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Posts for tag: root canal treatment

By Edward Joseph, D.D.S.
October 09, 2018
Category: Dental Procedures
3FactorsThatCouldAffecttheSuccessofaRootCanalTreatment

A tooth with deep decay is in real peril. If the disease isn’t stopped, it can eventually infect the bone and greatly increase the risk of losing the tooth. But tooth decay removal and a root canal treatment can stop advancing decay and resulting infection in its tracks.

During this common procedure we first drill into the tooth to access the inner pulp. After removing the infected pulp tissue, we disinfect and fill the empty chamber and root canals with gutta percha. We then seal the tooth and crown it to protect against re-infection.

But while most root canals are successful and long-lasting, sometimes the tooth becomes re-infected. Here are 3 factors that could affect the long-term success of a root canal treatment.

Early treatment. Like many health problems, the sooner we detect decay and treat it, the better the outcome. A tooth in which the infection has already advanced beyond the pulp is at greater risk for re-infection than one in which the infection is localized in the pulp. Keeping up your regular dental visits as well as seeing the dentist at the first sign of abnormality—spots on the teeth or pain—can increase your chances of early diagnosis.

Tooth complications. Front teeth with their single roots and canals are much easier to access and treat than a back molar with an intricate root canal network. Root canals can also be extremely narrow making them easy to miss during treatment. In cases like this the expertise and advanced equipment of an endodontist (a specialist in root canal treatment) could help increase the odds of success in complex situations.

The aging process. Teeth do wear over time and become more brittle, making them increasingly susceptible to fracture. A previous root canal treatment on an aging tooth might also increase the fracture risk. To avoid this, it’s important for the tooth to receive a crown after the procedure to protect the tooth not only from re-infection but undue stress during chewing. In some situations, we may also need to place a post with a bonded composite buildup within the tooth to give it extra support.

Even if a tooth has these or similar complications, a root canal treatment may still be advisable. The benefits for preserving a decayed tooth often far outweigh the risks of re-infection.

If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment.”

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By Edward Joseph, D.D.S.
July 31, 2018
Category: Dental Procedures
TheRightTreatmentforYourChildsInjuredToothIncreasesitsSurvival

Children have a lot of energy that's often channeled through physical activities and sports. Unfortunately, this also increases their risk of injuries, particularly to their teeth.

Injuries to the mouth can endanger permanent teeth's survival. For an older tooth, a root canal treatment might be in order. Not so, though, for a pre-adolescent tooth, even if it is permanent.

A young permanent tooth is still developing dentin, the large layer just below the enamel. This growth depends on the connective tissue, blood vessels and nerves within the pulp in the center of the tooth. Because a root canal treatment removes all of this tissue, it could stunt dentin and root growth and endanger the tooth's future.

Instead, we may need to treat it with one of a number of modified versions of a root canal, depending on what we find. If the tooth's pulp is unexposed, for example, we may need only to remove the damaged dentin, while still leaving a barrier of dentin to protect the pulp. We then apply an antibacterial agent to minimize infection and fill in the area where we've removed tooth structure.

If some of the pulp is exposed, we may perform a pulpotomy to remove just the affected pulp and any overgrown tissue. We then place a substance that encourages dentin growth and seal it in with a filling. If we go deeper toward the root end, we might also perform procedures that encourage the remaining pulp to form into a root end to stabilize the tooth.

If the entire pulp has been damaged beyond salvage, we may then turn to a procedure called an apexification. In this case we clean out the pulp chamber; at the root end we place mineral trioxide aggregate (MTA), a growth stimulator that encourages surrounding bone to heal and grow. We then fill in the root canals and chamber with a special filling called gutta percha to seal the tooth.

The deeper we must penetrate into the pulp, the higher the chances the young tooth's dentin and roots won't form properly, leading to later problems and possible loss. But by employing the appropriate one of these methods, we can minimize the risk and give your child's damaged tooth a fighting chance.

If you would like more information on children and dental injuries, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saving New Permanent Teeth after Injury.”

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By Edward Joseph, D.D.S.
July 16, 2018
Category: Dental Procedures
WhatHappensinaRootCanalTreatmentandHowitCanSaveYourTooth

Along with periodontal (gum) disease, tooth decay poses one of the two greatest threats to your teeth. Cavities are just the start: if decay invades the pulp, the tooth’s innermost layer, the infection created can continue to advance through the root canals to the supporting bone. This worst case scenario could cost you your tooth.

But we can stop this advanced decay in its tracks with a procedure called a root canal treatment. A root canal essentially removes all the infected tissue within the tooth and then seals it from further infection. And contrary to its undeserved reputation for being painful, a root canal can actually stop the severe tooth pain that decay can cause.

At the beginning of the procedure, we deaden the affected tooth and surrounding tissues with local anesthesia—you’ll be awake and alert, but without pain. We then isolate the tooth with a dental dam of thin rubber or vinyl to create a sterile environment around it to minimize contamination from bacteria found in saliva and the rest of the mouth.

