Endodontics is a branch of dentistry that deals with the complex internal structure of the tooth. This involves dealing with the health, diagnosis, and treatment of the dental pulp, the soft tissue in the middle of the tooth. The main goals of endodontic treatment are to alleviate pain, eradicate infection, and finally save your natural tooth.
General dentists can refer the patient to an endodontist in complex or difficult dental cases. Endodontists are experts who have undergone specialized and advanced training following dental school and are, therefore, specialists in treating intricate structures inside the tooth. This comprehensive education allows them to treat complicated endodontic issues, including simple root canals and complex surgical cases, and treat traumatic dental injuries.
At Agoura Hills Advanced Dentistry, we provide general and special endodontic services to assist our patients in preserving their natural smiles, so get in touch to see how we might help.
Tooth Anatomy and Pulp Pathology Basics
To comprehend the complexity of endodontic treatment, it is necessary first to learn the basic structure of a tooth and the course of the disease. Every tooth is a multifaceted organ that consists of three layers, including:
- Enamel—This is the outer shell of the tooth, the hardest part of the body, and it is non-living; therefore, it serves as a protective shield.
- Dentin—This is the sensitive middle layer, porous, and composed of the tooth’s central part. It has microscopic tubules that carry sensations such as temperature to the nerves.
- Pulp—The vital center of the tooth is a system of nerves and blood vessels. It gives feeling and life, reaching the crown and the root canals.
The leading cause of endodontic treatment is pulpitis, or inflammation of this vital pulp tissue. It is usually provoked when bacteria enter the pulp via the channels formed by severe decay, cracks, or trauma. Your body’s immune response causes swelling, but since the pulp is stuck inside the rigid walls of the tooth, the swelling causes extreme pressure on the nerve, causing extreme pain.
The most common ones are a chronic toothache, constant sensitivity to hot or cold, and pain during chewing. When this inflammation is not treated, the pulp tissue may die (a condition known as necrosis). The infection may then extend past the root tip to create a painful abscess, which may be very harmful to the nearby jawbone and dangerous to your overall health.
Root Canal Treatment
The process of starting a root canal is a well-organized and careful procedure. The main aim is your comfort and a successful result, and these are the steps that will help to turn a painful issue into a long-term solution:
- Diagnosis and Numbing—Your care starts with a complete evaluation, with diagnostic X-rays, to have a clear view of the root canal anatomy and the level of any infection. Then, your dentist will use local anesthesia to numb the tooth and the surrounding area so you will not feel any pain.
- Isolation and Access—A rubber dam is a small protective sheet placed around the tooth to keep it clean, dry, and free of bacteria in your saliva. This makes the environment sterile, vital to the procedure’s success. Once the tooth is isolated, your dentist will make a small, accurate hole through the crown to reach the inner pulp chamber.
- Cleaning, Shaping, and Disinfecting—The main part of the process is removing the infected or dead pulp tissue inside the tooth. Your dentist will clean all the root canals using small, bendable tools. The canals are also carefully molded to prepare them to be filled and sterilized using antimicrobial solutions to kill any bacteria left behind.
- Filling and Sealing—After the canals have been established clean and dry, they are filled with a biocompatible rubber-like material known as gutta-percha. This substance and adhesive cement form an airtight seal that prevents bacteria from re-entering the tooth. Lastly, a temporary filling is inserted to seal the hole in the crown and safeguard the tooth as it heals.
Post-Treatment Care and Your Ultimate Restoration
Once you have had a root canal, taking good care of yourself is essential for an easy recovery. Some mild tenderness during a few days of healing of the surrounding tissues is normal and can usually be treated with over-the-counter pain relievers. You are not supposed to chew on the treated tooth throughout this period.
The most important part of your follow-up treatment is returning to have your permanent restoration. The temporary filling is not made to last long. A root canal tooth can be brittle; therefore, a permanent crown is generally required to prevent fracture and give the tooth full strength. Procrastination in this last action may jeopardize the treatment process, resulting in reinfection or breakage.
Cost Considerations
Although the price of a root canal depends on the complexity of the tooth, it is nearly always cheaper than the alternative, which is extraction and replacement. Extracting a tooth and replacing the gap with a dental implant or bridge is much more costly and time-consuming.
