Endodontics

Endodontics is the dental discipline concerned with the prevention and treatment of diseases and injuries to the dental pulp (the nerve and blood supply to the tooth). Root canal treatment is the most common treatment provided in endodontics. A dentist who specifically provides endodontic treatment is referred to as an endodontist.

What is endodontic treatment?

Endodontic treatment removes infected or damaged tissue from inside a tooth. This tissue, called the pulp, contains nerves and blood vessels that help nourish the tooth. After the pulp is removed, the pulp chamber and root canals arc cleaned, disinfected, filled and sealed.

What are the benefits of endodontic treatment?

Endodontic treatment saves teeth that would otherwise need to be extracted. Although the pulp is removed, the treated tooth remains alive, nourished by the surrounding tissues. There is no real substitute for your own tooth in terms of health and investment.

What caused the problem with my tooth?

The most common cause of pulp damage is severe decay or a fracture that exposes the pulp to bacteria that may cause infection. Other causes of pulp damage include traumatic injury such as a blow to the mouth, a cracked or loose filling or repeated fillings in a tooth, and occasionally periodontal disease.

How many appointments are necessary?

Sometimes endodontic therapy is completed in one appointment but usually two or three visits may be necessary.

How long will the tooth last?

With proper restoration and care it may last a lifetime

Pulp Damage

Signs and Symptoms

  • Discolouration: a front tooth with a dead pulp will often turn grey or brownish, possibly over the course of several years.
  • An abscess or a small persistent small hole on the gum: it may look like a pimple.
  • Signs or symptoms of a spreading dental infection: high temperature, tender or swollen lymph nodes under the lower jaw or upper neck area, or swelling of the soft tissues of the face and under the lower jaw.
  • Recent toothache: severe throbbing tooth pain of irreversible pulpitis and/or pain on biting. When the pulp has died the throbbing toothache may stop completely.
  • A history of trauma to the tooth: the dental pulp of front teeth is more likely to die from trauma while for back teeth, tooth decay or deep fillings are the more likely cause.
  • Pain which lasts more than three days after dental treatment: especially if it involved dental work close to the pulp.

 

What are the main causes of pulp damage?

Tooth Decay (Dental Caries)

Deep dental cavities contain millions of germs. As they spread through the dentine they will cause pulp inflammation and toothache which if left untreated will eventually kill the pulp. The bacteria will continue to pass through the dentine until they have infected the dead pulp space.

Dental Injury/Trauma

Periodontal trauma (injury to the gum, bone and ligaments around a tooth): if a tooth receives a sudden blow, the root will be forced against the bone. Often this just results in minor tenderness when biting for a few days. However, in severe cases the vulnerable area where the nerves and blood vessels of the pulp enter the root apex may be crushed or severed. This will result in the death of the pulp inside the tooth because its blood supply has been stopped. Depending on the type and severity of injury the dead pulp space may remain free of bacteria or it might become infected.

Tooth fracture: moderate or large fractures can damage or expose the dental pulp, resulting in severe pulp inflammation, pulp infections and pulp death. Prompt dental treatment will improve the chances of preserving pulp vitality, keeping the pulp alive, but in severe cases tooth extraction or root canal treatment (RCT) will be necessary.

Front teeth are more vulnerable to both types of dental injury but back teeth with cavities or fillings can also fracture too. Custom-made mouth guards are the most effective way to protect your teeth if you participate in activities which pose a risk of dental injury.

 

Micro Surgery

This is required when conventional root canal therapy alone hasn’t achieved the required outcome or where there is no access to the root canal system with standard techniques. It is indispensable in locating root fractures & diagnosing cracked roots. The most common procedure is an Apicectomy. Apicectomies are most frequently carried out on upper & lower front teeth.