Protaper

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Protaper Endodontic Files

 ProTaper geometries:


 The Endodontic ProTaper files have a unique features, including:

- Changing percentage tapers over the length of its cutting blades.
 - The progressively tapered design replicates the Schilderian Envelope of Motion technique and serves to significantly improve flexibility, cutting efficiency, and safety.

 - They are convex, triangular cross-section, which enhances the cutting action while decreasing the rotational friction between the blade of the file and dentin.
 - They have a changing helical angle and pitch over their cutting blades, which reduces the potential of an instrument from inadvertently screwing into the canal.
 - The noncutting, modified guiding tip. This feature allows each instrument to safely follow the secured portion of a canal, while the small flat on its tip enhances its ability to find its way through soft tissue and debris.
 - The ProTaper system is comprised of three Shaping and five Finishing files

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 There are two types of files for the ProTaper Endodontic Files;
 "The Shaping Files" and "The Finishing Files" ...

 The Shaping Files:

 - Shaping Files are Two: File No. 1 & File No. 2, Termed S1 & S2, Purple and White Respectively.
 - The Auxiliary Shaping File, termed SX, has no identification ring on its gold-colored handle and, with a shorter overall length of 19 mm.
 - The S1 and S2 files have D0 diameters of 0.17 mm and 0.20 mm, respectively, and their D14 maximal flute diameters approach 1.20 mm.
 - SX File, provides excellent access when space is restrictive. The SX file has a D0 diameter of 0.19 mm and a D14 diameter approaching 1.20 mm.
 - The Shaping files have increasingly larger percentage tapering, allowing each instrument to engage, cut, prepare and shape the canal, performing its own 'crown down' work.
 - SX File has a much quicker rate of taper between D1 and D9 as compared to the other ProTaper "S files", it is primarily used after the S1 and S2 files to more fully shape canals in "coronally broken down" or "anatomically shorter" teeth.

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 The Finishing files:

 - There are five "Finishing files" named F1, F2, F3, F4, and F5 have yellow, red, blue, double black, and double yellow colores corresponding to D0 diameters and apical tapers of 20/07, 25/08, 30/09, 40/06, and 50/05, respectively.
 - From D4–D14 each instrument has a decreasing percentage taper which serves to improve flexibility, reduce the potential for dangerous taper-lock, and reduce the potential to needlessly overenlarge the coronal two-thirds.

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 ProTaper shaping technique:

 - First, one should know that: The potential to consistently shape canals and clean root canal systems is significantly enhanced when the coronal two-thirds of the canal is first pre-enlarged, followed by preparing its apical one-third.

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 Scout the coronal two-thirds:

 - "Hand files" sizes 10 and 15 are measured and precurved to match the anticipated full length and curvature of the root canal.
 - The 10 and 15 hand files may be utilized within any portion of the canal until they are loose and a smooth reproducible glide path is confirmed.
 - The loose depth of the 15 file is measured and this length transferred to the ProTaper S1 and S2 files.

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 Shape the coronal two-thirds:

 - The secured portion of the canal can be optimally pre-enlarged by first utilizing S1, then S2. Prior to initiating shaping procedures,
 - The pulp chamber is filled with a full strength solution of NaOCl.
 - Without pressure, the ProTaper Shaping files are inserted into the canal and follow the glide path freely and easily.
 - For more optimize safety and efficiency, the Shaping files are used, like a brush, creating lateral space, which will make the Shaping file’s larger, stronger, and of more active cutting blades.
 - N.B: this brush-cutting action can be used to:
 Eliminate cervically positioned triangles of dentin,
 More effectively shape into fins, isthmuses, and canal irregularities, and
 To relocate the coronal aspect of a canal away from furcal danger.
 - N.B: If any ProTaper File ceases inside the secure Portion of the canal, then withdraw it and know that the debris blocked the intrablade spaces making the walls push the file away and decrease the cutting effeciency.
 - N.B: Upon removing each Shaping file, visualize where the debris is located along its cutting blades to better appreciate the region within the canal that is being prepared.
 - Following the use of each Shaping file, irrigate, recapitulate with a 10 file to break up debris, and move it into solution, then re-irrigate.

