Non-Surgical Root Canal Treatment

What is a root canal?

A root canal-also known as "endodontic treatment" is one of the most common dental procedures, well over 14 million are performed every year. This simple treatment can save your natural teeth and prevent the need for dental implants or bridges.

When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or "root canal" contains a pulp of soft tissue, blood vessels and nerves. Pulp helps to build the surrounding hard tissues of the tooth during development. The pulp is important during a tooth’s growth and development. Once a tooth is fully mature, it can survive without the pulp.

Endodontic treatment is necessary when the pulp becomes inflamed or infected. Infection of the pulp can be caused by trauma to the tooth, deep decay, tooth fracture, periodontal disease or repeated dental procedures. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess. Signs of pulp damage include pain in the tooth, prolonged sensitivity to heat or cold, and swelling in the nearby gums. Sometimes, there may be no symptoms.

How is a root canal performed?

The endodontist removes the inflamed or infected pulp, and the root canal system is thoroughly cleaned and sealed. This therapy involves local anesthesia and is usually completed in one visit in our office. Depending on the complexity of each individual case, a second visit may be required in order to achieve the highest level of quality care. The success rate for endodontic treatment is over 90%. If your tooth is not amenable to endodontic treatment or if the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatments. We use local anesthesia to eliminate discomfort. In addition, we will provide nitrous oxide, the "laughing gas", if indicated. You will be able to drive home after your treatment, and you probably will be comfortable returning to your normal routine.

Under certain circumstances, microsurgery may be indicated. We are experts in performing this procedure, and utilize sophisticated equipment to ensure the best result.

What happens after treatment?

Endodontic treatment has now been completed. The root canal system has been permanently sealed. However, the outer surface is sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay. A record of your treatment will be sent to your restorative dentist. You should contact his/her office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

Included in your treatment is a follow-up examination to evaluate the progress of healing. This appointment will require only a few minutes and no additional fee will be charged for the first check-up visit. Please call our office for a recall appointment when it’s due.

Apicoectomy/ Endodontic Surgery

What is an apicoectomy?

The above diagram illustrates this simple procedure. The endodontist makes an incision in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. Most patients return to work or other routine activities within a short period of time.

Why would I need endodontic surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain. Damaged root surfaces or persistent infection in the bone area after a root canal treatment may also be treated with this procedure.

Are there other types of endodontic surgery?

The most common surgery used to save damaged teeth is an apicoectomy or root-end resection. Other endodontic surgeries include dividing a tooth in half, repairing an injured root, and removing one or more roots.

FAQS--Frequently Asked Questions

What is endodontics?

Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp and surrounding tissues of the tooth.

Who are endodontists?

Endodontists are dentists who received an additional two or more years of an advanced training in endodontics. They limit their practice to endodontic treatments only because they are specialists. Endodontists perform routine as well as difficult and complex endodontic procedures. They are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

I'm worried about x-rays. Should I be?

No. While x-rays will be necessary during your endodontic treatment, we use an advanced non-film computerized system, called digital radiography, that produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to cotherapists via e-mail or diskette. For more information contact Schick Technologies, Inc.

What about infection?

Again, there's no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

What new technologies are being used?

Operating Microscopes:

In addition to digital radiography, we utilize special operating microscopes. Magnification and fiber optic illumination are helpful in aiding the doctor to see tiny details inside your tooth. Also, a tiny video camera on the operating microscope can record images of your tooth to further document the doctor's findings.

Ultrasonic:

With the constant improving of endodontic practice, the root end cavity preparation during apicoectomy is now accomplished with ultrasonic and tips designed by Dr. Gary Carr. This advanced technique allows endodontists to make a deeper preparation with less root reduction, thus improve the long-term prognosis of the tooth. Ultrasonic is also used in post removal during endodontic retreatment to minimize dentin removal.

Endoscope:

Endoscope is used in the visualization of surgical or conventional root canal treatments. E.V.S. (Endoscopic Visualization System) allows us to illuminate, magnify and visualize the root canal system to unprecedented levels. Innovative advancements in endoscopic technology have brought endodontic treatments to their highest level of excellence. Dr. Irene Yeh is the first endodontist in the Northern California area to incorporate the newest technology in the practice.