by Dr. Jacqueline S. Allen | Oct 12, 2016 | Blog, Endodontics, Root Canal
Endodontically treated teeth can last a lifetime. Some of these teeth, however, may not heal properly or may develop new problems months, or even years, after they were initially treated. An additional endodontic treatment, called a retreatment (a second root canal procedure), can be performed, which could again, allow a patient to keep his or her tooth for a lifetime.
Root canal treatment is like any other medical or dental procedure. It may not heal or respond to treatment, as expected for many different reasons:
- Often times, the permanent or temporary restoration may not have prevented salivary contamination inside the tooth.
- There may have been an extended period of time between when the crown or other restoration was placed, and when the root canal treatment was completed. Most endodontists and studies agree that a definitive restoration should be placed within one month following an endodontic procedure.
- There may be canals that were undetected, or canals that were too narrow, or calcified, to negotiate for the original practitioner.
There are occasions when a new problem arises with a tooth that has been treated previously that may compromise the original endodontic procedure:
- If a tooth develops a vertical fracture after endodontic therapy, it is no longer a viable tooth to keep in the oral cavity.
- A new cavity could develop in the tooth and expose the root canal to recontamination with bacteria.
- The restoration that was placed in or on the tooth after the endodontic treatment was complete can break down, creating microleakage of bacteria into the canals, which can cause recontamination.
Before endodontic retreatment is started, the endodontist may want to take a CBCT of the tooth. A CBCT is a 3-dimensional X-ray that allows the endodontist to look at the tooth in all planes to help diagnose a pattern of bone loss that may be indicative of a vertical fracture, canal anatomy that may not have been addressed in the original endodontic therapy, and other factors that will help your endodontist determine the best treatment for the tooth.
Even though a CBCT may offer more information about why a retreatment may be necessary, sometimes the endodontist must go back into the tooth and look for a potential cause that prevented the original root canal from healing.
A retreatment procedure consists of removal of the original contents of the crown and canals and exploration of the tooth and internal root structure that remains. If any canals were missed, they are addressed at that time. If a fracture exists, then the tooth will ultimately need an extraction, and may be removed at that time or may be removed at some point in the future by another practitioner. Once these issues are addressed, and once the canals are free of their filling material, they are disinfected, and an antibacterial paste is placed in each of them. This paste may be left in the tooth for several weeks until the tooth is symptom-free, and all other clinical signs of infection have disappeared. At that point, the patient returns, and the root canals would once again be filled with the endodontic filling material and a restoration crown would top the tooth. Most endodontists will evaluate the tooth for proper healing for several years after a retreatment is performed.
Although the goal of primary endodontic therapy is to save the natural tooth for a lifetime, there may be factors that can affect that overall outcome. When this happens, other treatments can save a natural tooth for a lifetime.
by Dr. Jacqueline S. Allen | Oct 3, 2016 | Apicoectomy, Blog, Root Canal
Even though contemporary root canal procedures have very high success rates, not every root canal treatment is permanently effective. Tooth root systems can be complex, and undiscovered and untreated canals can harbor infections that threaten the pulp of a tooth months, or even years, after the initial procedure.
If you’re experiencing pain and swelling around a tooth that’s received a root canal, visit your dentist or endodontist to have it examined. He or she may suggest that an endodontist perform an apicoectomy, which treats an infected tooth from its root end, rather than from the biting surface of the tooth.
Here’s a brief guide to how an apicoectomy can save a natural tooth that’s already received a root canal treatment.
Apicoectomy: A Step Beyond Root Canal Treatment
- Apicoectomies can be useful when a root canal retreatment won’t work. If the tooth has received a crown as part of its root canal process, or is part of a fixed dental bridge, those restorations will have to be disassembled and replaced to do another root canal. Accessing the infection through the root avoids this.
