Endodontic Procedures

Root Canal Therapy

Root Canal Therapy also known as Endodontic Therapy, is more common than most people think. The root canal process is no more invasive than having a filling placed. The reputation that root canal therapy is painful is undeserved because there is no pain associated with having the treatment performed.

Root Canal is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s Nerve lies within the root canal. The function of the nerve is for growth and to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth. However, not treating the infection can lead to serious health problems, especially in seniors and young children.

Symptoms of pulp damage include, pain, sensitivity to hot and cold, or pressure. Signs to look for include, tooth discoloration, swelling, and tenderness around the gums. However, if the tooth is Necrotic, there may not always be any symptoms or signs.

Root Canal Therapy is used to repair and save a tooth that has an infection in the nerve. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Gutta Percha filling is used to seal the tooth. Gutta Percha filling is made of a rubber substance that is melted into the canal to seal the end of the tooth to prevent bacteria from exposing the canal. A temporary filling is used in order to protect from exposure to bacteria or decay, until the patient returns to their regular dentist.

Without treatment, there is a constant entry of bacteria into your body through the nerve.The only two options are Root Canal Therapy, or to extract the tooth. While extracting a tooth may seem like the easiest solution, what is not realized is that removing the tooth can cause problems in adjacent teeth.

Other causes for needing Root Canal Therapy may be cracked teeth or traumatic injuries.

Extracting a tooth versus Root Canal Therapy? While some people think it is very easy to remove the tooth, not only does it affect your adjacent teeth, it also affects your bite, your health and your self esteem. If you remove your tooth the only option is to replace the tooth using foreign objects such as Implants, or Bridges. Both alternatives are expensive and require invasive procedures. Saving your natural teeth is always the best recommendation.

Dr. Brian Haymore is very skilled and proficient in all Endodontic procedures. Haymore Endodontics assures you we will get to the root of the problem.

Endodontic Retreatment performed by Dr. Haymore

Endodontic Retreatment

A Root Canal Treatment can last as long as your natural teeth. Occasionally, as with any dental or medical procedure, a tooth may not heal as well as expected. However, if your tooth has failed to heal or has developed new problems, an Endodontic Retreatmentgives you another chance to save your tooth.

Common reasons a Retreatment is needed include:
Curved, or narrow canals that were not treated in the initial procedure or complicated canal anatomy. A patient did not get the crown or restoration within two weeks as directed. A restoration did not seal the tooth completely allowing salivary contamination to enter the tooth.

There are times new problems can occur after the first treatment, such as: a loose, cracked tooth, a tooth injury or fracture, or a cracked crown that may have exposed the tooth to new decay.

How is the Retreatment performed?
During a Root Canal Retreatment, the canal is re-opened in order to gain access to the root canal filling material. In many cases any restorative matter such as crowns or post core material may need to be disassembled and removed in order to properly reach the root canal. After removing the canal filling, the canals are cleaned and all bacteria is removed.

The canal is carefully examined using special illumination and magnification instruments to gain full view of any anatomy problems or any additional canals.

A new filling material will be placed in the canal and sealed in order to eliminate any exposure to the canal.

A temporary restorative filling is used to protect the treated tooth until you see your general dentist. If a canal is too narrow or blocked, Endodontic Surgery may be recommended. Dr. Haymore will discuss your options and recommend the best treatment for your tooth.

It is imperative that you do not delay in returning to your dentist within two weeks to place a permanent crown or other restorative material on the retreated tooth.

Is Endodontic Retreatment painful?
There is no pain associated with the procedure as Dr. Haymore is very skilled and proficient in his specialty. Dr. Haymore and his staff do everything they can to make you as comfortable as possible.

It is normal for the retreated tooth to experience sensitivity to pressure when biting down for up to three weeks. A prescription of antibiotics and appropriate pain reliever will be given along with post operative instructions.

The investment of Endodontic Retreatment can last many years, giving your teeth full functional benefits lasting almost a life time. Saving your natural teeth is always recommended and is the most inexpensive dental procedure available.

