Endodontics – inside (endo) the tooth (dontia). The dental pulp is the tissue (composed of nerves, blood vessels, and other tissues) contained within the tooth. It functions in the development of the tooth (the crown and roots) and it continues to provide nourishment, and sensory response throughout life. The specialty of Endodontics is devoted to the biology, physiology, pathology and treatment of the dental pulp.
The dental pulp can become diseased and inflamed and the damage (most often indicated by sensitivity to temperature or deep seated throbbing) is sufficiently advanced that the pulp tissue cannot be treated and made to recover. This irreversible problem requires removal of the dental pulp, hence a root canal procedure.
This deterioration can be more intense and the dental pulp has become dead tissue. The tooth will no longer respond to temperature changes and sweets. The dead pulp tissue and bacteria from the inside of the tooth can affect the bone and cause infection outside the tooth at the tip of the root(s).
Symptoms most commonly associated with non-vital infection are a tooth that hurts to bite on or becomes sore to touch. An x-ray will help in the diagnosis of this problem, but only when the infection is so advanced as to cause loss of bone around the root tip of the tooth.
The treatment of either of those two categories of infection is essentially the same in routine cases. Root canal therapy is the treatment of the inside of the tooth so that the source of the infection or the source of inflammation causing the dental pain can be removed. The tooth is then protected from the problem recurring in the future.
The goal of root canal therapy is to create an environment inside the tooth to enable the infection to heal and render the tooth symptom free. This environment should be as sterile as possible, removing all tissue debris and bacteria to the tip of the root. The space must then be filled with an inert material to maintain this clean space.
The sophistication of endodontic techniques and new materials has made modern day endodontics a painless and uncomplicated procedure. Invariably, it is no different in its scope than a dental visit for a large filling. The majority of endodontic procedures are done in a single appointment. State-of-the art local anaesthesia (freezing) techniques are always used in conjunction with relaxants to minimize stress and anxiety; nitrous oxide sedation is available as well. Upon completion of your treatment, we immediately communicate with your referring dentist so that follow-up treatment for restoring and protecting your tooth can be provided by them by them at the earliest opportunity. It is important that you contact your dentist for this treatment after your final visit with us. The tooth is finished with a permanent seal over the root canal system and a temporary filling in the access chamber which your dentist will remove and replace.
You will be completely numb during the procedure. Dr. Martin Katzman is well versed in a wide variety of anaesthesia protocols to ensure that you will feel nothing whatsoever during the procedure. There may indeed be post operative sensation, but for the most part, this is manageable with a specific regimen of over-the-counter medication.
Unfortunately not………Antibiotics are indicated when there is swelling, a temperature, or other systemic signs of infections. Antibiotics may be useful to diminish symptoms such as biting pain before the root canal can be started, and may help prevent some types of post treatment pain involved with having the root canal performed. However, antibiotics cannot cure a root canal infection because the source of infection is inside the tooth where there is no blood supply. Therefore there is no mechanism to deliver the antibiotics. The cure is the complete cleaning, shaping and obturation of the contaminated root canal space.
Patients are referred for a root canal therapy because their dentist has recognized a need for special case management more suitably treated by an endodontic specialist. Acceptance of a ‘treatment’ appointment means you are prepared to proceed with the necessary procedure. However, if you have questions concerning the nature of the therapy required or you feel that special issues (medical history, insurance coverage) need to be discussed, or you simply want to meet and get to know Dr. Martin Katzman and his team before treatment is started, then a short appointment for ‘evaluation and consultation’ should be made prior to treatment. All of your questions will be answered prior to accepting root canal therapy (informed consent) to save your tooth.