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 Scout the apical one-third:

 - The apical one-third of the canal is fully negotiated and enlarged to at least a size 15 hand file, Working length confirmed, then the patency file is established.
 - NOW, A decision must be made between whether to finish the apical one-third with rotary or hand instruments.

 - If, a new size 15 hand file glide easily inside the canal without any interupption, this means that the canal if of normal shape and having no irrigularities and anatomical morphologies, then the Rotary ProTaper will be very good, easy and successfull.
 - While If, a size 10 or 15 hand files must be precurved and necessitate a reciprocating handle motion, then the Manual ProTaper File is the best and most successful choice.

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 Shape the apical one-third:

 - Vigorous irrigation with NaOCl is very important now, to remove the debris that may decrease the effect of the shaping files (discussed befor in "Shape the coronal two-thirds" section), to avoid blockage of canals and facilitate the shaping proccess.
 - The ProTaper sequence is to carry the S1, then the S2, to the full working length.
 - Float, follow, and brush (discussed befor in "Shape the coronal two-thirds" section) until the terminus of the canal (Apical Foramen) is reached.
 - S1, then S2, will typically move to length in one or more passes depending on the length, diameter, and curvature of the canal.
 - Following each ProTaper file, irrigate, recapitulate with a size 10 file, then re-irrigate.
 - After using the Shaping files, particularly in more curved canals, working length should be reconfirmed, as a more direct path to the apical foramen has been established, leading to decrease working length.
 - The preparation can be finished using one or more of the ProTaper Finishing files in a non-brushing manner.
 - The F1 is selected and passively allowed to move deeper into the canal, in one or more passes, until the terminus is reached.
 - Apical flutes are inspected, and if they are loaded with dentin, then visual evidence supports, the shape is cut.
 - After using the F1 file, Irrigate with NaOCl, recapitulate, confirm patency, then re-irrigate to liberate debris from the canal.

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 ProTaper finishing criteria:


 - Following the use of the Protaper File F1, the ProTaper Finishing Criteria is to gauge the size of the foramen with a Manuale file 20 to determine if this instrument is snug or loose at length, If the 20 hand file is snug at length, then the canal is fully shaped and, if irrigation protocols have been followed, ready to pack.

- if the 20 hand file is loose at length, then gauge the size of the foramen with a 25 tapered hand file. If the 25 file is snug at length, then the canal is fully shaped and ready to pack.

 - If the 25 file is short of length, proceed to the Protaper File F2 and, when necessary, the Protaper File F3, the Protaper File F4, and the Protaper File F5, gauging after each ProTaper Finisher with the same D0 correspondingly sized hand file.
 - If the 50 hand file is loose at length, then use alternative NiTi rotary or manual files to finish the apical extent of these larger, easier, and more straightforward canals.


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Abrasion, Erosion

Dental Abrasion:It may seem logical that the harder you brush your teeth, the cleaner they'll be. But applying too much pressure can actually weaken the outer layers of the tooth structure. This condition, called dental abrasion, can occur when any foreign object causes friction against your teeth and gradually wears away the enamel on the surface. 

Tooth abrasion is not caused by one method alone but by numerous different activities. The main cause however can be due to brushing your teeth incorrectly. Brushing your teeth to hard to fast or even using the wrong toothpaste can lead to serious tooth abrasion. Other causes of tooth abrasion include grinding your teeth using your teeth as a cutting tool and chewing on hard objects.

Dental Abrasion Treatment: What You Should (and Shouldn’t) Do

While there are multiple ways to treat dental abrasion, it's always better to prevent dental issues before they start. You can start your dental treatment by following a few simple guidelines:

- Always use a soft-bristled toothbrush.
- Ask your dentist for tips on how to brush properly, and avoid brushing too hard.
- Refrain from chewing on toothpicks and pencils or biting your nails.
- Make sure removable dental appliances fit properly and have them checked on a regular basis.
- Don't forget to schedule regular dentist visits to give your dentist a chance to detect any problems early on.

