Endodontics

Endodontics | NW Heights Dental | Portland OR

Who is a candidate for a root canal?

When infection penetrates the enamel and the dentin, the soft tissues of the pulp are defenseless. The infection will spread throughout the tooth and can eventually lead to abscesses and possible spreading of infection to other parts of the body.

When the pulp, where the tooth nerves are found, becomes infected the tooth will become very sensitive. The patient will have pain, prolonged sensitivity to hot or cold, tenderness to the touch and when chewing, discoloration of the tooth, swelling and tenderness of the surrounding gum tissue, and persistent pimples on the gums. The only way to address the infection and pain is to either extract the tooth or to perform a root canal.

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Endodontic Diagnostics

Problems within the dental pulp can often be identified through X-ray images. Occasionally, these problems do not show up on an X-ray, despite the patient’s complaints of related symptoms. In such cases, a diagnostic root canal may be performed to help identify tiny holes or cracks in the tooth that may be the cause of dental pulp damage.


Endodontic Procedures

Young female model smiling

Sometimes referred to as the practice of root canal therapy, endodontics encompasses a wide range of surgical and non-surgical procedures that keep the teeth free from diseases and injuries of the pulp and surrounding tissue. Like other dental specialties, the goal of endodontics is to maintain good oral health. Common endodontic procedures include root canal and apicoectomy.

Root Canal

The most common endodontic procedure is a root canal, which can diagnose and treat damage in the dental pulp. A hole is drilled into the tooth and thoroughly cleansed from the inside. The hole is carefully sealed so no dirt or bacteria can reenter the tooth. A filling is needed after the procedure to restore the appearance of the tooth and prevent further damage.

Apicoectomy

Also known as root end resection, apicoectomy involves the removal of infected tissue and the end of the root. This procedure is most commonly performed after an unsuccessful root canal procedure. A filling is needed after the procedure to restore the appearance of the tooth and prevent further damage.

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Endodontic Treatment

An endodontist treats problems of the dental pulp, the soft tissue within the tooth that contains blood vessels, nerves and connective tissue which helps create the surrounding hard tissue that makes up the outside of the tooth. The pulp extends from the crown of the tooth to the tips of the roots and into the surrounding tissue. Dental pulp is vital to the growth and development of healthy teeth, but is not necessarily needed once the tooth has fully matured.

Endodontic treatment is needed when the dental pulp becomes infected or inflamed. This may occur as a result of decay, repeated dental procedures, a crack or chip in the tooth or injury with no visible signs of damage. When the pulp is affected, it can lead to pain or the development of an abscess, as well as increased sensitivity, tenderness and discoloration.


Recovery From Endodontic Treatment

After endodontic treatment, patients may experience pain, swelling and increased sensitivity in the treated area for one to two days. Anti-inflammatory medication can be helpful to treat the pain and swelling. After recovery, most patients report that their treated tooth feels the same as their natural teeth and have no problems eating, speaking or smiling.

Endodontics FAQs:

Does a root canal require anesthesia?

Yes. The tooth and the surrounding area need to be fully numbed with local anesthesia prior to Dr. Smith or Dr. Hiebert performing the root canal. General anesthesia is not necessary.

When a root canal is necessary, it means the pulp inside the tooth has become infected. That pulp contains blood vessels, connective tissues, and nerves. The bacteria that has invaded the pulp is what is behind the pain a patient feels prior to having a root canal. Removing the infected nerves would be quite painful without anesthesia, but once we numb the area you don’t feel a thing.

Interestingly enough, once we remove the pulp from the tooth interior and replace it with gutta percha, the tooth will no longer have any sensation at all. It won’t have any nerves.

Do I have to restrict my diet after having a root canal?

Not at all. There isn’t any acute pain at all following a root canal. That’s because gum tissue hasn’t been cut. The infected tooth was accessed through a hole drilled in the top; the interior was completely cleaned out and disinfected; it was filled with gutta percha; and then it was closed with a filling and likely received a crown. None of this creates any acute pain afterwards. There can be some soreness from the prior infection and inflammation and from having your mouth open for a period of time, but it’s nothing that can’t be handled with over-the-counter pain medication. Correspondingly, you don’t have to eat a soft diet.

How will I know if I need an apicoectomy?

An apicoectomy is also known as root end surgery. It can be a necessity if a new infection develops or if the original infection in a tooth was not fully removed by a former root canal. Now, a conventional root canal will not remove the infection and save the tooth. An apicoectomy is needed.

In this procedure, an incision is made in the gum near the tooth to expose and get rid of any inflamed or infected tissue. The tip of the tooth root is also removed. Then the end of the root canal is sealed with a small filling.

Can children have root canals?

If a tooth has been injured by trauma, such as a fall, it may develop an infection in the pulp. Of course, this also happens when lax home care has allowed decay to enter the interior of the tooth. Now the tooth needs a root canal to be saved from extraction.

Question is — What if it’s a baby tooth? Does a baby tooth need a root canal?

The answer is yes. While we all think of baby teeth as eventually falling out, and they will, they are also critical for their job of keeping the spacing correct in the child’s mouth. If a heavily infected tooth is pulled (rather than saved with a root canal) then the adjacent teeth on each side of the gap will slide over. This will mess up the child’s overall tooth alignment and bite, which can impact his mouth for the rest of his or her life.

Just as with adult teeth, root canals can be lifesavers for baby teeth. The procedure is completely safe, and the pain is minimal, really no more than having a typical filling placed.

Do I need to do anything to prepare for a root canal?

There isn’t anything you need to do prior to your appointment at NW Heights Dental. If we want to place you on a course of antibiotics, you’ll need to fill your prescription prior to your appointment. That’s about it.

Schedule Your Endodontics Consultation Today!

Interested in learning more about root canal therapy & apicoectomies? Call 503.646.1463 to schedule your consultation with Dr. Keri Smith and Dr. David Hiebert today!

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