Endodontics is a specialization in the area of soft tissue inside the tooth. Dr. Ford performs most endodontics (root canals) in this office but may refer you to a specialist in certain situations.

Root Canal
A root canal is a procedure that extracts decayed pulp from the central part of the tooth, reshapes the canal and replaces it with strengthening filler.

A cavity is the result of superficial decay of the enamel of the tooth. Left long enough, this decay can burrow into the deeper reaches of the tooth, causing extensive damage to tooth structure. When the damage goes beyond what can be treated with a filling, dentists can perform a root canal (or endodontics), preserving the tooth and retaining its original integrity; thereby, saving a tooth that in the past would have to have been pulled.

Procedure:

  • The tooth is numbed.
  • A dental dam is used to isolate the tooth.
  • The tooth is opened to allow for removal of infected or dead dental pulp.
  • The tooth is comprehensively cleaned, including any cracks and canals.
  • With special tools, the doctor reshapes the canals.
  • The tooth is filled again with cutting edge biocompatible filling material.
  • A temporary covering is used to cover the access opening.
  • Patients MUST return soon for a permanent restoration of the tooth.

Apicoectomy
Also known as a root-end resection, an apicoectomy literally means the removal of the apex of the root of the tooth. This procedure, done following a root canal, treats the bony area surrounding the end of your tooth, which has become inflamed or infected. By folding back the gum near the tooth, the doctor can access the underlying bone and extract the inflamed tissue. At the same time, the very tip of the root is removed and usually replaced with a small plug or filling. At this time, the doctor may treat the area with antibiotics and will then close the area with a small suture. Eventually, the jaw surrounding the tooth will fill in with bone, supporting the tooth as before. This procedure helps ensure the lasting result of your endodontic treatment. An apicoectomy is only done in rare cases when a root canal requires additional treatment.

Treatment for Injured Teeth

There are many things a dentist can do to help save a tooth that has endured a trauma. This ability to treat a tooth successfully depends on what you do between the time of the injury and arriving at the doctor’s office.

If you have knocked out a tooth:

  • Immediately locate the tooth.
  • Handle the tooth only by its crown (chewing surface).
  • If tooth is clean, attempt to place it back in its socket. If tooth is dirty, GENTLY rinse with water and attempt replacement.
  • If you can’t replace the tooth in its socket, either store the tooth in between your cheek and gum or carry it in milk or water. DO NOT LET IT DRY OUT.
  • Get to a dental professional AS SOON AS POSSIBLE! If no dentist is available, get to a medical professional immediately.

If you have cracked or otherwise fractured a tooth:

  • Call your dentist immediately.
  • If you are also bleeding, try not to jar or touch the tooth with any foreign object, including gauze or bandage.
  • Get to a medical professional if no dentist is available and injury is severe.

Time is of the essence when it comes to avulsed (knocked out) or fractured teeth. Keeping a cool head and getting help as soon as possible will increase your chances of saving a tooth or reducing the amount of work needed to stabilize it.

When Endodontics Can’t Help

Endodontic treatment is nearly always successful. Sometimes, even taking all precautions, a tooth cannot be saved or becomes reinfected. There are different reasons for reinfection:

  • The crown or filling may have loosened and allowed bacteria to re-contaminate the root canal systems.
  • The tooth may have a fracture. 
  • Periodontal disease (bone loss) may have loosened the tooth beyond salvage ability. 
  • There may be multiple canals in the tooth that were not treated the first time. 
  • The original treatment may not have been thorough enough and infection or inflammation developed. 

Re-treatment

When treatment was not successful the first time, re-treatment is an option, months or even years later. If a root canal was not cleaned properly the first time, pulp material can remain behind and cause infection. If this infected tissue leaks beyond the root tip, it can cause bone loss and tissue destruction. Either of these can cause pain when biting.

Procedure:

  • The tooth is numbed.
  • A dental dam is used to isolate the tooth.
  • The crown is opened to allow for removal of old filling materials.
  • The tooth is comprehensively cleaned, including any new cracks or previously untreated canals.
  • The tooth is filled again with cutting-edge biocompatible filling material.
  • A temporary covering is used to cover the access opening.
  • Patients MUST return soon for a permanent restoration of the tooth.