Dental Erosion: Frequently consuming foods with a low pH value, such as soft drinks, fruit juices, pickles, fresh fruit and yogurt can lead to irreversible dental erosion. When food or drink that is acidic is consumed the enamel will soften for a short amount of time. Typically, saliva slowly helps to restore the natural balance of the acid found in the mouth. 

Veneeers

Chips, cracks, gaps, misalignment and discolorations in the front teeth can detract from the rest of your facial cosmetics. Today porcelain veneers can be easily placed over your front teeth and can painlessly correct these imperfections to help you achieve a magnificent smile. Veneers are thin custom lab made porcelain that is bonded to your teeth to accomplish a healthy, natural looking and beautiful smile in two visits.

Root Canal Treatment

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Teeth Whitening

Tooth Whitening, A Whiter Smile for a Brighter Smile

Often enough, when we look to improve our appearance, we do not focus enough on the influence of our teeth on our looks. A whiter set of teeth invariably brightens your smile and improves your looks.

It is possible today to attain whiter teeth though a variety of teeth whitening options performed either in-office by your dentist or by yourself at home.
In-office tooth whitening involves applying a protective gel to your gums. A bleaching agent is then applied to the teeth, while a special light is used to enhance the chemical action. The whole process takes place under the dentist’s supervision and lasts approximately an hour.
For take-home whitening, your dentist will take impressions of your teeth and make customised bleaching trays for you. The whitening gel is spread onto the custom-made trays, which are fitted over the teeth. The trays are typically worn for up to two hours a day for two weeks. While in-office whitening is much quicker and effective, some may prefer at-home whitening for its ease of use and lower cost.
Tooth whitening can generally improve the colour of your teeth by five to even 10 shades in some individuals. Results may vary between individuals depending on lifestyle habits and cause of the stained teeth. Tooth bleaching is most effective if your teeth are darkened from age, coffee, tea or smoking. With proper maintenance and regular dental check-ups, the results of your tooth whitening should last you for more than a year.
Tooth whitening procedures are safe, and normally painless. A small percentage of people may experience a minor dull ache following the procedure and temporary sensitivity towards hot and cold drinks.
Those who wish to lighten his or her teeth can benefit from the tooth whitening treatment. You should see your dentist who will first conduct a thorough dental examination to ensure both your teeth and gum tissues are healthy and acceptable for treatment.
The procedure will not soften or damage teeth.
Not everyone is a good candidate for tooth whitening though. In some cases of serious discoloration and pitted teeth, for example, veneers may be more appropriate than bleaching. Moreover, crowns, bridges, and fillings do not bleach, so it may be necessary to replace dental work to make it blend with the new colour of your bleached teeth.
Take the first step to achieving your winning smile today!

Fractured Tooth

Fractured and Broken Teeth

What You Can Do

Teeth are remarkably strong, but they can chip, crack (fracture) or break. This can happen in several ways:

• Biting down on something hard
• Being hit in the face or mouth
• Falling
• Having cavities that weaken the tooth
• Having large, old amalgam fillings that don't support the remaining enamel of the tooth

When a tooth chips or breaks, it may not hurt. However, your tongue usually feels the sharp area quite quickly. Minor tooth fractures usually don't cause pain, but if a large piece of the tooth breaks off, it can hurt. The nerve inside the tooth may be damaged. Extreme discomfort also can happen when nerve endings in the dentin are exposed to air, or to hot or cold foods or drinks.

Pain from a broken or cracked tooth may be constant or may come and go. Many people feel pain when they chew because chewing puts pressure on the tooth.

What You Can Do

Cracked (Fractured) Teeth
There is no way to treat a cracked tooth at home. You need to see your dentist. Sometimes the tooth looks fine, but it hurts only when you eat or when the temperature in your mouth changes (because you drank something hot or cold, for example). If your tooth hurts all the time, it may have a damaged nerve or blood vessels. This is a serious warning sign. You will know if you have a cracked tooth if it does not hurt to biteon the tooth, but pain occurs when you release the bite.

Broken Teeth
If you have a broken tooth, see your dentist as soon as possible. Your dentist can figure out if the break was caused by a cavity, and if the tooth's nerve is in danger. A damaged nerve usually will require root canal treatment.

