Southern California Endodontics

Root Canal/CBCT

Education

What is an Endodontist?

An Endodontist is a dental specialist who deals with infections that occur inside the tooth. You might be experiencing pain or sensitivity to hot or cold temperatures, biting, swelling, gum sensitivity, abscess, discoloration of the tooth or you may have no symptoms at all. You might be experiencing these symptoms because of deep decay, trauma, chipping, cracking or repeated dental procedures. In some cases, the inside of the tooth (called the pulp) dies, or becomes necrotic, for no immediately apparent reason.

There are several ways in which Endodontists save teeth that have infections or necrosis. However the most common procedure is called root canal treatment. More than 14 million teeth receive some form of root canal treatment each year-you're not alone. Moreover, you are in good hands. All Endodontists complete additional years of post doctorate education to become a specialist.

What is Root Canal Therapy?

Root canal therapy is the most commonly performed procedure amongst all endodontic treatments. An endodontist performs root canal treatments to treat problems related to the soft inner pulp of a tooth.

Every tooth consists of three different layers. The enamel is the outer layer ot the tooth, which is the hardest part of the body. The inside layer is called dentin and the pulp is soft tissue and nerve located in the root canals of each tooth.

If for any reason the pulp space is exposed to the outside, the tissue becomes contaminated and eventually infected. The exposure of pulp happens in many circumstances.

Root canal treatment is the process of going inside the pulp space and removing the infected and dead tissue. The space is disinfected  and sealed with special materials. Root canals are performed with advanced techniques and materials and are more comfortable and faster than in years' past.

Why do I need a Root Canal?

Root canal treatment is required when nerve tissue inside the teeth degenerates. Without root canal treatment, the infection in the tooth pulp can result in an abscess, which in turn can cause damage to the jawbone. You will need a root canal to save your tooth and to ensure that the tissue around the root of the tooth remains healthy and free from inflammation. There are several reasons why your tooth may become inflamed, such as deep decay, large fillings, trauma to the tooth, a chipped tooth or repeated dental work.

What are the symptoms that a Root Canal is needed?

You may need a root canal if a tooth is causing you pain or if the gums adjacent to the teeth are tender and swollen. Another symptom is if the tooth appears discolored and has become extra sensitive to heat and cold. If these symptoms reveal inflamed and infected pulp inside the tooth then your dentist may recommend a root canal procedure.

What are the causes of Dental Pulp or Nerve damage?

Dental caries (cavities), chipped teeth, cracked dental fillings and injury to the teeth can cause damage to the dental pulp. If dental caries are not treated in time, the decay spreads inwards into the tooth pulp causing nerve damage. Cracked dental fillings allow saliva and harmful bacteria to reach the root canal and infect the pulp. Fractured teeth can expose the pulp. Injuries to the teeth can cause pulp damage as well, even though there are no external signs of damage to the inside of the teeth.

What does the Root Canal procedure involve?

The procedure takes place in four steps. First, the dentist studies the x-ray of the infected tooth and then administers a local anesthetic. The dentist will remove the inflamed nerve tissue through an opening in the crown of the tooth. The root canal is cleaned properly so that no debris or bacteria is left behind. This will ensure that the infection and tissue swelling does not happen again. The dentist will seal off the cleaned root canal space. The root canal is filled with gutta percha and a temporary filling is placed. A crown needs to be placed on the sealed tooth which will allow the tooth to function normally but you are sent to your general dentist for the final restoration.

Will there be pain?

Root canal treatment can be one of the most painless dental procedures. As a matter of fact, the pain that requires treatment is most frequently eliminated at your initial visit. At Southern California Endodontics, we have the most advanced anesthesia available. In addition to nitrous oxide analgesia, we untilize the latest advances in local anesthesia and interosseous injections.

Risks associated with Root Canals

After completion of the root canal therapy, you may feel some discomfort for a few days. To alleviate the discomfort you can follow the dentist's recommendation of taking any over the counter pain medication. In more extreme cases, the dentist may prescribe an antibiotic and prescription strength pain reliever to help reduce any remaining infection.

Following a root canal, you should never chew directly on the repaired tooth until its final restoration has occured or your tooth may crack. Also, keep in mind that the longer you wait to complete the final restoration the more likely bacteria will reinfect the treated canal requiring the therapy to be performed all over again.

Root canal therapy, like every other treatment is not free of unknowns and complications. There is a possibility that during the procedure a shaping file could break and get stuck in the root canal or that the root of the tooth fractures. In other cases, a good seal may not be achieved due to the shape of the root. Lastly, it is possible to miss a hidden root or an extra canal that is in need of treatment. Of course, these complications are the exceptions and not the norm.

In the event that root canal therapy is unsuccessful, the dentist can discuss alternative options including retreating the tooth, treating the tooth surgically or extracting the tooth and discussing an implant option.

What are Dental Implants?

While nothing is quite as good as the natural tooth, implants have been around for many years and have gained wider and wider acceptance over time as they have proved a successful method for replacing missing teeth. They offer a way to have artificial teeth that look natural and feel secure.

The implant itself, often made of titanium, is used like an artificial root to support the false tooth or teeth. The dental surgeon places the implant into a hole made in the jawbone. A post can then be secured to this artificial root and can be used to secure a prosthetic device, such as a crown or bridge, above the gum. Implants can also be used in conjunction with a removable denture to create a more secure and stable base for the denture.

Implants have many advantages over removable dentures. Because removable dentures are not permanently fixed in place, they can move around when you eat and speak. Additionally, over time the bone that supports the denture changes and shrinks, making it increasingly difficult to support a denture comfortably.

Implants also have advantages over fixed bridges, especially when the teeth adjacent to the missing tooth or teeth are healthy, In order to create a fixed bridge, your general dentist must usually place crowns on these adjacent teeth-as they are the support for the replacement tooth or teeth. If these teeth are free from decay and existing restorations, you may prefer to leave them in their natural state, rather than alter them to hold the necessary supporting restorations. Implants replace the missing tooth or teeth while elaving all adjacent teeth unaltered.

How successful are Implants?

While impalnts are highly successful, the likelihood of success depends on several factors. The amount of bone available to support the implant, the patient's health, whether or not the patient smokes and the quality of ongoing home care effect long term success.

Cone Beam-Computed Tomography

As of 01/31/2012, we will have a J. Morita Veraviewpocs 3De Pan. This unit will give us great advantage in the diagnosing and treatment of root canal retreatments and surgeries, not to mention implant surgeries. The technology is advancing patient care within the confines of endodontics and oral surgery exponentially. Our unit is also available for use by referring doctors needing Pano's and Cone Beam scans for their patient needs in their offices. Please call any of our front office staff with questions you may have. For more information on CBCT technology in endodontics, please visit www.aae.org/colleagues and check out the Summer 2011 Endodontics Colleagues for Excellence article: Cone Beam-Computed Tomography in Endodontics. 

• "Dr. Greiner was a very professional, kind and courteous. A very compentant man indeed."
  -Richard D.
• "Sydney went above and beyond to help me get through the x-rays. Love her for that."
  -Cheryl N.