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Dr Fiona McMichen | Endodontics

THE TANSHIRE CLINIC

 
Endodontic treatment
What Happens During Endodontic Treatment? or What is a Root Canal?

You will be made completely comfortable.  A protective cover will be placed around the tooth to isolate it,  keeping it clean and dry during treatment.  The number of visits will depend on your particular problem. Some treatments take may be carried out on visit which will be separate to the consultation, but generally our protocol for treatment involves two visits as we feel this may maximise healing potential. Where teeth are very complex or diseased, there may be advantages in staging treatment over a longer time to achieve more predictable healing and some of these teeth may benefit from three visits. In between visits it is fine to carry with your normal routine, inclucing travelling abroad.

The time taken for any individual case will be dependant on the level of infection/inflammation and complexity of the anatomy.  Our aim is to carry out the very best treatment we are able to for your tooth .  Let's look at the basic steps for nonsurgical endodontic therapy.

There are, of course, no guarantees.  Root canal or endodontic therapy has a very high degree of success resulting in healing, up to 90%.  Teeth which can be treated near ideal have a success rate up to ninety percent!  We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision.  If a tooth does not completely heal following root canal or endodontic therapy you still have options. Where teeth have endodontic disease, successful endodontic treatment will result in bone regeneration. Unfortunately if a tooth is lost, inevitably some level of bone will be lost. Certain teeth are not suitable for endodontic treatment and if this is the case Dr McMichen will always advise other treatment options.

Diagnoses and Treats Pain

Oral pain such as toothaches or cracked / fractured teeth can often be difficult to pinpoint.  Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist has specialist training in diagnosing and treating this type of pain.

Treats Traumatic Injuries

Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child's permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. In certain cases revitalisation of teeth can be promoted. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.

Will I need to return to your office for Additional Visits?

Once endodontic therapy is completed the treatment on your tooth should be reviewed, usually 6-12 months after completion.  This allows us to make sure the tooth has healed or is healing properly.  You will be sent a reminder when we feel it is appropriate to reevaluate the area. Certain teeth may need to be followed up over a longer period.

Retreatment

 

Occasionally a tooth that has undergone endodontic treatment has ongoing signs of disease or pain despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth often can be maintained with further endodontic treatment. A common cause of continued disease is structural breakdown of a restoration or the tooth surrounding a restoration. This allows bacteria from the mouth to filter into the tooth. In the past endodontically treated teeth have often already been heavily filled. Crowning a heavily filled tooth may help to protect the underlying tooth structure from flexing and cracking around a large filling. Dr McMichen will advise you if this is necessary for your tooth and your own dentist would carry out this procedure for you. We go to great lengths to preserve tooth structure and if endodontic treatment has not already been carried out on a tooth, with the use of microscopes, specialised flexible instruments and in some cases 3D radiography, maximum preservation of the tooth structure can be achieved and the internal work can be carried out very conservatively . This takes time and is more technically challenging.

The images show a molar before and after conservative endodontic treatment. Older style treatment involves greater removal of tooth to access the internal system. It should be highlighted that this level of tooth conservation is only possible if the structure is sound, if decay is present it burrows under tooth structure that may need to be removed in order to eliminate the decay.

 

 

Fiona McMichen | Endodontics | Endodontic treatment | Root Canal