Endodontic Surgery performed by Dr. Haymore

Endodontic Surgery

To understand Endodontic Surgery, it helps first to know something about the nonsurgical endodontic procedure, or “root canal”.  A root canal is necessary when the soft inner tissue, or “pulp,” of the tooth becomes inflamed or infected.  This may happen as a result of deep decay, repeated dental procedures on the tooth or a blow to the tooth.  Endodontic treatment removes the damaged pulp.  Then the tooth’s canals are cleaned and filled to help preserve the tooth.

In a few cases, however, nonsurgical endodontic treatment alone cannot save the tooth.  In such a case, your dentist or endodontist may recommend surgery.

Who performs endodontic surgery?
All dentists received training in endodontic treatment in dental school.  However, because endodontic surgery can be more challenging than providing nonsurgical treatment, many dentists refer patients needing surgery to endodontists.

Endodontists are dentists with at least two years of advanced education and training in root canal techniques and procedures.  In addition to treating routine cases, they are experts in performing complicated procedures including surgery.  They often treat difficult cases – such as teeth with unusual or complex root structure or small, narrow canals.  This special training and experience can be very valuable when endodontic surgery is necessary.

Why would I need endodontic surgery?
Surgery can help save your tooth in a variety of situations.

-Surgery may be used in diagnosis.  If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment.  In such a case, surgery allows the endodontist to examine the root of your tooth, find the problem and provide treatment.

-Sometimes calcium deposits make a canal too narrow for the cleaning and shaping instruments used in nonsurgical root canal treatment to reach the end of the root.  If your tooth has this “calcification”, the endodontist may perform endodontic surgery to clean and seal the remainder of the canal.

-Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment.  However, in a few cases, a tooth may fail to heal.  The tooth may become painful or diseased months or even years after successful treatment.  If this is true for you, surgery may help save your tooth.

-Surgery may also be performed to treat damaged root surfaces or surrounding bone.

What is an apicoectomy?
Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection.  When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicoectomy.

In this procedure, Dr. Haymore opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue.  The very end of the root is also removed.

A small filling may be placed to seal the end of the root canal and a few stitches are placed in the gum to help the tissue heal properly.

Over a period of months, the bone heals around the end of the root.

Are there other types of endodontic surgery?
Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root or even removing one or more roots.  Dr. Haymore will be happy to discuss the specific type of surgery your tooth requires.

In certain cases, a procedure called intentional replantation may be performed.  In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth and then replaced in its socket.

These procedures are designed to help you save your tooth.

Will the procedure hurt?
Local anesthetics make the procedure comfortable.  Of course, you may feel some discomfort or experience slight swelling while the incision heals.  This is normal for any surgical procedure.  Dr. Haymore will recommend appropriate pain medication to alleviate your discomfort.

Dr. Haymore will give you specific postoperative instructions to follow.  If you have questions after your procedure, or if you have pain that does not respond to medication, call our office.

Can I drive myself home?
Often you can, but you should ask Dr. Haymore before your appointment so that you can make transportation arrangements if necessary.

When can I return to my normal activities?
Most patients return to work or other routine activities the next day.  The doctor will be happy to discuss your expected recovery time with you.

Does insurance cover endodontic surgery?
Each insurance plan is different.  Check with your employer or insurance company prior to treatment.

How do I know the surgery will be successful?
Endodontic surgery has been suggested because your dentist or Dr. Haymore believes it is the best option for you.  Of course, there are no guarantees with any surgical procedure.  The doctor will discuss your chances for success so that you can make an informed decision.

What are the alternatives to endodontic surgery?
Often, the only alternative to surgery is extraction of the tooth itself.  The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting.  Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most cost-effective option for maintaining your oral health.

No matter how effective modern tooth replacements are – and they can be very effective – nothing is as good as a natural tooth.  You’ve already made an investment in saving your tooth.  The pay-off for choosing endodontic surgery could be a healthy, functioning, natural tooth for the rest of your life.

Dr. Haymore is a specialist members of the American Association of Endodontists (AAE) and provides the highest standard of professional care in a friendly, caring, and comfortable environment.

If you would like additional information, please contact us at 702-586-0955 or by email at brianhaymore@msn.com.