Until you get to the dentist's office:

• Rinse your mouth well with warm water.
• Apply pressure with a piece of gauze on any bleeding areas for about 10 minutes or until the bleeding stops. If this doesn’t work, use a tea bag with pressure on the area to stop the bleeding.
• Apply a cold pack to the cheek or lips over the broken tooth. This will help reduce swelling and relieve pain.
• If you can't get to your dentist right away, cover the part of the tooth that is in your mouth with temporary dental cement. You can find this at a drugstore.
• Take an over-the-counter pain reliever.

Inlays And Onlays

Dental Inlays/Onlays

Inlays and Onlays are similar to tooth fillings as they are restorative treatments used to repair small tooth fractures, tooth decay, and other sorts of damaged surfaces of the teeth. An inlay is similar to a filling and lies within the center of a tooth. When the damaged tooth instead requires inclusion of one or several points of the tooth or even full coverage of the biting surface, this is described as an onlay. Benefits of Inlays and Onlays are that they are not likely to discolour over time as tooth-coloured resin fillings have a tendency to. Dental inlays are better at sealing teeth to keep out bacteria and are therefore preferred when the cavity is between the teeth as they are extremely stable and durable.

Dental Inlays and Onlays
To repair a damaged tooth’s biting surface or side, a dentist will often use an inlay, or an onlay. A dental inlay or onlay is an indirect filling that consists of a solid substance, such as porcelain or gold. These are sometimes seen as more conservative alternatives to crowns, which fully covers a tooth. With the material used, it is a strong and long-lasting solution to tooth decay or tooth damage.
Dental inlays and onlays have the same function as traditional dental fillings, but have a more permanent result. Whereas dental fillings are molded into place during one single dental visit, inlays and onlays need at least two visits to the dentist since the material is fabricated indirectly in a dental lab before being fitted and bonded to the tooth.


The Difference between Dental Inlays and Dental Onlays
An inlay is similar to a filling and lies within the center of a tooth, this is called an inlay. These are custom-made to fit the cavityand then cemented into place. When the damaged tooth instead require inclusion of one or several points of the tooth, or even full coverage of the biting surface, this is described as an onlay. An onlay is therefore a more extensive reconstruction, but will still conserve more of the tooth structure in comparison to a crown.

Benefits with Dental Inlays and Dental Onlays

Not likely to discolour over time as tooth-coloured resin fillings have a tendency to do.
Preserve as much healthy tooth as possible and work as an excellent alternative to a crown when the damaged area is very small.
An inlay is tailored after the tooth. While a composite filling can shrink with time, and the edges of a crown can sometimes not fit perfectly with the tooth, an inlay is tailored after all edges. This means that the tooth cleaning is easy.
Dental inlays are better at sealing teeth to keep out bacteria, therefore they are preferred when the cavity is placed between the teeth.
Extremely stable and long-lasting.
Dental inlays and onlays only protect the weak areas of the tooth, which means that a full reshaping of the tooth is not necessary.
An inlay will not stain.

Disadvantages with Dental Inlays and Dental Onlays
More costly than amalgam or composite fillings
The procedure is carried out during two appointments (instead of one for composite or amalgam filling)

Diastema Closure

Performing esthetic and affordable diastema closures with composite restoratives

   Flowable restoratives are still relatively new to the dental materials world. Given that it often takes the dental community a decade or two to embrace a material, many dental professionals are of the opinion that the jury is still out on flowables. My personal observation is that flowables are either overutilized or underutilized, depending on the clinician. However, I believe that by finding the proper balance between flowable and paste composites, clinicians can make these materials an invaluable part of their repertoire.

The recent availability of an anatomic diastema closure matrix (Bioclear Matrix Systems) makes it possible to achieve porcelain-like contours with composite materials, allowing dentists to offer an alternative treatment to patients who wish to avoid the expense of porcelain. But with this new capability, it is extremely important that dentists select the proper flowable material. For maximum success, a flowable should:

1. Be strong enough to avoid wear and fracture.
2. Achieve and maintain a high level of polish to compete with porcelain.
3. Provide strong esthetics, and match the corresponding shades of paste composite.

