As an Endodontist, Dr. MacDonald has had the training and experience at diagnosing the source of dental pain. He will be able to differentiate between pain caused by your tooth and other facial pain. Sometimes an initial consultation visit is required to gather necessary information and to answer some questions. For example…What treatment is needed and what options are there? What is the long term prognosis of the tooth? How much time and how many appointments are required to complete treatment? How much will treatment cost?
Root Canal Treatment:
Endodontic treatment is necessary when the pulp becomes inflamed or infected. Signs and symptoms that indicate treatment is needed include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gums. Sometimes there are no symptoms.
The following are some reasons why a tooth needs root canal treatment:
- An infection or abscess inside the tooth.
- Accumulative effects of numerous treatments such as drilling, heat, and fillings to a damaged tooth
- Traumatic injury to a tooth, such as an accidental blow to the mouth, or other cause of a crack in the tooth
The procedures for Root Canal Treatment
A hole is made in the side or top of the tooth, and the interior pulp and nerve tissue of the tooth is removed, down to the tip of each root. The newly cleaned interior of the tooth is filled with an inert material to seal it, and a filling is placed over the tooth (the filling may be temporary or permanent). If a temporary filling is placed another appointment is needed with your regular dentist, in which a permanent filling or crown is placed over the tooth.
Nonsurgical Root Canal Retreatment
Although the majority of teeth that are treated endodontically can last just as long as your natural teeth with good hygiene and regular check ups, there are some root canals that can become reinfected and do not heal properly. By retreating the root canal, it gives the tooth a second chance for healing.
The following are some reasons why a root canal fails to heal.
- Decay or leakage under a crown or filling
- Narrow or curved canals
- Breakdown of the original root canal seal.
Surgical Root Canal Therapy:
Surgical Root Canal Therapy, also known as an apicoectomy, is performed when non surgical root canal therapy was unsuccessful.
Some reasons for a surgical approach are:
- Canals are inaccessible from the crown of the tooth.
- Previous root canal therapy has failed to heal.
- Diagnosis of a crack that cannot be seen on a x-ray or from the crown of the tooth.
- Treatment and repair of root surface and damaged bone
An Apicoectomy is done under local anesthesia. Dr. MacDonald will retract the gum tissue near the tooth, and any inflamed or infected tissue that is around the tip of the root is removed. Once the tissue is cleaned out the root is shortened and a small filling is placed in the end of the canal. A few stitches are used to help hold the gum in place. Depending on the type of stitches used you may need to return to our office after one week to have the stitches removed and the surgical site checked to make sure everything is healing properly. If the Apicoectomy is a success the bone will fill in around the tooth.