- An apicoectomy removes and seals the tip of the tooth root. During an apicoectomy, the endodontist will cut and lift the gum away from the tooth so the root is easily accessible. The infected tissue will be removed, along with the last few millimeters of the root tip. Then the endodontist cleans and seals the end of that root, removing a critical avenue where infection can manifest and cause problems.
- The preparation for an apicoectomy gives the endodontist an accurate picture of your natural tooth. Endodontists use state-of-the-art technology to perform apicoectomies, including fiber optic lights, operating microscopes and ultrasonic cleaning instruments that remove infection via high frequency vibration. Between this and the imaging technologies employed before the procedure, your endodontist will have an exceptionally clear picture of the health of your tooth, and what can be done to preserve it.
“If an infection threatens a tooth that’s had a root canal, and a retreatment isn’t an option, an apicoectomy can preserve it and keep it useful and functional for years to come,” says Dr. Allen of the Phoenix Endodontic Group.
by Dr. Jacqueline S. Allen | Jul 14, 2016 | Blog, Endodontist, Root Canal
If your tooth has become compromised due to disease or injury, you may be wondering what a Scottsdale endodontist can do to help you. Since even the best dental implant doesn’t function as well as your natural tooth can, it’s important to understand how Scottsdale endodontists can save your natural teeth. Here’s a brief overview of the work that these dental specialists are trained to do.
How A Scottsdale Endodontist Can Save Your Teeth
- Endodontists’ training as dental specialists focuses on preserving the inside of your tooth. Endodontists receive two to three years of training beyond general dentistry, learning how to treat problems with the pulp inside your teeth and how to diagnose and treat problems in your root canals.
- Endodontists have access to special tools and materials to treat a damaged natural tooth. They are trained in the use of special cleaning files to remove infection from a root canal. They use the sealant gutta-percha to permanently seal off tooth roots that have experienced severe infection, and they prepare the tooth to be permanently protected by receiving a crown (and sometimes a post as well) to shore up the structure of the tooth. Because root canals often permanently resolve the damage to a natural tooth, in the long run, they can prove to be less costly and less invasive than opting for a dental implant.
- Endodontists are able to use a variety of procedures to save your natural tooth. Root canals are only one of the treatments that endodontists can utilize to preserve a compromised natural tooth. They can do a root canal retreatment if needed, as well as specialized procedures such as an apicoectomy.
- Endodontists are experts in relieving tooth pain. Scottsdale endodontists are able to quickly diagnose even baffling tooth pain, ensuring your natural tooth gets treated at the earliest possible moment.
“You don’t have to live with dental pain or have damaged natural teeth extracted,” says Dr. Allen, a Phoenix endodontist who practices with the Phoenix Endodontic Group. “Endodontic treatment can save your natural teeth and preserve your quality of life!”
by fisherwebdesign | Jun 29, 2016 | Blog, Endodontics, Phoenix Endodontic Group, Root Canal, Technology
Endodontics became a specialty in the early 1960s, but dentists have been performing root canal procedures on patients since the 1800s. Thankfully, the world of root canals has come a long way since the turn of the 19th century.
Implementing a root canal has gotten much easier, and the overall outcome of the procedure itself has improved since the introduction of nickel-titanium files. These files were first introduced in the late 1980s and are made of a unique alloy that is extremely flexible, which helps to preserve the original anatomy of the root canal. This, in turn, results in better efficiency, predictability, and improved clinical results of endodontic treatment, especially in significantly curved canals.
Digital radiography is another handy tool that we use as endodontists. Originally introduced in the 1990s, it has certainly revolutionized the field of endodontics, as well as the entire dental community, by allowing the dentist to manipulate an image and provide a much higher overall diagnostic quality. Thankfully, it does this with much less radiation than was needed to capture a standard radiographic dental film in the past.
In addition to digital radiography, the operating microscope is relatively new in the endodontic world. Magnification and fiber optic illumination are helpful in aiding the endodontist by allowing him or her to see very small details inside the teeth that that need work. Also, a tiny video camera on the operating microscope can record images of a patient’s tooth to further document the doctor’s findings.