The following case demonstrates an appropriate and balanced use of flowable and paste composites to perform diastema closures.

Case description

The patient had diastemas between both the upper central incisors and peg laterals (Fig. 1). Treatment plans were presented to restore the teeth with either porcelain or composite veneers, and the patient chose to move forward with the lower-cost composite treatment.


Fig. 1: The patient’s peg laterals presented a restorative challenge

A rubber dam was placed in order to provide interproximal gingival retraction. An aluminum chloride astringent was placed underneath the dam and burnished into the sulci to control crevicular fluids.

The centrals and canines were restored first in order to build out the areas surrounding the very small peg laterals, which were left for last. For each procedure, Bioclear DC203 diastema closure matrices were placed inciso-gingivally to the point where the gingival aprons on the matrices were near the depth of the sulcus (Fig. 2). The rubber dam provided sufficient lateral pressure in this step to seal the gingival margins. Alternately, dentists may use gentle approximating devices, such as an Interproximator (Bioclear). A traditional wooden or plastic wedge should not be used in this wedging step in order to avoid deforming the precurved matrix.


Fig. 2: Bioclear diastema closure matrices are placed inciso-gingivally 

A 37% phosphoric acid was applied to etch the area, then rinsed and dried. Next, a thin layer of bonding resin was placed. This bonding resin was air-thinned, but not cured. A small amount of 3M™ ESPE™ Filtek™ Supreme Ultra Flowable Restorative in shade B1 was placed into the interproximal form, both facially and lingually (Fig. 3). The flowable was not light-cured, but rather immediately followed with injection of 3M™ ESPE™ Filtek™ Supreme Ultra Universal Restorative in shade B1. The two restoratives were then light-cured together and the restorations were polished (Fig. 4).


Fig. 3: A small amount of Filtek Supreme Ultra Flowable composite is injected into the matrices, then followed with paste composite 


Fig. 4: The diastemas were esthetically treated with the combination of paste and flowable composites

Discussion

This case explains how an appropriate and balanced use of flowable and paste composites can be used to create the proper emergence profile to close space and regenerate papillae. The knife-edged emergence profile created by the anatomic matrix makes it virtually impossible for a paste composite to reach everywhere, but use of the flowable material both fills these tiny spaces and serves as a wetting agent for the subsequent application of paste, helping it get in hard-to-reach areas of the matrix.

The spacing of the patient’s teeth in this case was such that the peg laterals could not be treated alone. Small amounts of bulk were added to both distals of the central incisors and the mesials of the canines to appropriately close the significant space left by the laterals. The same technique was applied to build each tooth with the combination of flowable and paste composites.

For cases such as this where esthetics is vital, Filtek Supreme Ultra flowable restorative offers the shine and polishability necessary to rival a porcelain restoration. It also offers a strong shade match with its paste counterpart, helping further assure strong esthetics. The ability to restore cases such as this with a composite treatment, as opposed to only being able to offer porcelain, helps dentists offer patients a more economical option without compromising esthetics. I would recommend both this product and the unique technique described here for predictable and successful restorative outcomes.

Apicoectomy

What Is It?
What It's Used For
Preparation
How It's Done
Follow-Up
Risks
When To Call a Professional

What Is It?
Your teeth are held in place by roots that extend into your jawbone. Front teeth usually have one root. Other teeth, such as your premolars and molars, have two or more roots. The tip or end of each root is called the apex. Nerves and blood vessels enter the tooththrough the apex. They travel through a canal inside the root, and into the pulp chamber. This chamber is inside the crown (the part of the tooth you can see in your mouth).

During root canal treatment, your dentist cleans the canals using special instruments called files. Inflamed or infected tissue is removed. An apicoectomy may be needed when an infection develops or won't go away after root canal treatment or retreatment.

Root canals can be very complex, with many tiny branches off the main canal. Sometimes, even after root canal treatment, infected tissue can remain in these branches. This can possibly prevent healing or cause re-infection later. In an apicoectomy, the root tip, or apex, is removed along with the infected tissue. A filling is then placed to seal the end of the root.

