Restoring the Tooth After Root Canal

After the root canal procedure your tooth may need to be restored. This gives your tooth natural shape and appearance. In the front teeth a composite filling material is used to restore the tooth. The molars and premolars need a crown. Before the crown is made your dentist will make a base or foundation to reinforce the tooth and support the crown. The base to reinforce the tooth is called a core. A post may be needed to hold the core in place. The post is a rod made of metal. Your dentist may take out a little root filling material from the root canals to make space for the post. The crown is prepared in a dental laboratory. Material used to make crown are porcelain, metal, or a combination of the two. The crown is cemented onto the base or foundation.

Root canal procedure can fail. Reasons for failure of root canal include

All the infection from a canal was not removed
All  the canals were not cleaned or desinfected
Tooth gets infected again if there is a leakage around an old filling or crown from which the bacteria can enter the tooth.
The procedure to do a repeat root canal treatment is the same but it is more complicated and time consuming than the first one because the restorative material has to be removed before the second root canal.

Most of the failed root canal treatments have infection that are difficult to eliminate.
You may need endodontic surgery, either in place of or after retreatment. If a second root canal is not possible endodontic surgery apicoectomy may be needed. During apicoectomy, the root tip, or apex, and the infected tissue are removed. Then filling is done to seal the end of the root. An apicoectomy is performed using an operating microscope. That's why apicoectomy is also called endodontic microsurgery. Apicoectomy may be needed if the tooth remains infected after retreatment. The success rate for apicoectomy is approximately 80% to 90%. If the tooth remains infected after apicoectomy also it will have to be extracted.

  Dr. Claudio A. Sorrentino

  www.dentalpalermo.com.ar

Root Canals, nothing to be afraid of…

Of all the terms you hear in a dentist’s office, to most people root canal is probably the scariest. So, what is a root canal? Simply put, a root canal is a treatment to repair and save a badly decayed or infected tooth. A root canal procedure involves removing the nerve and pulp, cleaning the inside of the tooth, and finally sealing the inside of the tooth. Think of it simply as a filling inside the tooth instead of on top of the tooth. Without treatment, the tissue around the tooth will become infected and abscesses may form.

The term “root canal” actually refers to the natural cavity within the center of the tooth. The soft area within the root canal is called the pulp or pulp chamber. The tooth’s nerve is also within the root canal.

Why does pulp and nerve need to be removed?
When a tooth’s pulp or nerve is damaged, it breaks down and bacteria begins to grow within the tooth. The bacteria, along with other decayed debris, can cause an infection, or even an abscessed tooth. An abscess is a puss filled pocket that forms at the ends of the tooth’s roots. In addition to an abscess, an infection in a root canal can also cause:

1. Swelling in the gums, and even spreading to the face, neck, or head.
2. Bone loss around the tip of the root.
3. A hole can be created in the side of the tooth with drainage leaking into the gums and even through the cheek into the skin.

What causes pulp or nerve damage in the first place?

The nerve and/or pulp can become inflamed, irritated, and infected due to several things. The most common causes are deep decay, repeated dental procedures on a single tooth, large fillings, a crack/chip in the tooth, or trauma to the face.

How do you know you need a root canal?

Some of the common signs that a root canal procedure may be needed are:

- Severe toothache when chewing or applying pressure.
- Extended sensitivity or pain to hot or cold temperatures.
- A darkening of the tooth, discoloration.
- Swelling and/or tenderness in the nearby gums.
- A reoccurring pimple on the gums.

How much pain is involved?

Root canals have a long standing reputation of being very painful, but actually most patients compare it to a filling, which is minimal pain.

For a few days after the procedure there may be sensitivity due to natural tissue inflammation, especially if there was pain and infection before the procedure. Most patients control this with simple over-the-counter medications and prescribed antibiotics. Most return to normal activities the next day.

Are there any alternatives?

Saving the natural teeth is always the best option, if possible. The only alternative is to extract the tooth and replace it with either a bridge, implant, or a removable denture to restore chewing function and prevent other teeth from shifting. These alternatives are not only more expensive, but also require more treatment time and additional procedures to adjacent teeth and supporting tissues.

Prevention

Prevention is very simple in theory; brush twice a day, floss at least once a day, and see your dentist regularly. Also, when playing sports, remember to where a mouth guard to avoid trauma.

  Dr. Claudio A. Sorrentino

  www.dentalpalermo.com.ar