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Endodontics - inside (endo) the tooth (dontia). The
dental pulp is the tissue (composed of nerves, blood vessels, and other
tissues) contained within the tooth. It functions in the development of
the tooth (the crown and roots) and it continues to provide nourishment,
and sensory response throughout life. The specialty of Endodontics is
devoted to the biology, physiology, pathology and treatment of the
dental pulp.
Most common reasons a tooth may develop inflammation or infection:
- Dental decay (large deep cavities)
- Accumulative effects of placing several filling over time
- Restorative insults to teeth (drilling, heat and desiccation)
- Traumatic injury (accident)
 The
dental pulp can become diseased and inflamed and the damage (most often
indicated by sensitivity to temperature or deep seated throbbing) is
sufficiently advanced that the pulp tissue cannot be treated and made to
recover. This irreversible problem requires removal of the dental pulp,
hence a root canal procedure. This deterioration can be more intense and the
dental pulp has become dead tissue. The tooth will no longer respond to
temperature changes and sweets. The dead pulp tissue and bacteria from the
inside of the tooth can affect the bone and cause infection outside the
tooth at the tip of the root(s).Symptoms
most commonly associated with non-vital
infection are a tooth that hurts to bite on or becomes sore to touch. An
x-ray will help in the diagnosis of this problem, but only when the
infection is so advanced as to cause loss of bone around the root tip of the
tooth. The
treatment of either
of those two categories of
infection is essentially the same in routine cases. Root canal therapy is
the treatment of the inside of the tooth so that the source of the infection
or the source of inflammation causing the dental pain can be removed. The
tooth is then protected from the problem recurring in the future.
The goal of root canal therapy
is to create an environment inside the tooth to enable the infection to heal
and render the tooth symptom free. This environment should be as sterile as
possible, removing all tissue debris and bacteria to the tip of the root.
The space must then be filled with an inert material to maintain this clean
space.
What is the nature of treatment?
 The
sophistication of endodontic techniques and new materials has made modern
day endodontics a painless and uncomplicated procedure. Invariably, it is no
different in its scope than a dental visit for a large filling. The majority
of endodontic procedures are done in a single appointment.
State-of-the art local anaesthesia (freezing) techniques are always
used in conjunction with relaxants to minimize stress and anxiety; nitrous
oxide sedation is available as well. Upon completion of your treatment, we
immediately communicate with your referring dentist so that follow-up
treatment for restoring and protecting your tooth can be provided by them by
them at the earliest opportunity. It is important that you contact your
dentist for this treatment after your final visit with us. The tooth is
finished with a permanent seal over the root canal system and a temporary
filling in the access chamber which your dentist will remove and replace.
Does the root canal procedure
hurt?
You will be
completely numb during the procedure. Dr.McClammy is well versed in a wide
variety of anaesthesia protocols to ensure that you will feel nothing
whatsoever during the procedure. There may indeed be post operative
sensation, but for the most part, this is manageable with a specific regimen
of over-the-counter medication.
Can antibiotics cure a root canal
infection?
Unfortunately not………Antibiotics
are indicated when there is swelling, a temperature, or other systemic signs
of infections. Antibiotics may be useful to diminish symptoms such as biting
pain before the root canal can be started, and may help prevent some types
of post treatment pain involved with having the root canal performed.
However, antibiotics cannot cure a root canal infection because the
source of infection is inside the tooth where there is no blood supply.
Therefore there is no mechanism to deliver the antibiotics. The cure is the
complete cleaning, shaping and obturation of the contaminated root canal
space.
Technical Considerations
Patients are referred for a root
canal therapy because their dentist has recognized a need for special case
management more suitably treated by an endodontic specialist. Acceptance of
a 'treatment' appointment means you are prepared to proceed with the
necessary procedure. However, if you have questions concerning the nature of
the therapy required or you feel that special issues (medical history,
insurance coverage) need to be discussed, or you simply want to meet and get
to know Dr.McClammy and his team before treatment is started, then a short
appointment for 'evaluation and consultation' should be made prior to
treatment. All of your questions will be answered prior to accepting root
canal therapy (informed consent) to save your tooth.
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