An apicoectomy is sometimes called endodontic microsurgery because it is often done using an operating microscope.

What It's Used For
If a root canal procedure has been done in the past and it becomes infected again, it's often because of a problem near the apex of the root. In many cases, a second root canal treatment is considered before an apicoectomy. With advances in technology, dentists often can detect other canals that were not adequately treated. In this case, they may be able to clear up the infection by doing a second root canal procedure. This will avoid the need for an apicoectomy.

An apicoectomy is done only after a tooth has had at least one root canal procedure and retreatment has not been successful or is not possible. For example, retreatment is often not a good option when a tooth has a crown or is part of a bridge. Retreatment of the root canal would require cutting through the crown or bridge. That might destroy or weaken the crown or bridge. An apicoectomy is often considered in a situation like this.

An apicoectomy is not the same as a root resection. In a root resection, an entire root is removed, rather than just the tip

Preparation
Before the procedure, you will have a consultation with your dentist. A general dentist with advanced training may do an apicoectomy. However, with the advances in endodontic microsurgery most patients are referred to an endodontist or to an oral and maxillofacial surgeon. An endodontist has at least two years of extra education in diagnosis and root canal treatment, including apicoectomies. Oral and maxillofacial surgeons are dentists who have an extra four to six years of training in surgery.

Before the surgery, your dentist may take more X-rays of the tooth and surrounding bone. You may be given an antimicrobial mouth rinse, a medicine to reduce inflammation, and/or antibiotics.

Your dentist also will review your medical history. Make sure you tell your dentist of all medicines you take. This includes over-the-counter medicines, vitamins and supplements. Depending on other existing medical conditions, your dentist may consult with your physician before the procedure.

How It's Done
The endodontist will make a small incision (cut) in your gum and lift the gum away from the tooth and bone. The dentist may need to use a drill to gain access to the root. The infected tissue will be removed along with the last few millimeters of the root tip. The endodontist may use a dye to highlight cracks and breaks in the tooth. If the tooth has large cracks or breaks, it may need to be extracted. In this case, the apicoectomy will not continue.

To complete the apicoectomy, the endodontist will clean and seal the end of the tooth's canal. The cleaning usually is done under a special microscope using ultrasonic instruments. The light and magnification allow the endodontist to see the area clearly. This increases the chance that the procedure will succeed. The endodontist then will take an X-ray of the area before stitching the tissue back in place.

Most apicoectomies take 30 to 90 minutes. The length will depend on the location of the tooth and the complexity of the root structure. Procedures on front teeth are generally the shortest. Those on lower molars generally take the longest.

Follow-Up
Your endodontist will tell you which medicines to take and what you can eat or drink. You should apply ice to the area, alternating 20 minutes on and 20 minutes off. Do this for 10 to 12 hours after the surgery, and rest during this time.

The area may bruise and swell. It may be more swollen the second day after the procedure than the first day. Any pain usually can be controlled with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofem (Advil, Motrin and others). In some cases, you may be given a prescription for pain medicine. If so, follow the instructions for taking it.

To allow for healing, avoid brushing the area or rinsing vigorously. Don't smoke or eat crunchy or hard foods. Do not lift your lip to examine the area. This can loosen the stitches and disrupt formation of the blood clot that is needed for healing.

You may have some numbness in the area for days or weeks after the surgery. If so, tell your dentist about it. The numbness usually goes away with time.

Your stitches may need to be removed 2 to 7 days after the procedure, or they may dissolve by themselves. All soreness and swelling are usually gone within 14 days.

Even though an apicoectomy is considered surgery, many people say that recovering from it is easier than recovering from the original root canal treatment.

Risks
The endodontist will review the risks of the procedure at the consultation visit. Make sure to ask questions if something the dentist has told you is not clear. The main risk is that the surgery may not work and the tooth may need to be extracted.

Depending on where the tooth is located, there may be other risks. If the tooth is in the back of your upper jaw, the infection can involve your sinuses. Your dentist may suggest or prescribe antibiotics and decongestants.

The roots of the back teeth in the lower jaw are close to some major nerves. Surgery on one of these teeth carries a slight risk of nerve damage. However, your endodontist will use your X-rays to see how close the roots are to the nerves. The chance of nerve damage is extremely small.

