All About Endodontics
Biological Endodontics/Root Canal Therapy
A root canal is usually needed when the tissue within the tooth (The Dental Pulp) is infected or injured. This may occur via a deep cavity, traumatic injury, cracked teeth, chipped teeth, or dental procedures in close proximity to the pulp where a new filling or crown has been placed. Patients may have pain or sensitivity to hot and/or cold, spontaneous pain, pain to pressure or biting, dull ache, sharp shooting pain, and sometimes facial swelling.
If you have any of these symptoms, you will most likely need a root canal in order to removed the unhealthy pulp tissue within the tooth. During the root canal procedure, the diseased pulp is removed and root canal system is thoroughly cleaned and disinfected. The success rate of this procedure is 90-95% when performed by Dr. Jeffrey Etess, a board eligible root canal specialist. If the chance of success is unfavorable, Dr. Etess will inform you at the consultation appointment or when unfavorable signs are seen within the tooth during treatment and make alternative treatment recommendations.
1 = crown, 2 = root, 3 = enamel, 4 = denting & dentin tubules, 5 = pulp chamber, 6 = blood vessels & nerve, 7 = periodontal ligament, 8 = apex, 9 = alveolar bone
Common Root Canal Systems
- Constant Pain
- Spontaneous Pain
- Intermittent Pain
- Sharp Shooting Pain
- Dull Ache
- Sensitivity to Hot and/or Cold Food & Drink
- Pressure Pain on Biting
- Shooting Pain on Bite, then release & dull ache.
- Gum Swelling
- Gump "Pimples"
- Facial Swelling
How Does a Biological Root Canal Treatment Save the Tooth?
Dr. Jeffrey Etess will completely remove the inflamed or infected pulp from the tooth. He will carefully clean and shape the inside of the root canal using the most advanced mechanical, chemical, ultrasonic, laser and ozone techniques. This proprietary disinfection and cleaning methodology has been the culmination of over 18 years of Dr. Etess being a Root Canal Specialist. After Dr. Etess is fully satisfied that the root canal is maximally disinfected and cleaned, he will then fill and seal the space with the most biologically compatible bioceramic sealers and root canal filling materials. It doesn’t stop there, Dr. Etess recommends an immediate seal of either a composite core, or composite and fiber reinforced post and core, all done with strict biomimetic principles. Afterwards, a crown or other restoration is prepared for the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Will I Feel Pain During or After the Procedure?
Many root canal procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable and pain free during the procedure. With comfort management protocol at Integrative Dental Specialists of Long Island, most patients report of only a mild soreness or awareness that work has been performed, which can mostly can be managed with over-the-counter medication or with natural holistic remedies. In some cases, prescription medications are indicated and will be tailored prescribed to you by Dr. Etess.
Examination & X-Rays
Dr. Etess examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure. It is essential to have an aseptic field in place and is the standard of care.
Opening the Crown
Dr. Etess makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
Cleaning, Shaping & Filling
After the root canal space is cleaned and shaped, Dr. Etess fills the root canals with a biocompatible material, usually a bioceramic containing material. The root canal filling is placed with a bioceramic sealer to ensure complete sealing of the root canals. In most cases, Dr. Etess will place a permanent seal over the root canal to prevent future contamination.
Crowns and Other Restorations
After the root canal is completed, a crown or other restoration is placed on the tooth to protect and restore it to full function.
Why Would I Need A Root Canal?
As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:
- Narrow or curved canals were not treated during the initial procedure.
- Complicated canal anatomy went undetected in the first procedure.
- The placement of the crown or other restoration was delayed following the endodontic treatment.
- The restoration did not prevent salivary contamination to the inside of the tooth.
In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:
- New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
- A loose, cracked or broken cornw or filling can expose the tooth to new infection.
- A tooth sustains a fracture.
What will happen during the "retreatment"?
First, Dr. Etess will discuss your treatment options. If you both choose "retreatment", he will reopen your tooth to gain access to the root canal filling material. In many cases, the complex restorative materials like the crown, post and core materials must be disassembled and removed to permit access to the root canals.
After removing the canal filling, Dr. Etess can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment
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