Umhlanga Dental
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• Root canal treatment and Apicectomy
question What happens during root canal treatment?
answer An examination, including x-rays, will be performed. A local anesthetic will be given, if necessary. The complete treatment consists of the following five basic steps:
Step 1. An opening is made to access the affected nerve tissue (pulp).
Step 2. The pulp is removed from within the canals of the roots. Tiny instruments (“files”) are used to clean the root canals and shape them to a form that will ensure they will be well sealed. If the root canal is not completed in one visit, then a temporary filling would be placed to seal the opening and protect the tooth between visits.
Step 3. The root canals are filled and sealed with a material that prevents bacteria from re-entering if tooth are not painful at all. The opening in the crown of the tooth is sealed with a temporary filling. Radiographs (x-rays) are made before, during and after treatment.The tooth should be left ideally for 4 to 6 weeks
Step 4. Your dentist will later remove the temporally filling and replace it with a permanent restoration
Step 5. A crown on the specific tooth is recommended after 6 months the tooth will be come very brittle over a period because off no more blood flow to the tooth after removing the nerve that supply a tooth with blood.

Root Canal Therapy   Endodontic File

question How long should my tooth last after having a root canal?
answer Depends on how much tooth structure is left. A crown on the specific tooth is recommended because after 6 to 8 months the tooth will become increasingly brittle over a period of time due to lack of blood flow to the tooth, since the nerve that supplies blood flow has been removed.

question Does every root canal require a crown?
answer Not every root canal requires a crown immediately   after a root canal  treatment however many of them do ,in order to lend the tooth the proper strength and support. Often times there is not enough tooth structure remaining after a large cavity or fracture to survive without one. Additionally, the tooth can become more brittle after root canal therapy, and would then become more susceptible to fracture, especially if one is a heavy grinder.

question Couldn’t I just have my tooth removed instead of having a root canal?
answer You could, but then adjoining teeth may shift and interfere with biting and chewing if you remove the tooth and fail to replace it.  You may also consider placing an implant or fill in a missing space with a ‘dummy tooth’ as part of a fixed bridge. A fixed bridge may require removing adjacent, healthy tooth structure, and may be expensive and require even more dental treatment. If you can save your own tooth with any degree of long term predictability, then that would always be the first choice.

question Why would someone need a root canal?
answer Root canal therapy (endodontic treatment) is necessary when the nerve (pulp) becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities, repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

question What are the signs and symptoms that root canal therapy is indicated?
answer Indications for treatment include prolonged sensitivity to heat or cold, spontaneous pain, discoloration of the tooth, and swelling or tenderness of the gums adjacent to the tooth in question. Transient sensitivity to cold may just be due to exposed root surfaces or heavy teeth grinding. If the cold sensation lingers, and radiates up giving you a headache, chances are there has been irreversible damage to the nerve. Sensitivity to heat is usually a clear indication that there is some nerve damage present. Sometimes there are no symptoms, and diagnosis is made from a routine x-ray. Other times root canal treatment is recommended as a result of the bacteria from the decay extending into the nerve (pulp) of the tooth; this is seen by the dentist during the examination of the tooth.


question What is the pulp?
answer The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding dentin and enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.
Tooth Structure
question Why do Root Canals have such a bad reputation?
answer The vast majority of root canal procedures proceed painlessly, both during and after each visit! With modern techniques and anesthetics, people report that having a root canal treatment is about as unremarkable as having a cavity filled.

On the other hand, some people present with what we call a hot tooth. A hot tooth is one in which the nerve is alive, but badly inflamed. The tooth is generally already very painful, especially to hot or cold stimuli. These are the ones that require multiple anesthetic injections to get numb.

question Is it normal to feel sore after a root canal?
answer Yes, it is normal to experience a little soreness after the appointment. This may be due to the injection, the necessity of keeping the mouth open for a long time, or the treatment. The instruments used to remove the pulp from within the tooth can sometimes irritate surrounding tissues causing discomfort for a few days. This is usually minor in most cases. Your temporary filling will be hard enough to bite on within approximately a half-hour, but avoid biting or chewing on the treated tooth if it hurts, especially if there was pain or infection present before the procedure.

question Why do some root canals fail?
answer Although only about 5% of root canals fail, there are many possible explanations as to why this might happen. There may be one or more extra canals that the dentist was unable to locate or fully clean out. This trapped nerve tissue can cause abscesses or ongoing bouts of pain and may lead to failure. A fractured root may cause failure of a root canal. Teeth with dead nerves are always brittle. Fractured roots are generally impossible to repair and this means the loss of the tooth. And in some cases there may be a hypersensitivity to the materials used to fill the canals, although this is a very rare occurrence since the gutta percha used to fill the canal is quite inert and is generally very well tolerated.

 


question What is an apicectomy?
answer our teeth are held in place by roots that extend into your bone. The tip or end of each root is called the apex. Nerves and blood vessels enter the tooth through the apex. They travel through a canal inside the root, and into the pulp (nerve) chamber. This chamber is inside the crown (the part of the tooth you can see in the mouth). During root canal treatment, the canals are cleaned. Inflamed or infected tissue is removed. An apicectomy may be needed when an infection develops or won't go away after root canal treatment or retreatment. Root canals are very complex, with many small branches off the main canal. Sometimes, even after root canal treatment, infected debris can remain in these branches. This can possibly prevent healing or cause re-infection later. In an apicoectomy, the root tip, or apex, is removed along with the infected tissue. A filling is then placed to seal the end of the root. An apicectomy is sometimes called endodontic microsurgery because it is often done using an operating microscope. Most apicectomies take 30 to 90 minutes. The length will depend on the location of the tooth and the complexity of the root structure. Procedures on front teeth are generally the shortest. Those on lower molars generally take the longest.
apicectomy