Posts for: February, 2017
A root canal treatment is a highly effective way to save a deeply decayed tooth. Sometimes, though, complications make it difficult or even impossible to perform the traditional procedure. In those cases, we may need to use a different option.
Tooth decay becomes an imminent threat to a tooth's survival if it works its way into the pulp, the innermost layer of a tooth. It's only a short advancement from there into the roots by way of the root canals.
In a typical root canal treatment, we access the pulp by drilling a small hole in the biting surface of a back tooth or the back side of a front tooth. We remove all the tissue within the pulp and fill it and the root canals with a special filling to prevent re-infection. After sealing the access hole, we cap the tooth with a crown to further protect it.
Although root canal treatments have a high success rate, re-infection can still occur. Often, a second root canal will save the tooth from the new infection.
In some cases, though, using the traditional procedure might do more harm than good. It's possible we may find extra canals previously undetected branching out from the primary canal at the root end. Canals can calcify and narrow, making them extremely difficult to fill. Subsequent dental work may also prove troublesome: we would have to take the restoration apart, which could further weaken the tooth.
The alternative is a procedure known as an apicoectomy. Instead of accessing the pulp through the crown, we access the root end through the gum tissue. We then focus on removing infected tissue at the tooth's root end, along with a tiny amount of the root tip. We then place a small filling at the end of the root canal (essentially plugging it up) to prevent further infection. We may also perform grafting to encourage bone growth in any voids left by the procedure.
Endodontists, specialists in root canals, have the advanced training and specialized equipment to perform an apicoectomy. With their expertise, they may be able to save your tooth with this specialized procedure when a root canal treatment won't work.
If you would like more information on options for treating decayed teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”
You might think David Copperfield leads a charmed life:Â He can escape from ropes, chains, and prison cells, make a Learjet or a railroad car disappear, and even appear to fly above the stage. But the illustrious illusionist will be the first to admit that making all that magic takes a lot of hard work. And he recently told Dear Doctor magazine that his brilliant smile has benefitted from plenty of behind-the-scenes dental work as well.
“When I was a kid, I had every kind of [treatment]. I had braces, I had headgear, I had rubber bands, and a retainer afterward,” Copperfield said. And then, just when his orthodontic treatment was finally complete, disaster struck. “I was at a mall, running down this concrete alleyway, and there was a little ledge… and I went BOOM!”
Copperfield’s two front teeth were badly injured by the impact. “My front teeth became nice little points,” he said. Yet, although they had lost a great deal of their structure, his dentist was able to restore those damaged teeth in a very natural-looking way. What kind of “magic” did the dentist use?
In Copperfield’s case, the teeth were repaired using crown restorations. Crowns (also called caps) are suitable when a tooth has lost part of its visible structure, but still has healthy roots beneath the gum line. To perform a crown restoration, the first step is to make a precise model of your teeth, often called an impression. This allows a replacement for the visible part of the tooth to be fabricated, and ensures it will fit precisely into your smile. In its exact shape and shade, a well-made crown matches your natural teeth so well that it’s virtually impossible to tell them apart. Subsequently, the crown restoration is permanently attached to the damaged tooth.
There’s a blend of technology and art in making high quality crowns — just as there is in some stage-crafted illusions. But the difference is that the replacement tooth is not just an illusion: It looks, functions and “feels” like your natural teeth… and with proper care it can last for many years to come.Â Besides crowns, there are several other types of tooth restorations that are suitable in different situations. We can recommend the right kind of “magic” for you.
If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Crowns & Bridgework” and “Porcelain Crowns & Veneers.”