An apicoectomy is usually a permanent solution. It should last for the life of the tooth.

When To Call a Professional
If you're having any pain or swelling from a tooth that has had root-canal treatment, contact your dentist. Sometimes after a root canal a pimple develops near the tooth. This pimple will often go away and then come back. This is called a fistula. You may notice pus draining from the fistula. The fistula is a sign that there is an infection and your body is draining it out through the pimple. There is usually no pain in this situation, but you may notice a bad taste or odor in your mouth.

Common Dental Symptoms..

Common Dental Symptoms

Symptom: Momentary sensitivity to hot or cold foods.

Possible problem: If this discomfort lasts only moments, sensitivity to hot and cold foods generally does not signal a serious problem. The sensitivity may be caused by a small decay, a loose filling or by minimal gum recession that exposes small areas of the root surface.

What to do: Try using toothpastes made for sensitive teeth. Brush up and down with a soft brush; brushing sideways wears away exposed root surfaces. If this is unsuccessful, see your general dentist. If the sensitivity is coming from a decay you should see your general dentist.

Symptom: Sensitivity to hot or cold foods after dental treatment.

Possible problem: Dental work may inflame the pulp inside the tooth causing temporary sensitivity.

What to do: Wait two to four weeks. If the pain persists or worsens, see your general dentist.

Symptom: Sharp pain when biting down on food.

Possible problem: There are several possible causes of this type of pain: decay, a loose filling or crack in the tooth. There may also be damage to the pulp tissue inside the tooth.

What to do:See a dentist for evaluation. If the problem is pulp tissue damage, your dentist will perform a procedure that cleans out the damaged pulp and fills and seals the remaining space.

Symptom: Lingering pain after eating hot or cold foods.

Possible problem: This probably means the pulp has been damaged by deep decay or physical trauma.

What to do: See your dentist to save the tooth with a root canal treatment.

Symptom: Constant and severe pain and pressure, swelling of gum and sensitivity to touch.

Possible problem: A tooth may have become abscessed, causing an infection in the surrounding gingival tissue and bone.

What to do:See your dentist for evaluation and treatment to relieve the pain and save the tooth.

Symptom: Dull ache and pressure in upper teeth and jaw.

Possible problem: The pain of a sinus headache is often felt in the face and teeth. Grinding of teeth, a condition known as bruxism, can also cause this type of ache.

What to do: For sinus headache, see your physician. For bruxism, consult your dentist.

Frequently asked questions

Root Canal Therapy

Nothing is as good as a natural tooth! And sometimes your natural tooth may need a root canal (endodontic) treatment for it to remain a healthy part of your mouth.

Most patients report that having a root canal treatment today is as unremarkable as having a cavity filled.

Frequently Asked Questions:

(Adapted from the American Association of Endodontist’s website (www.aae.org).

Who performs root canal therapy?

All dentists, including general dentists, receive fundamental training in endodontic treatments. Some very complex root canal procedures are sometimes referred to an endodontist specializing in root canal therapy.

Why would I need a root canal?

Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain and can lead to an abscess.

What are the warning signs?

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes, as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.

How does root canal therapy save the tooth?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, a channel inside the root, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on 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 endodontic 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 during the procedure. If at anytime during the procedure you feel sensitivity, you simply advise the doctor of this and proper measures will be taken to keep you comfortable.

For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your dentist’s instructions carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your root canal therapy is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your dentist.

How much will the procedure cost?

The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat, the fee is usually more. Most dental insurance policies provide some coverage for this treatment.

Generally, root canal therapy and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.

Our practice offers a variety of financing options to meet your dental needs, please ask any staff member to explain them to you.

Will the tooth need any special care or additional treatment after root canal therapy?

You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings. In most cases it is advisable to place a core restoration and a crown on the endodontically treated tooth to help prevent the risk of fracture.

Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.

What causes an endodontically treated tooth to need additional treatment?

New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure.

Can all teeth be treated this way?

Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in dental technology are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

Procedure for root canal

Root Canal Treatment