Many dental insurance plans offer root canal coverage, and the procedure is an affordable and worthwhile investment in your future dental health. Talk to your dentist and insurer to determine what endodontic services are covered. If not, ask your dentist if they offer flexible payment plans.
Surgical Endodontics/Apicoectomy
Although a regular root canal is very successful, there are cases where an infection is persistent at the end of a tooth root. In cases where a standard treatment is insufficient, your endodontist might suggest a microsurgical procedure known as an apicoectomy to help preserve your tooth and eliminate the problem at its origin.
This operation is required if you still have some symptoms, such as pain or swelling, even after a root canal or when an X-ray shows a non-healing infection. Several reasons may necessitate an apicoectomy:
- Complex Anatomy—The root can contain small, branching canals that cannot be reached during the first treatment and contain a chronic infection.
- Concealed Cracks—A tiny crack at the tip of the root may enable bacteria to grow and thus fail to heal.
- Chronic Inflammation—An inflamed tissue or cyst surrounding the root tip may never heal without a direct surgical intervention.
The apicoectomy procedure is particular. First, local anesthesia is used to numb the area completely to make you feel comfortable. Your endodontist then makes a small cut on the gum tissue to expose the underlying bone and the infected root tip.
The infected tissue is then delicately extracted under the microscope with the final few millimeters of the tip of the root. This procedure removes the small canals, which usually cause the problem. A small specialized filling is used to seal the end of the root canal hermetically to avoid reinfection. The gum tissue is then put back in its place and fixed using a couple of small sutures.
The recovery after the surgery is usually easy with tolerable tenderness and swelling. Although an apicoectomy has a very high success rate, should it fail to clear the infection, the main alternative is extraction. Then your dentist will assist you in considering the merits of the replacement, such as a dental implant or bridge.
Endodontic Retreatment
An effective root canal is expected to last a lifetime, but a treated tooth sometimes fails to heal properly or can be re-infected years later. When this happens, endodontic retreatment provides a second opportunity to save your tooth and solve the problem at its root, which allows you to avoid an extraction.
Either of the two scenarios usually necessitates retreatment, for example, a problem with the original treatment or a new problem that undermines the tooth.
- Initial Treatment Problems. The tooth’s anatomy might have been very complicated, and the canals were narrow or curved and could not be cleaned thoroughly. In other instances, a small, concealed canal could have been overlooked.
- New Contamination. A new cavity, a crack in the tooth, or a loose or leaking crown may provide access for bacteria to reinfect the sealed canal system.
Retreatment is more complicated than a first root canal. Your endodontist should take care to remove the old crown or filling to be able to reach the inside of the tooth. Then, with special tools and frequently an operating microscope to give them a better view, they will carefully clear out the old filling material, trying to find the cause of the failure.
This diagnostic phase is essential in detecting missed canals or unseen problems. After cleaning and disinfecting, the canals are temporarily filled with a biocompatible material known as gutta-percha.
As in the first process, the last part is to place a new permanent crown to guard against future fracture and infection of the tooth. Although retreatment is more expensive because it is a more complex procedure, it is still the most economical option as opposed to removing the tooth and replacing it with a dental implant or a bridge. It enables you to preserve your natural tooth, the most desirable choice for long-term oral health.
Management of Traumatic Dental Injuries Using Endodontics
Sports and falls or other accidents might cause traumatic dental injuries that may be frightening, but endodontics plays a vital role in preserving your smile. Treatment will vary according to the nature of the injury, but immediate and appropriate intervention is the most critical factor for a successful outcome.
- Chipped or Fractured Teeth
Treatment depends on the depth of the fracture. Small chips can be smoothed or bonded, and larger cracks might need a crown. When the crack is deep enough to reveal the inner pulp, a root canal is necessary to avoid infection and save the tooth.
- Dislodged Teeth
A tooth forced out of its usual place needs dental care immediately. Your dentist will reposition it and fix it with a temporary splint. A root canal is usually required a few weeks later to avoid future infection because the nerve supply is generally destroyed.
- Knocked-Out Teeth
The knocked-out tooth is an emergency. To preserve the tooth, you should act within 30-60 minutes.
