Root Canal Treatment

Root Canal Treatment
Dental Pain can take many forms and can greatly impact on your quality of life. Symptoms can include sensitivity to hot or cold, sharp pain when biting down or even a dull aching pressure in the jaw. If you are experiencing pain or discomfort, this may be a sign that you require Endodontic (Root Canal) treatment.

At Belvedere Dental Care all root canal treatments are carried out by Dr Browne who is a specialist in Endodontics. Dr Browne uses the most up-to-date materials and equipment, including a Dental Operating Microscope and Cone-Beam Computed Tomography (CBCT) Scanner, to ensure that all endodontic treatments are carried out to the highest international standards. Dr Browne undertakes all aspects of endodontics including Primary Treatments, Re-treatments, Apicectomy and Trauma Management.

FAQ

What is Root Canal Treatment?
A root canal (Endodontic) treatment involves removing the damaged or infected pulp from within the tooth. Once the inside of the tooth has been cleaned and disinfected, it is then filled with a material designed to seal the root and prevent further infection. A filling will then be placed to seal the entrance into the tooth through which the pulp was accessed.

Root Canal Treatment

Root Canal Treatment

Why do I need a Root Canal Treatment?
Root canal treatment is the only means to save a tooth when irreversible pulp (nerve) damage has occurred. This commonly manifests as pain or tooth ache. However it may also manifest as an incidental finding on X-rays or during a dental examination where a painless blister or swelling is observed on the gum.

Root Canal

The damage to the pulp may have been caused by deep decay, cracks in the tooth, trauma or repeated dental procedures. If the tooth is not treated the pain may persist, an abscess may develop which can be even more painful and debilitating. In the event where there was no pain, the infection can increase in size making the subsequent treatment more difficult.

Is it Painful?

Contrary to popular belief, root canal treatments should not be painful. The aim is not to cause pain but to relieve it. Dr Browne uses the most effective anaesthetic techniques to make sure you feel nothing during the entire procedure.

After the treatment has been completed, the tooth may feel a little tender or uncomfortable to bite on for a few days. Occasionally (5% incidence) a “flare-up” can occur which can give rise to significant pain &/or swelling. Should this occur the acute symptoms are usually treated with antibiotics and anti-inflammatories (painkillers). A flare up is an unfortunate and rare occurrence and does not affect thelong-term success of the treatment. If a flare up does occur each patient receives clear instructions on how to manage it and will also receive an emergency mobile number to contact out of hours.

Is Root Canal Treatment Successful?

Root canal treatment is a very successful treatment when performed to a high standard. However, it is important to remember that it is impossible to guarantee the success of any medical procedure. Even with the very best treatment, healing may not occur due to circumstances beyond the control of the clinician. For teeth without an abscess or an established infection, root canal treatment enjoys a very high rate of success (90%-95% survival at 10-15 years). Once a tooth has become infected the success rate can diminish with the increasing size of the abscess. Success in these cases could be quoted at 70%-85% survival at 10-15 years. 

Re-treatments (doing a root canal treatment for a second time) have a slightly lower success rate, however 80% is a reasonable expectation.

Will the tooth Discolour after Root Canal Treatment?

While not all teeth discolour following root treatment it is reasonable to expect some slight alteration in colour of the tooth following root canal treatment, particularly where a front tooth is involved. Colour change may be already present due to a number of factors including amalgam fillings or trauma. Post treatment discolouration may be caused by the root filling materials in the visible portion of the tooth. All steps are taken to try and reduce the chances of this happening. It is also important to note that discolouration following trauma may take months or even years to develop.

If the discoloration proves to be a problem, there are a number of procedures which can be undertaken to improve the colour and appearance dependent on the type and severity of the discolouration. These include Internal Bleaching, Veneers and Crowns.

How Long Does It Take?

This can vary according to the complexity of the root canals, the presence of infection, or if re- treatment is being carried out. Sometimes treatment can be carried out in one session lasting between one to two hours. If the canals are heavily infected or are being re-treated, Dr Browne usually treats these teeth over two visits. In these cases, an anti-bacterial dressing is placed in the canals and the tooth is sealed for a period of at least a week and then the treatment is generally completed a second visit.

What if I don’t have the treatment?

Unfortunately, the only predictable alternative to root canal treatment is extraction of the tooth. Once the pulp is irreversibly inflamed or infected, the tooth will not heal spontaneously. Antibiotics and Analgesics may temporarily alleviate symptoms, but they will not permanently resolve the problem.

What is an Apicetomy or Surgical Root Treatment?

An apicectomy is the surgical removal of the infected root apex or tip of the root followed by the the placement of an apical or root end filling.

