Endodontics

Root Canal Therapy

What is a Root Canal?

A “root canal” is a term used to describe the natural cavity in the center of a tooth. This area contains a soft area known as the pulp chamber that houses the nerves. If it becomes irritated or infected due to cavities, trauma or decay, root canal therapy is necessary. If left untreated, the infection can cause an abscess, which can lead to swelling of the face and neck, and bone loss around the roots of teeth.

Symptoms of a Root Canal Problem

  • Severe tooth pain and sensitivity to hot and cold temperatures
  • Tooth becomes discolored
  • Swollen, tender gums
  • A reoccurring pimple that forms on the gums

Root Canal Therapy Procedure

  1. The dentist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the dentist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
  2. The dentist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
  3. The root canals are filled with a biocompatible material, usually a rubber-like material, which is in turn placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
  4. Finally, your dentist will place the crown or other restoration on the tooth to protect and restore it to full function.

Pulpotomy

Underneath the exterior of a tooth is a pocket filled with nerves, blood vessels, and connective tissue. This is known as the “pulp” of the tooth. When a tooth has a bad cavity, the pulp of the tooth is exposed. This can be very painful because the sensitive nerves and tissue are vulnerable. If your child is complaining of a toothache, it might be because he or she has a large cavity. In this case, we’ll do a pulpotomy to remove the damaged pulp. A pulpotomy is a fairly common procedure for decayed baby molars.

During a pulpotomy, we first remove damaged tissue, sterilize the area, and then replace the pulp with a medicated filling. Sometimes, it is then necessary to place a crown to restore the structure and appearance of the tooth. A pulpotomy is usually very successful in saving a badly decayed baby molar.

Cavities that affect the pulp of the tooth can be quite painful. If your child is experiencing severe tooth pain, he or she may need a pulpotomy. Call Lombardi-Yersky Dentistry at 724-652-3241 to schedule an appointment

Apicoectomy

An apicoectomy is done only after a tooth has had at least one root canal procedure and retreatment has not been successful or is not possible. For example, retreatment is often not a good option when a tooth has a crown or is part of a bridge. Retreatment of the root canal would require cutting through the crown or bridge. That might destroy or weaken the crown or bridge.

The Apicoectomy Procedure
The endodontist will make a small incision in your gum and lift the gum away from the tooth and bone. The dentist may need to use a drill to gain access to the root. The infected tissue will be removed along with the last few millimeters of the root tip. To complete the apicoectomy, the endodontist will clean and seal the end of the tooth’s canal. The cleaning usually is done under a special microscope using ultrasonic instruments. The endodontist then will take an X-ray of the area before stitching the tissue back in place.

Most apicoectomies take 30 to 90 minutes. The length will depend on the location of the tooth and the complexity of the root structure. Procedures on front teeth are generally the shortest. Those on lower molars generally take the longest.

Cracked Teeth

How Is a Cracked Tooth Treated?
A cracked tooth means a crack extends from the chewing surface of your tooth vertically toward the root. The tooth is not yet separated into pieces, though the crack may gradually spread. Early diagnosis is important in order to save the tooth. If the crack has extended into the pulp, the tooth can be treated with a  root canal procedure and a crown to protect the crack from spreading. A cracked tooth that is not treated will progressively worsen. If the crack extends below the gum line, it is no longer treatable, and the tooth will need to be extracted. That’s why early treatment is so important. 

What Can I Do to Prevent My Teeth from Cracking?
While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks:

  • Don’t chew on hard objects such as ice, unpopped popcorn kernels or pens.
  • Don’t clench or grind your teeth.
  • If you clench or grind your teeth while you sleep, talk to your dentist about getting a retainer or other mouthguard to protect your teeth.
  • Wear a mouthguard or protective mask when playing contact sports.

Oral Trauma

Traumatic dental injuries often occur in accidents or sports-related injuries. Chipped teeth account for the majority of all dental injuries. However, dislodged teeth, knocked-out teeth, and root fractures are all considered traumatic injuries. No matter your dental injury, you should see a dentist or endodontist immediately. Endodontists specialize in oral trauma and are often able to save injured teeth.

Chipped or Fractured Teeth
There are different factors that would determine treatment for your chipped or fractured tooth. Most chipped or fractured teeth can be replaced by reattaching the broken piece or by placing a tooth-colored filling in the chipped area. If a significant part of the tooth is broken off, an artificial cap may be needed for restoration. Root canal treatment or extraction may also be necessary under certain circumstances.

Dislodged Teeth
Root canal treatment is usually needed for secondary teeth that have been dislodged. Children may not require treatment since their teeth are still developing. However, it is important to see a dentist or endodontist so that he or she can determine what the best option is for you or your child.

Knocked-Out Teeth
If your tooth is completely knocked out of your mouth, see an endodontist or dentist immediately. The length of time the tooth was out of the mouth will determine the chances of saving the tooth. The tooth will be placed back in the socket, and a stabilizing splint with be placed for a few weeks.

Root Fractures
Depending on the type of injury to your tooth, you may sustain a horizontal root fracture. In this case, the tooth may need to be stabilized with a splint for a required period of time.