WHO IS A SPECIALIST ENDODONTIST?
An Endodontist or a root canal specialist is a dentist with advanced dental training. It is a requirement of the New Zealand Dental Council to have a Doctorate in Clinical Dentistry obtained after 8 years of university study to register as a specialist endodontist. They are highly trained in techniques and procedures involved in diagnosing and treating problems that originate from inside teeth. They restrict their practice to endodontics only and therefore have extensive experiences in treating cases that a general dental practitioner may not wish to undertake or consider challenging.
WHAT IS A “ROOT CANAL”?
Healthy teeth have nerves, blood vessels and other cells contained within the canal(s) inside each tooth. These give us a cold sensation when we eat an ice-cream or drink cold water.
If bacteria enter the root canal system through deep decay, filling, trauma, cracks, or due to malformed teeth, it may result in an inflammation/infection where the contents of a root canal can be destroyed by the invasion of bacteria. This is the management of infected space within a tooth to eradicate bacteria and protect the disinfected space from re-infection. This is commonly termed “root canal”. The bacteria will continue to cause an infection within the teeth and the surrounding bone unless we carry out root canal treatment. The presence of any persistent infection within our body is unhealthy.
SIGNS AND SYMPTOMS
Constant throbbing or sharp pain, lingering sensitivity to hot or cold, discoloration of the tooth, swelling of the adjacent gums or tenderness of the tooth, pain on biting or chewing and a history of trauma to the mouth is generally the common indications for root canal treatment. Sometimes there are no signs or symptoms or there is no pain but swelling or pimple on the gum adjacent to the infected tooth. There may also be bad breath or a bad taste in your mouth.
During the consultation, we will discuss with you the concerns that you and your dentists have about your teeth. During this appointment, we discuss your general and dental health followed by a thorough examination and tests of the offending tooth or teeth. We will require radiographs (X-rays) to help us find a correct diagnosis. We will discuss the options, treatment plan, costs, risks and benefits of the treatment. We welcome any questions that you may have. We ensure that you understand the need for the treatment, what treatment involves and the possible outcome. The complete root canal treatment including the consultation can take 1-4 visits depending on the complexity of the tooth.
THE TREATMENT PLAN
Prior to commencing the treatment, topical anaesthetic followed by local anaesthetics is used to numb the tooth and surrounding area for your comfort. A rubber sheath called a dental dam is used to isolate the tooth requiring treatment. A small opening under magnification is made on your tooth to access the infected root canal(s). The Endodontist will clean and shape the canal with special instruments and disinfectants. The canal(s) is/are then filled with an antibacterial paste and covered with a temporary filling. The dental dam is then removed and another appointment may be scheduled to complete the root canal treatment.
During the next appointment, the temporary filling is removed and the canals are again irrigated with disinfectants under local anaesthesia and rubber dam. Following this, the canal(s) are filled using a rubber based material called Gutta Percha. Once the canals are filled, you may be instructed to return to your dentist for a permanent restoration. This is an integral part of the whole treatment as it restricts further entry of bacteria, protects the tooth, and restores the function and aesthetics of the tooth.
We will recall you in 6 months to check the progress of the treated tooth. If healing is apparent a crown/cap (to be placed by your dentist) is recommended at this stage to help make the tooth stronger. If healing of the tooth is not apparent we will schedule another appointment in 6 months and carry out another review. In majority of the cases, evidence of healing occurs by now. These are complimentary appointments as part of our service.