Apicectomy

Why Is an Apicetomy Necessary?
  1. If the infection fails to clear following a conventional root treatment and redoing retreatment looks very challenging because of complicated root anatomy or previous procedural difficulties, then a surgical approach may be justified.
  2. If there is a well-fitting and intact crown/bridge retained by a post & core, then the surgical approach may be justified to resolve this problem so as to avoid the difficulty and expense of having to replace the crowns/bridges.
  3. In a certain number of cases there may be a peri-apical cyst associated with the tooth. These cases first need to be treated with conventional root treatment and then followed by a surgical approach to remove the peri-apical cyst.

Dental Trauma

When Dental Injuries occur, it can be quite a traumatic and upsetting event, especially for the patient and parents of young children and adolescents. The important thing is to try not to panic.

As most dental injuries occur from the ages of 2yrs to 18yrs, it is important that parents, teachers and sports coaches know how to manage them appropriately. Below is a guide to help you do this or you can visit https://dentaltraumaguide.org/ for further advice. Dr Browne has a special interest in the management of sports injuries. Please contact Belvedere Dental Care at 021 4295556.

What if a Deciduous “Baby” tooth is Damaged?

The primary (Baby) teeth are very closely related to the permanent teeth, which are forming inside the bone. Injuries to primary teeth can damage the forming permanent teeth. This damage can affect the aesthetics of the permanent teeth resulting in whitish spots or deformation of the crown when they erupt. The more serious the injury, especially intrusion into the gum in particular, the more damage can occur.

Therefore, if a baby tooth is knocked out (Avulsed), it is important NOT to replace it back into the socket as this can also cause damage to the permanent tooth.

If a Baby tooth is fractured or chipped, it is important to contact the surgery as soon as possible to assess the extent of the damage. We will also assess if any emergency treatment is required.

What to do If I damage a Permanent tooth?

Contact Belvedere Dental Care at 021 4295556 a soon as possible for advice. Early and appropriate
management can have many advantages such as:

  • Increased possibility of conserving the tooth’s vitality;
  • Improve long-term prognosis
  • Possibly reduce future complications which can lead to more complex and costly treatments

If you have Chipped your Tooth:

  • Try to find the fragment, store it in milk and call Belvedere Dental Care as soon as possible. The dentist may be able to glue the fragment back on to the tooth but it is imperative to keep the tooth hydrated in milk.
  • Don’t worry if you can’t find the fragment, your dentist will be able to use a tooth-coloured filling material to build your tooth up. If part of a back tooth is broken, it may either need a filling or a crown (also known as a cap).
  • If the tooth is badly broken and the nerves are exposed, it may be a little sensitive and may even need root canal treatment. This involves removing the nerve and placing a root filling prior to rebuilding the tooth.

Chipped Tooth

If Your Tooth is Knocked Out (Avulsed):

  • Find the tooth. Hold the tooth by the crown (the white part), not by the root (the yellow part).
  • If contaminated with debris, rinse briefly with cold tap water (plug the sink)
  • If possible, Reimplant the tooth back in its socket immediately. This can be done by the child or an adult.
  • Hold the tooth in place. Bite on a handkerchief to hold it in position and go to the dentist immediately.
  • If you cannot put the tooth back in, place it in a cup of milk or saline. When milk or saline are not available, place the tooth in the patient’s mouth (between the cheeks and gums).
  • Seek dental treatment. Dr Browne has a special interest in the management of sports injuries.

For further advice go to dentaltraumaguide.org/

 

Only Permanent teeth can be re-implanted.
Baby teeth should NOT be re-implanted.

How to prevent Sports related Dental Injuries?

Unsurprisingly, one of the most common causes of dental trauma is participation in contact sports (like Hurling, Gaelic Football, Rugby, Boxing, Soccer, Camogie, Basketball). The risk of dental injuries compared with general injuries is low but related costs are high so prevention is key.  Most injuries involve the front upper 4 teeth. These teeth tend to be the most challenging clinically and aesthetically to treat.  Ideally any activity where the potential for dental trauma can exist should utilize MOUTHGUARDS/GUMSHIELDS to protect these vulnerable front teeth.

Role of Mouthguards to prevent Dental Injuries

A Mouthguard (gumshield) is defined as: a resilient device or appliance placed inside the mouth to reduce oral injuries, particularly to teeth and surrounding structures. They considerably diminish the injury to teeth subjected to stress in comparison with unprotected teeth. MG’s act by distributing the energy from an impact, decreasing the likelihood & severity of dental injury and brain concussion. MG’s are compulsory for all levels of Gaelic Football but we would recommend them for all contact sports.

There are two types of MG available – Boil & Bite and Custom-Made (provided by your dentist). While Boil & Bite are cheaper, they do not last as long or offer the same benefits as Custom-Made. Custom-Made MG’s are more comfortable, better quality, better fitting & specifically designed to prevent dental trauma and do not impact negatively on sporting performance.

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