- Touch the tooth with the chewing surface (the crown) only
- Rinse it in water, in case it is dirty. Do not scrub it
- In case you cannot, keep it moist in a small container of milk and get to a dentist as soon as possible
- Root Fractures
A root fracture is an unseen damage beneath the gumline, a crack in the tooth’s root. The prognosis of a tooth with a root fracture greatly depends on the site of the break; a fracture nearer the tip of the root has a much better prognosis than one near the crown. Dental X-rays are used to diagnose these fractures.
Treatment may consist of splinting the tooth in place over several months to allow the fracture to heal. Your dentist will keep a close eye on the tooth because, in some cases, the pulp may be healthy. If the pulp tissue dies, a root canal will be necessary on the part of the root above the fracture line to salvage that part of the tooth.
Pediatric Considerations
In case of a dental injury in a child, the treatment must be given special consideration to the developing smile. Among the most notable differences are knocked-out baby teeth. A primary, or baby, tooth is not replanted in most situations. When trying to replace a baby tooth in the socket, one may accidentally hurt the permanent tooth growing in the jaw beneath the baby tooth.
For young permanent teeth whose roots are not yet fully developed, your endodontist can apply special regenerative procedures to stimulate the root to resume its growth. Every traumatic injury in children should be assessed and monitored carefully to guarantee the future health of their permanent teeth.
Maintenance and Care After Treatment
Once you have completed your endodontic treatment, you have made a big step toward regaining oral health, but that is not all. Your procedure’s long-term success and the preserved tooth’s health will be guaranteed by consistent and careful post-treatment care and maintenance. Consider it insurance on your smile.
Best Practices of Oral Hygiene
Once you are treated, having excellent oral hygiene is more important than ever. You are supposed to brush your teeth at least twice a day with fluoride toothpaste, which will strengthen all your teeth, including the treated ones. Brush carefully yet thoroughly, particularly around the treated tooth and the gum tissue.
Another important daily routine is flossing. You must floss carefully but efficiently around the treated tooth to eliminate plaque between the teeth and under the gumline. In addition to your at-home practice, planning and maintaining regular dental cleaning and check-ups are essential.
These professional cleanings remove plaque and tartar that you cannot get rid of and enable your dentist to check the condition of your treated tooth and general oral health.
Diet and Activity Recommendations
The food you consume and how you utilize your teeth also contribute a lot to the lifespan of your endodontic work. Eating soft foods during the first few days after you receive treatment is prudent, particularly as long as you have a temporary filling. This reduces pressure on the healing tooth.
Being mindful should be continued when you go back to a normal diet. Do not chew hard objects such as ice, candy, or popcorn kernels, which may crack naturally and damage teeth. You should also avoid biting your nails and using your teeth to open packages. Eat and drink carefully with hot or cold food because you might still be somewhat sensitive during the healing period.
Monitoring and Early Intervention
Lastly, becoming an active player in monitoring your oral health is crucial. Be very careful with your treated tooth and around it. Although a bit of soreness can be expected a couple of days after treatment, any recurring discomfort, swelling, ongoing pain when biting, or loose sensation in the tooth should be monitored.
If you experience any of the above symptoms or if your temporary filling or permanent crown falls off, it is crucial to call your dentist immediately. Timely follow-up may assist in solving minor problems before they develop into major ones, avoid complications, and ensure the success of your endodontic care.
Reach Out To a Trusted Endodontist Near Me
Endodontics is a specialty that focuses on preserving your natural teeth by eliminating pain and healing your body internally. If you have symptoms such as a severe toothache, it is better to act quickly because the delay of treatment leads to the aggravation of the infection, the development of complications, and the decreased likelihood of saving the tooth.
Early treatment guarantees greater success rates and a more comfortable journey to recovery, keeping your natural smile intact for years. However, you need a reputable endodontist. Our reputable Agoura Hills Advanced Dentistry providers have over 20 years of endodontic experience, combining high-level skill and dedication to your comfort.
We proudly offer full-service endodontics in Agoura Hills and the surrounding areas. When you experience pain in your teeth, do not postpone the moment. Instead, call us at 818-878-7300 to schedule an appointment or consultation today.