires prompt medical evaluation and treatment. Treatment may include a splint, medication, a root canal or other procedures. Once treated, your tooth will be monitored to ensure it is healing as expected and so that any injuries or infections can be quickly resolved.
The blood vessels, nerves, and tissue that keep a tooth healthy and alive are located in the tooth’s pulp, which is protected by the outer enamel and tooth structure. Sometimes the pulp can become infected. The infected pulp can be removed with a pulpotomy. A medicated dressing is then placed in the tooth chamber to prevent further infection and to promote the healing of the remaining pulp. The chamber is then sealed. Because this procedure is often performed on deciduous (baby) teeth, it is sometimes referred to as a baby root canal.
Sedation with Nitrous Oxide
Nitrous Oxide is a sweet-smelling, non-irritating, colorless gas which you can breathe. Nitrous oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe, the patient receives 50-70% oxygen with no less than 30% nitrous oxide. The patient is able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep, not remembering all of what happened during their appointment.
There are many advantages to using nitrous oxide. The depth of sedation can be altered at any time to increase or decrease sedation. There is no after effect such as a “hangover”. Inhalation sedation is safe with no side effects on your heart and lungs, etc. Inhalation sedation is very effective in minimizing gagging. It works rapidly as it reaches the brain within 20 seconds. In as little as 2-3 minutes its relaxation and pain killing properties develop.
Reasons to not use Nitrous Oxide: You should not utilize Nitrous Oxide if you have been diagnosed with chronic obstructive pulmonary disease (COPD). Though there are no other major contraindications to using nitrous oxide, you may not want to use it if you have emphysema, exotic chest problems, M.S., a cold or other difficulties with breathing.