Allied Endodontics offers a wide array services to treat orofacial pain.
Most times, endodontic treatment can be done the same day as the consultation. If you are experiencing any pain, treatment can be instituted immediately. Be assured that our doctors will stay in touch with your referring dentist at all times.
Root Canal Treatment
Root canal treatment is needed when the soft tissue inside the root of a tooth, known as the pulp experiences inflammation or infection. Inflammation or infection can occur as a result of several things, including severe decay, repeated dental procedures, trauma, or the presence of a chip or crack. Often this injury occurs without any symptoms, however, if the tooth remains untreated, pain or sensitivity may occur and an abscess could develop.
You may experience the following symptoms prior to root canal therapy:
- Persistent throbbing, sensitivity to hot and/or cold
- Pain which may wake you in the middle of the night
- Pain which radiates to your upper or lower jaw, ear, or side of face
- Tooth discoloration
- Sensitivity to chewing and touch
- Infection, drainage and sensitivity in the lymph nodes, nearby bone and gum tissues
Sometimes, however, you may not experience any symptoms but still be in need of endodontic treatment
Under a microscope, your endodontist will remove the inflamed or infected pulp, and then thoroughly clean and carefully reshape the canal. Afterwards, the canal space is filled with either a temporary antimicrobial paste or a biocompatible permanent root filling. Your endodontist will place a temporary filling on the chewing surface in order to close the space between office visits and also after the root canal therapy is completed. You will need to see your general dentist after the root canal therapy is completed for a permanent restoration (filling or crown) of the tooth. This will seal and protect the remaining tooth structure and restore your tooth to its proper function.
Root Canal Re-treatment
Most teeth that have had root canal therapy heal uneventfully. In some cases, however a tooth that has had endodontic treatment develops a persistent or resistant infection. Occasionally, the tooth can become painful or diseased years after successful root canal therapy. If your tooth has not healed or has developed new symptoms, you may have a second chance at saving your tooth. Another procedure, root canal re-treatment, may be performed by your endodontist.
A previously root canal treated tooth may need a re-treatment for one of the following reasons:
- During initial treatment, narrow or curved canals were not properly cleaned.
- The final restoration was delayed following endodontic treatment.
- The restoration did not protect the central portion of the treated tooth from salivary contamination.
- A fracture of the crown or root occurs on the treated tooth.
- New decay develops, exposing the canal to bacteria and a new infection.
- Infection of the canal space occurs due to a loose or cracked crown or filling.
Treatment
When re-treatment is necessary, your endodontist will re-open the tooth and remove the old root filling material. The canals will be thoroughly cleaned and carefully examined under a microscope to observe for cracks, decay, and infection. Once the canals are comprehensively cleaned, your endodontist will place a permanent root filling into the canal space.
After re-treatment is completed, you will again need to see your general dentist for the final restoration (filling or crown). If possible, preserving your natural tooth is always the best option. Teeth that have been restored with a filling or crown can last for years, even a lifetime.
Endodontic Surgery
Also known as root-end resection, apicoectomy may be necessary if initial root canal therapy or re-treatment has failed. Sometimes, apicoectomy may be performed in conjunction with or instead of endodontic re-treatment.
This procedure treats the bony area surrounding the end of your tooth, which has become inflamed or infected. By folding back the gum near the tooth, your endodontist can access the underlying bone and extract the inflamed tissue. At the same time, the very tip of the root is removed and usually replaced with a small plug or filling.
Treatment
Your endodontist will make a small incision into the gum tissue near your tooth to examine and diagnose the surrounding bone and to remove any inflamed or infected tissue. After this, the endodontist will fill the end of the root to seal it from future infection, and will suture the gum tissue together to encourage proper healing. Over the course of the next few months, the existing bone tissue will gradually grow back in to replace the infected tissue which was removed. Most patients are able to return to their normal routine as early as the day after their surgery.
Before committing to treatment, your endodontist will inform you of the specifics of your case, the risks and benefits of all proposed treatment options, as well as how to properly prepare for the procedure and steps to be taken after the procedure is finished.
Regenerative Endodontic Procedures
Regenerative Endodontic Treatment utilizes tissue engineering to restore the root canal to a healthy state, allowing for continued development of the root and surrounding tissue. Endodontists’ knowledge in the fields of pulp biology, dental trauma, and tissue engineering can be applied to deliver biologically based regenerative endodontic treatment of necrotic immature permanent teeth resulting in continued root development, increased thickness in the dentinal walls and apical closure. These developments in the regeneration of a functional pulp-dentin complex have a promising impact on efforts to retain the natural dentition, the ultimate goal of endodontic treatment.***
***Information provided by American Association of Endodontics
Treatment of Traumatic Injuries to the Teeth and Orofacial Structures
Dental injuries occur most often to the front upper and lower teeth, resulting in pain or discomfort of varying degrees. Minor injuries may require simple monitoring of the traumatized area only. More severe injuries may cause the tooth or teeth to become loose and damage the nerve inside. In these cases, the tooth may be repositioned and root canal therapy initiated in order to prevent more serious sequelae. Trauma may also result in discoloration of the injured tooth, which can be treated with root canal therapy and internal bleaching of the discolored crown.
The American Association of Endodontists’ position on the use of mouth guards to prevent dental injury is as follows:
Impact injuries to the dentition, such as those occurring during participation in sports, often result in the need for endodontic treatment. The American Association of Endodontists recommends the use of mouth guards during participation in sports as their use may minimize the effect of impact injuries on the dentition and supporting structures. Participants in sporting events are encouraged to contact their dentist for fabrication of a custom mouth guard. In addition, organizers and coaches of children’s sports are encouraged to recommend and/or require the use of mouth guards for all of their participants.