As an Endodontic Specialist, Dr McMichen has undergone 3 years of further training and taken a degree specifically in Endodontics. Endodontics is a branch of dentistry that deals with problems and diseases affecting the internal part of the tooth, known as the dental pulp.
Endodontists have an in depth knowledge of pulpal disease and extensive training in its management. This knowledge is greatly enhanced by the use of modern technology.
Your dentist is likely to refer you to an Endodontist when they anticipate a level of difficulty in the diagnosis or treatment of your problem.
Some facial pain and toothache may not really be from a tooth, but come from a different source. In this case another type of treatment may be needed and not endodontic treatment. Your endodontist can help with this type of difficult diagnosis.
An endodontist's role is also that of educator. It is important to help patients understand their problem, what treatment involves and what can be done to ensure the best possible outcome. We believe that a well informed patient has the best chance of achieving the optimal result.
Endodontics is a field of Dentistry that deals with problems affecting the internal part of the tooth, known as the dental pulp, and conserving its surrounding structures.
Treatment is carried out by an Endodontist. In our clinic, this is usually carried out over one or two long appointments after the initial consultation. In some unusually complex cases or where disease is likely to be persistent, a third visit may be recommended and these visits are usually spread over a few months. In between visits your tooth is sealed solidly. The long term goal is for healing and this may take time.
Once treatment is complete there may be a waiting period to see if healing is taking place. At the end of treatment where possible the tooth is filled in such a way that no additional treatment is needed. However, in some cases, your own dentist may wish to place a crown or different type of restoration over the tooth. We usually are able to advise you about the final restoration of the tooth at the consultation stage. We work closely with your dentist to try to achieve the best outcome for you.
Endodontic treatment helps reduce the inflammation in and around your tooth. As the inflammation goes, in most cases any pain goes too. Not all pain is endodontic in origin and this is carefully considered at your examination.
Reduction in inflammation means less irritation to the bone around your tooth and new bone may regenerate as the disease moves on.
One common cause of tooth loss is due to the structure literally cracking up. The more heavily filled your tooth is, the greater the risk of structural failure. In some rare cases, teeth have never been filled, but the biting forces running through the teeth can cause them to crack.
Where the need for endodontic treatment is confirmed, an Endodontist removes the inflamed or infected pulp, carefully cleans the canal system taking great care to preserve healthy tooth structure whilst reducing any very thin or weak areas that could be prone to cracking.
The canal system may be sealed and the access cavity restored with a bonded restoration. In some cases no further treatment is needed. Dr McMichen feels certain problems may benefit from a multiple visit approach to allow repeated disinfection and medication of the internal system. If this is appropriate, your tooth is solidly sealed at the end of visit one and the second stage is often carried out 4-6 weeks later. Where possible Dr McMichen likes to review the treatment about a year after completion to confirm healing is taking place and your tooth is functioning properly. Some teeth need further restorations such as crowns, but with changes in modern bonded composite techniques this is not always needed. Dr McMichen will discuss with you at the consultation stage and confirm at the end of treatment if she feels you are likely to need further restorative work. This is more common when a tooth already has a large pre-existing restoration or part of a tooth has broken away. In these cases Dr McMichen will return you to your dentist for any long term additional reconstruction.
The restoration of the tooth is an important part of treatment because it seals the cleaned canals from the oral environment, protects the tooth and restores it to function. In our clinic we go to great lengths to carry out minimally invasive dentistry, protecting and preserving specific areas of the tooth. This is helped by using the microscope and in certain cases with the pre-treatment anatomical information gained from a CBCT scan.
Depending on the original problem, there may be some ongoing discomfort post-treatment for a short while. This is usually managed very well over the counter medication such as ibuprofen and paracetamol. It is essential to check any medication is suitable for you. Antibiotics should generally be avoided and are usually only recommended if you have a facial swelling and raised temperature.
Have Additional Questions?
While Dr McMichen will thoroughly explain any questions you might have regarding endodontic treatment at the time of your appointment, feel free to let us know if you have further questions by calling or emailing the Clinic.