For Patients

Post Root Canal Treatment advice

Root canal treatment also known as endodontics, is a dental procedure designed to treat infection or irreversible inflammation of the nerve or pulp of a tooth. This may be caused by deep decay, a fracture of the tooth or severe periodontal disease.
This Treatment is carried out by specialist endodontist in our practise.

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. Today, Endodontists understand a great deal about pain management. With modern techniques and aneasthetics, the vast majority of patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. Over-the-counter medications, such as Ibuprofen® or Paracetamol®, are usually enough to manage this sensitivity. In some cases, prescription medications may be necessary and are available from your endodontist. Follow your endodontist’s instructions carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. Of course, if you experience pressure or pain that lasts more than a few days, call your endodontist.

Post Root Canal Treatment advice

After your procedure, your endodontist will send you home with instructions for pain management and how to care for your tooth while recovering from treatment and until a follow-up visit. Following guidelines for care is especially important if a temporary filling or crown is in place.

As the medication used to numb your mouth during the procedure wears off, you may feel some tenderness in the area for a few days as everything heals and some mild soreness in your jaw from keeping your mouth open for an extended period during the procedure. These temporary symptoms usually respond well to over-the-counter medication but your doctor may prescribe stronger, narcotic medication as well. It’s important to carefully follow the instructions for medications and that narcotics can make you drowsy so you should exercise caution when taking them and driving a car or operating dangerous machinery.

Though you may experience a slightly different sensation from your treated tooth than your other teeth for some time, you should contact your endodontist immediately if you experience any of the following symptoms:

  • Severe pain or pressure lasting more than a few days
  • Visible swelling inside or outside your mouth
  • An allergic reaction to medication (rash, hives or itching)
  • Your bite feels uneven
  • The temporary crown or filling, if one was put in place, comes out (losing a thin layer is normal)
  • Symptoms you experienced prior to treatment return

After your procedure wait until the numbness in your mouth wears off before eating so you won’t bite your cheek or tongue. Don’t chew or bite down on the treated tooth until it is fully restored by a dentist to avoid damaging it. Remember to brush and floss daily as you normally would to keep the area clean and avoid infection.

Once your root canal and any follow-up appointments are completed, you’ll need to return to your dentist for a final crown to fully restore the tooth. It’s important to make this appointment as soon as your endodontist completes work on your tooth. A properly treated and restored tooth can last as long as your natural teeth.

Take care of your teeth by brushing, flossing, regular check ups and cleanings and be sure to return to your dentist and/or endodontist if you experience pain or swelling in the future. It’s possible for a properly treated tooth to require treatment again even years after a first procedure but often when this occurs the tooth can be saved.

What is Resorption

For adults, root resorption is an uncommon and troublesome dental condition in which the body’s own cells eat away and dissolve tooth structure. It isn’t a problem for growing kids, however; in children, resorption is the natural process that causes the roots of baby teeth to be removed, facilitating their replacement with permanent teeth.
Root resorption in permanent teeth may begin on the inside of the tooth (internal resorption), but more often it starts from the outside and works inward (external resorption). The effects of external (cervical) resorption (ECR), which you seem to be describing, occur near the gum line at the cervical (“neck-like”) region of a tooth. In its early stages, this condition may produce pink spots where the enamel is undermined and filled with the pinkish cells that do the damage. In time, these spots progress to cavity-like areas.
Resorption (breakdown) and deposition (adding to) are normal processes by which the body maintains balance. This is especially true of bone, in which it is a response to normal stressors: pressure and tension. In fact, these processes are what allow orthodontic movement of teeth to occur. Once formed however, adult teeth do not normally resorb.
While the exact nature of external cervical resorption isn’t fully understood, there are a number of factors that can make someone more likely to develop it. If excessive orthodontic force is placed on teeth, it can cause root resorption in later years. Or, a tooth that has been traumatized may suffer damage to the periodontal (“peri” – around; “odont” – tooth) ligament. Disturbance to this ligament, which attaches a tooth to the bone, can initiate resorption. Certain habits like teeth grinding (bruxism), and some dental procedures, such as intra-coronal (“intra” – from within; “coronal” – crown) tooth-bleaching, may also make an individual more predisposed to ECR. However, the vast majority of people with these risk factors never go on to develop this problem.
ECR is most often seen in the upper front teeth (the upper canines and incisors), and on the lower first molars. It’s possible for this painless condition to go undetected for some time, first showing up as a distinct dark spot on a routine x-ray examination. That’s unfortunate, because the longer ECR goes untreated, the more damage it can do. As the damage progresses, more and more of the tooth’s root structure — both its outer layer (cementum) and its inner layer (dentin) — are eroded away, and the affected tooth may look like it has a cavity. Unlike this far more common malady, however, the lesion (damaged area) caused by ECR doesn’t feel “sticky” to a dental probe.
Once root resorption has been discovered, it is necessary to treat it as soon as possible to prevent more damage from occurring, because the destruction can be rapid. Yet, as your dentist noted, it isn’t always possible to save an affected tooth; treatment depends on how far it has progressed when it is detected.
If the lesion is small, it is sometimes possible to expose the affected area of the tooth’s root with minor periodontal (gum) surgery. Then the tissue cells causing the damage are removed, and a tooth-colored filling material, a composite resin or glass ionomer cement, is used to repair the tooth. Sometimes, a single-tooth orthodontic procedure may be recommended before surgery. With this treatment, the tooth is gradually moved outward from the jawbone. As it moves, gum tissue moves along with it, and new bone is built up behind. Then, after surgery, the final contours of the gum line will match up, and gum recession at the affected tooth can be avoided.

