Root Canal Treatment

Healthy teeth are comprised of a basic structure composed of dentin, which is mineralized tissue with many of the qualities of bone, and enamel which is the very hard coating of the exposed portions of each tooth. Inside the dentin of each tooth is the pulp. The pulp is living tissue composed of nerves and a blood supply that keep the organic components of the surrounding dentin supplied with moisture and nutrients. The pulp serves to signal extremes in temperature, pressure, or trauma to the dentin or pulp and actually work to replace damaged dentin. Despite its resilience, however, it is no match for decay.

Decay begins by attacking the enamel of the tooth, a process that may continue for a period of months or even years. Eventually, however, it will reach the dentin which is softer and much less resistant to decay. Once in contact with the dentin decay progresses rapidly to the pulp. While some individuals experience pain as the decay erodes the dentin, others remain oblivious of the problem until it breaches the dentin and attacks the pulp. If arrested at this point, the is a good chance that the pulp can be saved and the tooth restored. However, it is a point beyond which decay becomes most destructive and threatening to our health.

Left unchecked, decay attacks, infects and kills the tissue that comprises the pulp (see circle 1, in the diagram). In the process it builds pressure which generally manifests itself as a bulb or puss pocket at the root of the tooth (see circle 2). At this point, there is a good chance that the tooth may still be saved with prompt treatment commonly referred to as a root canal. Beyond this, however, the infection may spread and attack surrounding tissue and bone, which will likely require that the tooth be removed.

Another threat to healthy teeth is concussion injury that occurs when a tooth forcibly comes in contact with a hard object, such as a baseball, pool edge, hand rail, etc. If the force of the concussion is significant,the blood supply to the pulp of the tooth may be interrupted. If the blood supply is interrupted for any length of time, it is likely that the pulp will not recover. Whether or not an infection develops, it the pulp dies the tooth will become progressively weaker and will eventually turn gray in appearance.

Treatment

A root canal procedure is generally a four step process and with few exceptions generally requires one to two visits.

The first step, at Deadwood Dental, is to ensure that the patient is comfortable and pain free. Experience has taught us that the procedure takes far less time and is much easier for the patient when pain is removed from the equation.

If the tooth is infected, the dentist will likely prescribe a course of antibiotic to be taken for approximately a week prior to the initial treatment visit. Not only will it make treatment safer for the patient, but it will also the effectiveness of any anesthetic that may be utilized.

After the patient is entirely comfortable and no longer sensitive to pain, the dentist begins by opening the tooth and removing all traces of decay. If a crown or onlay is planned, the tooth will be shaped to ensure both fit and support. Next, an impression may be taken, to allow a dental laboratory to produce the crown or onlay.

If the tooth is impacted as a result of infection, it is generally packed with a sterile dressing and the patient released in order to give the tooth a chance to drain the infected pocket. If the infection appears serious or wide spread, the doctor may prescribe a course of antibiotics to aid in ending the infection. If, on the other hand, an active infection is not present, the dentist will move directly to the next step.

During the next step, the dentist will use specially designed instruments to remove any remaining tissue and prepare and sterilize the canals for filling. This step is important because it effectively stabilizes the root(s) and significantly strengthens the tooth's structure.

Next, the canals are sealed and filled with with an acrylic substrate. In most instances a temporary filling material is used to seal the surface, and the patient discharged for a week to 10 days. 

In the interim, the impression that was taken will be utilized by the dental lab for production of the determined restoration. The final restoration will be placed, most often without the necessity of anesthetic, during the final treatment visit.

Please feel free to discuss any questions you may have regarding the content in our website with either Dr. Hopper or Dr. Mills. Either will be more than happy to address any questions or concerns you may have.

You may reach the clinic at 605-578-3810 or 800-641-2035, or
email us at: deadwooddental@mato.com