To understand Endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature, it can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.
Endodontic treatment can often be performed in one or two visits and involves the following steps:
Once it is determined that the tooth requires root canal treatment through a thorough exam, the Endodontist administers local anesthetic. After the tooth is numb, the Endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
With proper care, most teeth that have had Endodontic (root canal) treatment can last as long as other natural teeth. In some cases, however, a tooth that has received Endodontic treatment fails to heal or the pain continues. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has failed to heal or has developed new problems, you have a second chance. Another Endodontic procedure may be able to save your tooth.
As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:
- Narrow or curved canals were not treated during the initial procedure
- Complicated canal anatomy went undetected in the first procedure
- The crown or other restoration was not placed soon enough after the procedure
- The restoration did not prevent saliva from contaminating the inside of the tooth
In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:
- New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth
- A loose, cracked or broken crown or filling can expose the tooth to new infection
To understand Endodontic surgery, it helps first to know something about the nonsurgical Endodontic procedure, or “root canal”. A root canal is necessary when the soft inner tissue, or “pulp” of the tooth becomes inflamed or infected. This may happen as a result of deep decay, repeated dental procedures on the tooth, or a blow to the tooth. Endodontic treatment removes the damaged pulp. Then the tooth’s canals are cleaned and filled to help preserve the tooth.
In a few cases, however, nonsurgical Endodontic treatment alone cannot save the tooth. In such a case, your dentist or Endodontist may recommend surgery.
Usually, a tooth that has undergone a root canal can last the rest of your life and never need further Endodontic treatment. However, in a few cases, a tooth may fail to heal. The tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth. Although there are many surgical procedures that can be performed to save a tooth, the most common is called an “apicoectomy” or “root-end resection”. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicoectomy.
- Treating infection that is not responding to traditional root canal therapy
- Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment.
- Sometimes calcium deposits make a canal too narrow for the cleaning and shaping instruments used in nonsurgical root canal treatment to reach the end of your root. If your tooth has this “calcification”, Endodontic surgery may be able to clean and seal the remainder of the canal.
In this procedure, the gum tissue near the tooth is opened to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.
Our Endodontists are specifically trained to treat recurring Endodontic infections, both surgically and nonsurgically. We offer the most up to date and technologically advanced surgical treatment in our office.
We recommend evaluating the tooth in 6-12 months following the procedure to ensure proper healing at no additional cost to you.