Root resorption should be treated as soon as it’s detected to prevent more damage from occurring, because the destruction can be rapid.

If ECR has reached the area near the dental pulp (the tissue housing the nerve in the tooth’s center), root canal treatment may also be required. The more extensive and invasive the resorption, the less likely it is that the tooth can be saved. Often, in cases where ECR is advanced, the preferred option is to extract (remove) the tooth and replace it with a dental implant.
In some cases, it isn’t possible to see how much damage has been done — and whether or not extraction is needed — until the root has been exposed by surgery. However, CBCT (cone beam computed tomography) scans can reveal tiny anatomical structures inside the tissues in three dimensions, with far greater detail than standard x-rays. This high-tech imaging method can help make treatment planning in advance more accurate.

Cracked Teeth

Your tooth could crack from an injury or general wear and tear. You may experience a variety of symptoms such as erratic pain when you chew your food to sudden pain when your tooth is exposed to very hot or cold temperatures. In many cases, the pain may come and go and your dentist may have difficulty locating the tooth causing the discomfort. If you experience these symptoms or suspect a cracked tooth, it’s best to see an endodontist as soon as possible.

Endodontists specialize in saving cracked teeth and will cater treatment to the type, location, and extent of the crack. The sooner your tooth is treated, the better the outcome. Once treated, most cracked teeth continue to function as they should, for many years of pain-free biting and chewing.

Endodontic Re-treatment

With proper care, you’ll keep teeth that have had root canal treatment for a long time but it’s possible for those teeth to heal improperly, becoming painful or diseased months or even years after treatment. If this happens to your treated teeth you have a second chance to save the tooth with retreatment. An additional procedure may be able to diminish dental pain or discomfort and promote healing. If you suspect a tooth that had a prior root canal requires retreatment, visit your dentist or endodontist for evaluation.

As with any dental or medical procedure, it’s possible your tooth won’t heal as expected after initial treatment for a variety of reasons, including:

  • Narrow or curved canals were not treated during the initial procedure.
  • Complicated canal anatomy went undetected in the first procedure.
  • The placement of the crown or other restoration was delayed following the endodontic treatment.
  • The restoration did not prevent salivary contamination to the inside of the tooth.

A new problem can also jeopardize a tooth that was successfully treated, such as:

  • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
  • A loose, cracked or broken crown or filling can expose the tooth to new infection.
  • A tooth sustains a fracture. During retreatment, the endodontist will reopen your tooth and remove the filling materials that were placed in the root canals during the first procedure. The endodontist then carefully examines the tooth, looking for additional canals or new infection. The endodontist then removes any infection, cleans and shapes the canals, and places new filling materials. The opening is then sealed with a temporary filling. Once the tooth heals, which may require more than one visit, a new crown or other restoration is placed on the tooth to protect it.

Endodontic Surgery from AAE

It’s possible that a nonsurgical root canal procedure won’t be enough to save your tooth and that your endodontist will recommend surgery. Endodontic surgery can be used to locate small fractures or hidden canals previously undetected on X-rays during the initial treatment. Surgery may also be needed to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth. There’s no need to worry about surgery if your endodontist prescribes this additional measure. Advanced technologies like digital imaging and operating microscopes allow these procedures to be performed quickly, comfortably and successfully. There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which may be needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure. Your endodontist performs this micro surgical procedure first making you comfortable by applying local anesthesia before opening the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. A small filling may be placed to seal the end of the root canal and a few stitches or sutures are placed to help the tissue heal. In the next few months, the bone will heal around the end of the root. Most patients return to their normal activities the next day. Post-surgical discomfort is generally mild.

Periodontal, Gum Treatment 

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Gum disease is a condition where the tissues surrounding the teeth have become inflamed due to bacteria. Periodontitis is when gum disease has progressed to bone lost, causing the tooth to become wobbly. The aim of the treatment of periodontitis would be to prevent further progression of the disease in order to keep as many teeth remaining in your mouth for as long as possible.

Dr. Peter Hensel specialist periodontist carries out this treatment.

Dental Implants

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American Association of Endodontics.

If your tooth must be extracted, you should consider a dental implant that will enable you to bite and chew properly, keep healthy teeth from shifting, and help you maintain a natural appearance. 

Dental Implants are the permanent solution to missing teeth. Unlike conventional bridgework, Implants can provide tooth replacement without the need to cut down adjacent teeth. They have also the added advantage of preserving and maintaining bone in the area around the Implant.

Dental Trauma Information and App

When the child first starts exploring the world by themselves, with the help of their first baby walker, they are exposed to falls that can affect their face and teeth. During the first years of life, the primary teeth are very closely related to the permanent teeth, which are forming inside the bone.When injury occurs to the primary teeth in this period, it can affect the aesthetics of the permanent teeth, which will present at approximately eight years of age with whitish marks or a deformation in the crown depending on the extent of the injury. The most serious lesions on the primary teeth can cause complications to the permanent successors; ie. intrusion (when the tooth is buried in the gum) and avulsion (when the tooth is knocked out). Both situations are more serious the younger the child is. The primary tooth should not be replaced once it has been knocked out.

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