Nerve Treatment

(Endodontics Or Root Canal Treatment)

Endodontics is the field of dentistry that deals with the tooth pulp and the tissues surrounding the root end of a tooth. The pulp (containing nerves and other soft tissues) can become diseased by deep decay or become injured when a tooth is knocked in an accident, or cracked in a traumatic bite. The pulp unlike the rest of the body is encased within the tooth and is unable to repair itself when irreversibly inflamed. If it gets inflamed and/or infected, root canal treatment is required.

The scope of endodontic services includes: pulp capping, root canal treatment or retreatment, endodontic surgery, bleaching of discolored non-vital teeth, treating of traumatic tooth injuries, and diagnosing and treating dental pain.


Types of Treatments

Endodontic microsurgery (apicoectomy, intentional replantation, etc)

Endodontics therapy(Root canal treatment) using microscope

Management of endodontic complications and errors

Management of odontogenic pain (Toothache)

Management of pulpal and periapical diseases

Vital pulp therapy

Management of traumatic dental injuries

Non-vital teeth whitening

Restoration of endodontically treated teeth

Regenerative endodontics of immature adult teeth


Why Root Canal Treatment?

Every healthy tooth has a pulp chamber, which contains the pulp: nerves and blood vessels. The pulp serves to form the roots of the tooth when it was developing. It also provides sensation to the tooth when exposed to extreme temperature and alarms us when there is decay.

However not all cavities can be resolved by just a filling, if the decay or pre-existing damage is too deep; the pulp can become irreversibly inflamed and infected eventually.

Once the pulp is injured, the tooth starts to die; this can cause extreme pain – a toothache.

Overtime, the infection can travel down the root to cause damage around the structures beyond the root. Swelling or pimple-like structure (sinus tract) can form around the gums of the tooth.

Other causes of pulp injury include very deep fillings, trauma, cracked tooth and severe gum disease.

Do I have any other options?

Once the injury or damage is bad enough to affect the pulp, the only other option apart from root canal treatment is Dental Extraction.

Dental Extraction causes many other problems affecting chewing and speech. Teeth adjacent and opposing the missing tooth can also drift with time. This may increases risk of decay and gum disease. Missing teeth in the front also poses aesthetic issues, which may affect confidence and self-esteem.

Root Canal Treatment is the best choice to save the tooth, if possible.

What are the steps in Root Canal Treatment?

Decay when present is first removed. An opening is made at the top of the tooth. Using this opening, the damaged pulp tissue is removed from the pulp chamber and root canals.

The canals are thoroughly cleaned and disinfected. Sometimes medication is placed in the canals and the opening is closed with a temporary filling until the next appointment.

After the canals are flushed clean and dried, they are sealed with a biocompatible material. The opening in the tooth is also sealed with a permanent filling usually called the core. If the tooth is too badly damage, a post may also be inserted to retain the core.

In order to better protect the back teeth (premolars and molars) after Root Canal Treatment is completed, a Crown should be placed on these teeth. Sometimes, front teeth that are badly broken down to begin with will also need crowns.

Anything else I need to know?

The cost and the number of visits required depend on which tooth and the degree of difficulty. Generally, Root Canal Treatment for the front teeth is easier, whereas the back teeth (premolars and molars) are more complicated and will cost more.

X-rays are also needed during Root Canal Treatment.

After Root Canal Treatment, the back teeth (all the time) and sometimes-front teeth will need a Crown. Without crowns, these teeth that are root canal treated may fracture with time.


Frequently Asked Questions On Endodontic Treatment:

What are the benefits of endodontic treatment?

Endodontic treatment saves teeth that would otherwise need to be extracted. Saving your natural teeth, if possible, is the best option. Occasionally a tooth cannot be saved if the decay is too huge or if the trauma sustained was too severe. Endodontic treatment can be performed only if the root canals are accessible and can be adequately cleaned and sealed. The tooth must also have sufficient bone support.

How many appointments are necessary?

Usually root canal treatment can be completed in one or two times. Sometimes it may need more visits depending on the complexity and severity of disease.

How long will the teeth last after root canal treatment?

With proper restoration and dental care such as proper brushing and flossing, regular dental check-up, it may last a lifetime. After the completion of endodontic treatment, your dentists will usually advise on a restoration, for instance a crown that protects the tooth from future fracture.

Is the procedure painful?

Endodontic treatment does not cause pain; in fact it relieves it. When you have a severe toothache, the toothache is most likely due to damaged tissues in the tooth. Endodontic treatment removes this damaged tissue from the tooth, thereby relieving the pain you feel. Before treatment, local anesthetic will be given thus there will be no pain during the procedure.

Will there be pain after procedure?

There may cause some tenderness after root canal treatment. But taking some painkillers can relieve the discomfort. If pain persists longer than advised, you may call your dentist or arrange for a review appointment.

Can the endodontic treatment fail?

Endodontic treatment can have success rate of up to 90% in general. However failure can occur if:

The affected tooth develops decay again underneath the core/crown due to ineffective oral hygiene

The tooth cracks due to failure to place a crown

Severe gum disease develops

If endodontic treatment fails, it may need endodontic surgery or extraction. Root canal retreatment may be considered in certain cases.

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