Endodontics – Treating Complex Dental Problems

Chelmsford endodontist, Dr Daniel Vaz De Souza, explains this treatment

Dental problems can occur when we don’t take care of our teeth correctly. This is not always deliberate and there are areas of the mouth that are notoriously difficult to clean, such as the very back of the rear teeth for example.

Problems can also happen when the teeth become under undue stress. This could include being hit in the face by a football or even biting on something unexpectedly hard. This type of impact can cause a tooth to chip, crack or even fracture.

Depending on whether we notice this or not and whether we decide the impact is enough to have it checked by a dentist, it is quite possible for what might seem like relatively light damage to have an impact deeper down in our teeth where the roots and other parts lay if not treated promptly.

Endodontics

Originating from the ancient Greek for ‘inside the tooth’, the field of endodontics deals with the interior of a tooth in the part that lies below not only the enamel but also the dentin layer below it. This area, most commonly known as the root canal, contains nerves, blood vessels and other soft pulp material and can become infected by bacteria when the enamel has been damaged and the inner part of the tooth exposed.

Providing that the initial damage to the tooth has been detected and checked by one of the Blue Sky Dental team, it can be treated before any harm comes to the root canals. Most commonly, this would be done by filling the tooth or, in the case of more significant damage, possibly a crown. Where this isn’t treated in time, bacteria can enter the porous dentin layer and work its way to the root canals of our teeth.  When this happens, it is usually treated using root canal therapy.

What is root canal treatment?

When the root canals of our teeth become infected, this can’t simply be reversed through, for example, antibiotic treatment, or where it is treated in this way it is a temporary measure and will almost inevitably flare up again. The only way to treat this in a permanent manner is with root canal treatment.

This is an invasive dental procedure and will be performed with a local anaesthetic. Despite its reputation with many members of the public, it is not to be feared and should cause no more discomfort than most invasive dental treatments.

Once the treatment area is fully numbed, the endodontist accesses the top section of the tooth so that the root canals can be reached. The infected pulp from this area will then be removed through suction and manually using special files. The hollow canals will then be cleaned and treated with an antibiotic material to remove any bacteria that might remain. To prevent reinfection and to strengthen the treated tooth, the root canals are then filled with a material called gutta percha which is used because of its excellent sealant properties. Finally, in most cases, a dental crown will be added to the tooth to give it a more natural looking appearance and for additional strength.

Not a ‘regular’ tooth

The newly treated tooth should be strong enough for everyday use and should last for many years. It is important though for patients who have received this treatment to be aware that it may not be as strong as a healthy natural tooth and also that it will have no sensation due to the removal of the nerves within it. This means that it can be hard to judge how much pressure is being applied to the tooth when eating. For this reason we recommend that you don’t use this tooth when eating harder foods in order to minimise the risk of any damage to it.

Although it may not be as strong as a natural tooth and won’t be capable of feeling a toothache, it is still essential that you clean it well. Other problems such as gingivitis and periodontitis can still occur and you could still lose the tooth if you don’t take proper care of it.

Alternatives

Because of the undeserved reputation of this treatment, we have had a number of our Chelmsford patients ask us if there is an alternative treatment that could be used instead. As we mentioned earlier, antibiotics usually only have a temporary effect. This only really leaves one alternative as the pain from an untreated root canal infected tooth would not be manageable for any length of time. The only other option would be to extract the tooth. This is generally inadvisable as it can also lead to other issues such as movement of the other teeth, causing crookedness.

We do understand that some people might have concerns about having a root canal treatment and we are more than happy to talk you through the treatment and answer any questions or concerns that you might have about it.

We have an experienced and caring team within our Chelmsford practice and you can be assured of receiving excellent treatment when you come to us. If you would like to discuss any dental issue with us or to arrange an appointment to see a dentist, please call Blue Sky Dental on 01245 211070 and talk to one of our receptionists.