We then drill a small hole through the enamel and dentin to access the interior of the tooth. With special instruments, we remove and clean out all the diseased or dead tissue in the pulp chamber and root canals. After disinfecting the empty spaces with an antibacterial solution, we’ll shape the root canals to make it easier to perform the next step of placing the filling.

To fill all the root canals and pulp chamber, we typically use a rubber-like material called gutta-percha. Because it’s thermoplastic (“thermo”—heat; “plastic”—to shape), we can compress it into and against the walls of the root canals in a heated state to fully seal them. This is crucial for preventing the empty tooth interior from becoming re-infected. Afterward, we’ll seal the access hole with its own filling; later, we’ll bond a permanent crown to the tooth for additional protection and cosmetic enhancement.

After the procedure you may have some temporary minor discomfort usually manageable with aspirin or ibuprofen, but your nagging toothache will be gone. More importantly, your tooth will have a second chance—and your dental health and smile will be the better for it.

If you would like more information on treating tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”

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By Edward Joseph, D.D.S.
February 22, 2018
Category: Dental Procedures
AnInfectedorInjuredPrimaryToothCanBeSaved-butitsComplicated

Primary (baby) teeth don't last long. But despite their short life span, they do a number of important things, like enabling a child to eat solid food. But perhaps their most important long-term function is “paving” the way for their permanent replacements.

If one is lost prematurely, though, the permanent tooth might not come in properly aligned. That's why if a primary tooth is in danger of loss due to decay or injury, we'll do our best to save it.

But that could get a little tricky if the infected or damaged part of the tooth is the innermost pulp. If it were an adult tooth, the best course might be a root canal treatment: access the pulp, clear out the diseased tissue, and then fill the space with a special filling. But with a primary tooth (or a young permanent tooth for that matter) that may not be advisable.

That's because the pulp plays a more important role in a child's tooth than an adult's. Its nerves and other tissues stimulate dentin growth; a full root canal could disrupt that growth and weaken the tooth in the long run.

With a child's tooth, we proceed carefully depending on how infected or damaged the pulp might be. If it's only slightly exposed or not at all, we try then to remove as much decayed tooth material outside the pulp as necessary, then apply antibacterial agents or dentin growth stimulators.

If we do have pulp exposure, we'll try to remove only as much of the affected pulp as necessary through a procedure called a pulpotomy. This technique will only be used if the remaining pulp looks healthy or restorable to health.

If not, we may need to perform a pulpectomy to remove the entire pulp. Most like a typical root canal, it's a last resort: without the pulp, dentin growth could be stunted and the tooth won't develop as healthy as it should.

Of course, the best approach is to prevent teeth from developing such problems in the first place. So, be sure to practice effective daily hygiene with your child and keep up regular dental visits beginning at age one.

If you would like more information on treating decayed primary teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”

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By Edward Joseph, D.D.S.
August 18, 2017
Category: Dental Procedures
NeedaRootCanalHeresaStep-by-StepGuideonWhattoExpect

You’ve recently learned one of your teeth needs a root canal treatment. It’s absolutely necessary: for example, if you have decay present, it will continue to go deeper within the tooth and it will spread to the roots and bone and could ultimately cause you to lose your tooth. Although you’re a little nervous, we can assure you that if we’ve recommended a root canal treatment, it’s the right step to take for your dental health.

There’s nothing mysterious — or ominous — about a root canal. To help ease any fears you may have, here’s a step-by-step description of the procedure.

Step 1: Preparing your mouth and tooth. We first take care of one of the biggest misconceptions about root canals: that they’re painful. We completely numb the tooth and surrounding tissues with local anesthesia to ensure you will be comfortable during the procedure. We isolate the affected tooth with a thin sheet of rubber or vinyl called a rubber dam to create a sterile environment while we work on the tooth. We then access the inside of the tooth — the pulp and root canals — by drilling a small hole through the biting surface if it’s a back tooth or through the rear surface if it’s in the front.

Step 2: Cleaning, shaping and filling the tooth. Once we’ve gained access we’ll clear out all of the dead or dying tissue from the pulp and root canals, and then cleanse the empty chamber and canals thoroughly with antiseptic and antibacterial solutions. Once we’ve cleaned everything out, we’ll shape the walls of the tiny root canals to better accommodate a filling material called gutta-percha, which we then use to fill the canals and pulp chamber.

Step 3: Sealing the tooth from re-infection. Once we complete the filling, we’ll seal the access hole and temporarily close the tooth with another filling. Later, we’ll install a permanent crown that will give the tooth extra protection against another infection, as well as restore the tooth’s appearance.

You may experience some mild discomfort for a few days after a root canal, which is usually manageable with aspirin or ibuprofen. In a week or so, you’ll hardly notice anything — and the tooth-threatening decay and any toothache it may have caused will be a distant memory.

If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-by-Step Guide to Root Canal Treatment.”

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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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