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Root Canal Therapy


Root canal treatment — also called endodontics (“endo” – inside, “dont” – tooth) — is a set of specialized procedures designed to treat problems of the soft pulp (nerve) tissue inside the tooth. While some mistakenly think of it as an unusually painful treatment, in most cases the procedure is no more uncomfortable than getting a filling. It's actually one of the most effective ways of relieving some kinds of tooth pain.

A root canal procedure becomes necessary when infection or inflammation develops in the pulp tissue of the tooth. Pulp tissue consists of blood vessels, connective tissue and nerve cells — which explains why a problem here may cause you to feel intense pain. Without treatment, however, the infection won't go away. It can lead to a dental abscess, and may even contribute to systemic problems in other parts of the body.


Next, a small opening is made in the surface of the affected tooth to give access to the pulp chamber and root canals. Tiny instruments are used, sometimes with the aid of a microscope, to remove the dead and dying pulp tissue from inside these narrow passageways. The chamber and empty canals are then cleaned, disinfected, and prepared to receive a filling of inert, biocompatible material. Finally, adhesive cement is used to seal the opening in the tooth, preventing future infection.

Apicoectomy


Previous root canal treatment can become reinfected for a variety of reasons: new or recurrent decay; previously undetected accessory (extra) canals branching from the primary canal at the root end of the tooth; and, occasionally, calcification (narrowing and hardening) of canals — a reaction to trauma or aging that can block the canals and prevent them from being fully cleaned by conventional root canal treatment. If conventional root canal therapy is not possible, an apicoectomy is an option to save the tooth.

Unlike traditional root canal treatment, an apicoectomy is a surgical approach through the gum. After the area is thoroughly numbed with local anesthesia, a small incision is made through the gum tissues at the level of the affected root, permitting direct access to the infected peri-apical tissues (“peri” – around; “apex” – root end). This allows removal of any inflamed or infected tissue near or around the tip of the root — along with a few millimeters of the root tip itself. A very small filling is then placed in the end of the root canal to seal the canal and prevent further infection. Afterward, a few sutures (stitches) are placed to assure that the gum tissues are closed and will heal properly. Where necessary, bone grafting or other techniques are used to help the bone to grow and fill back in, particularly if infection has left a significant void. Over time, the absence of infection will allow the area to heal and return to normal function.

Following root canal treatment, your tooth may feel some sensitivity or tenderness for a few days. Over-the-counter pain relievers like ibuprofen are generally effective in relieving discomfort, but prescription medications may also be given if needed. During this period, it may help to avoid biting hard on the affected tooth. All of these symptoms, however, should be temporary. To further protect the tooth and restore it to full function, it's usually necessary to have a crown placed on it.