Finally, three-dimensional radiographs (cone-beam commuted tomography) allows endodontists to help diagnose potential issues more accurately and provide treatment with unprecedented confidence. Unlike a traditional spiral CT scanner, this 3D system provides precise, crystal-clear digital images while minimizing the patient’s exposure to radiation. This system allows for unmatched visualization of anatomical detail, which aids in diagnosis, treatment planning, and the actual root canal treatment. Your doctors can use this innovative technology to quickly and easily share 3D images of the area of concern with your referring doctor, giving them an opportunity to collaborate on your care, improve your experience, and deliver a positive treatment outcome.
Although there are many other advancements in endodontics on the horizon (stem-cell regeneration of the root canal system, as well as reconstructing the teeth themselves), the current ones allow for much better diagnosis, treatment planning, and pain-free root canals than ever before.
by Dr. Jacqueline S. Allen | Jun 14, 2016 | Blog, Endodontics, Endodontist, Root Canal
Despite a recent increase in awareness of the role of endodontists, root canal therapy is still feared by more than half (54%) of all Americans, according to a 2014 survey. This is truly unfortunate because the procedure has great potential to improve a dental patient’s oral health and well-being.
Here are just a few benefits that a patient can receive when he or she undergoes root canal therapy.
Benefits of Root Canal Therapy
- Reduces or eliminates pain from a toothache. Root canals can often successfully treat tooth pain symptoms, as well as symptoms related to infected tooth pulp, such as tenderness, foul smell or taste, and swelling in the gum and jaw tissue surrounding a tooth.
- Saves your natural tooth. A root canal removes and replaces the damaged and infected pulp from the inside of your tooth and allows it to function normally after a restoration is placed on the tooth.
- Improves the appearance of your tooth. A custom-made crown is often placed over the treated tooth. This can improve the appearance of a tooth that’s been cracked or infected.
- It’s a simple, relatively quick procedure. Root canal therapy typically only involves one or two appointments, including the installment of the final restoration.
- It allows you to speak, chew and eat normally. By removing the source of pain and protecting the natural tooth structure, a root canal allows you to keep using your tooth the way nature intended you to.
- Reduces the need for future dental work. By stabilizing the tooth and removing dangerous infections, root canals can prevent the need for tooth extractions, dental implants, and dentures. Many teeth that receive root canal therapy will last for the rest of a patient’s life.
“Get beyond the myths – a root canal is one of the best methods for preserving your natural teeth and enhancing your oral health,” says Dr. Jacqueline S. Allen, an endodontist who is a member of the Phoenix Endodontic Group.
by Dr. Jacqueline S. Allen | Apr 27, 2016 | Blog, Endodontics, Root Canal
When faced with the decision of saving a natural tooth through endodontic treatment, a patient should feel confident that this is the best choice for their health and cosmetic results. There are many advantages to saving the natural tooth such as: normal biting forces, efficient chewing, maintaining a natural appearance and limiting the need for more costly dental work. That coupled with the fact that dentistry has yet to produce a replacement for the natural tooth that looks, feels and FUNCTIONS as well as a natural tooth.
A patient should never choose to have an extraction just because they think it will be cheaper. When a natural tooth is extracted, it will typically need to be replaced with an implant or some other dental prosthesis in order to prevent future problems. The cost of the implant or prosthesis and the extraction, is quite often, more expensive than the endodontic procedure that could help save the tooth for years to come. Most dental plans also cover endodontic procedures.
A patient should never choose extraction because they think the root canal treatment will be painful. Better anesthesia and modern techniques make most root canal treatments almost painless. In a recent study, patients that have root canal treatment are six times more likely to describe it as “painless” than patients that have never had root canal treatment at all!
A patient should never choose extraction because they think it will be quicker. Endodontic treatments generally require one or two visits lasting usually less than an hour each. Of course, an extraction is only one visit, but there can be several additional visits necessary to replace the tooth and they are usually longer.
