Root Canal Therapy

Root canal treatment involves removing the dental pulp. The dental pulp is the tissue inside the hard outer shell of the tooth. Pulp consists of blood vessels, nerves, and connective tissue. It is essential for the tooth’s formation and development. Root canal treatment saves the tooth from extraction.

A tooth is saved in the following manner:

1. First, a local anesthetic is given that numbs the tooth and surrounding tissue. Then the tooth is isolated from the oral cavity and saliva by a sheet of rubber called a dental dam.
2. A small opening is made in the crown of the tooth. With very small instruments, the pulp is removed from the pulp chamber and root canals. During this procedure, the canals are cleaned, shaped for filling, and disinfected.
3. After cleaning and shaping, the root canals are filled with a biocompatible material called gutta-percha. A temporary filling is placed to close the opening in the crown.
4. After completion of the root canal, you must return to your dentist for proper tooth restoration. This will protect the tooth and return it to full function.

For more information about Root Canal Therapy, visit the American Association of Endodontists website.

Endodontic Retreatment

Even though modern endodontic therapy has a success rate of greater than 90 percent, on occasion, as with any dental or medical procedure, a tooth that has been treated with a root canal may not heal as expected. It may even become painful or diseased months or years following the initial treatment. An endodontic retreatment can give your tooth a second chance.

If your tooth is a candidate for retreatment, it is accomplished in the following manner:

1. First, a local anesthetic numbs the tooth and surrounding tissue. Then the tooth is isolated from the oral cavity and saliva by a sheet of rubber called a dental dam.
2. Your tooth is re-opened to gain access to the root canal filling material. Complex restorative materials, such as core materials and posts, must be disassembled and removed to permit access to the root canals.
3. After removal of the root canal filling, the tooth is examined for cracks, additional canals, and/or unusual canal anatomy.
4. The root canals are cleaned, shaped, and disinfected prior to the placement of the gutta-percha filling. A temporary filling is placed in the opening within the tooth.
5. After the final visit for the retreatment, you will need to return to your general dentist for a new crown or other restoration. This will protect and restore the tooth to full function.

For more information about Endodontic Retreatment, visit the American Association of Endodontists website.

Cracked Teeth Evaluation

Because people are living longer and often more stressful lives, they are exposing their teeth to many more years of damaging habits such as clenching, grinding, and chewing on hard objects. These habits make our teeth more susceptible to cracks.

Although all dentists are trained in the diagnosis and treatment of cracked teeth, some cracks can be especially difficult to diagnose, and treatment may involve a root canal. That’s when an endodontist is required.

The treatment you receive for your cracked tooth will relieve pain, but it will also reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your endodontist about your particular diagnosis and his treatment recommendations.

The most common types of cracks include:

• Craze lines - tiny shallow cracks that affect only the outer enamel, cause no pain, and are of no concern beyond appearances.
• Fractured cusp - a fracture on a weakened cusp (pointed part of the chewing surface), sometimes breaking off on its own and other times needing removal by the dentist. Some pain is involved, but it is usually relieved by removal of the cusp and replacement with a full crown. A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed.
• Cracked tooth - a crack that extends from the chewing surface of the tooth vertically towards the root. In severe cases, the crack extends into the root. The position of the crack often results in damage to the pulp; therefore root canal treatment is frequently needed. Once this is done, your dentist can restore your tooth with a full crown. Early diagnosis is the key to saving a cracked tooth.
• Split tooth - this is often the result of a cracked tooth that has not received treatment. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth is nonrestorable and must be extracted.
• Vertical root fracture - a crack that begins in the root of the tooth and extends toward the chewing surface. Due to their minimal signs and symptoms, these types of cracks may go unnoticed for some time. They are often discovered when the surrounding bone and gum become infected. Tooth extraction is the typical method of treatment; however, endodontic surgery can sometimes save a portion of the tooth.

For more information about Cracked Teeth, visit the American Association of Endodontists website.