Endodontics (Root Canal Therapy)
Endodontics is the specialty of dentistry that involves treatment of the inside of the tooth. The primary goal of this treatment is to save teeth in which the tissue inside of the tooth, called the pulp, is damaged by decay, trauma or other irritants. Occasionally, this condition can extend into the surrounding tissues. It is the inside channels, or root canals, that contain the pulp, which is made of specialized tissue, including blood vessels, and nerves. Teeth can have anywhere from 1 to 5 or more root canals. The further back in the mouth a tooth is located, the more canals are usually present. Once all of the canals are cleaned of the pulp tissue using specialized techniques, the canals are then sealed with a sterile, inert material designed for root canal treatment called gutta percha. After this is completed, a temporary filling is placed, and the patient returns to their family dentist for a permanent restoration.
Sometimes root canal therapy needs to be retreated. This can be due to inadequate or incomplete prior treatment, difficult canal anatomy or recontamination with oral bacteria from a poorly sealed permanent restoration. If the previous treatment has created difficulties that make retreatment impossible, then there would be one other alternative to try to save the tooth, microsurgery.
Occasionally, the only alternative that remains to save the tooth is to surgically remove the tip of the affected root, and the infected surrounding tissue. This is called micro surgery or apicoectomy. The entire treatment is done using a local anesthetic, such as Novocaine. The procedure is done using an operating microscope with fiber optic lighting. After an incision is made to gain access to the affected area, the tip of the root is removed, the surrounding affected tissue is removed, and a permanent seal is placed at the root end. Sutures will then be placed, and an ice pack applied.
Necessary prescriptions will be provided to alleviate any possible discomfort. It is best to plan to rest for the remainder of the day. Most patients will sustain some swelling and, occasionally there may be some bruising.
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