Endodontics of Orange County – Irvine Root Canal Specialist Sam R. Gharib, D.M.D., M.S. the root canal specialty, explains the role of an endodontist, the reasons for root canal treatment, and the root canal treatment procedure.

Definition: Endodontics is the branch of dentistry that deals with diseases of the tooth root, dental pulp, and surrounding tissue. Endodontists are dentists with two extra years of education and training in finding the source of dental pain and infection, curing the disease, and saving teeth with root canal treatment, root canal retreatment, and endodontic surgery.

Historically, a tooth with a diseased nerve would be removed, but endodontists are now able to save the natural tooth when it is expected that root canal treatment will allow the tooth to function normally for an acceptable time period.

Signs and symptoms of problems related to endodontic disease:

  • There is swelling or a pimple on your gum next to a tooth.
  • Cold or hot sometimes cause pain that is very sharp or the pain lingers more than a few seconds
  • Tenderness when chewing and biting.
  • Tooth discoloration.
  • It hurts to bite on a tooth and the symptoms are not improving.
  • You have spontaneous pain and can not determine which tooth hurts.
  • You had a root canal treatment in the past. Now it is tender to bite, or feels loose, or there is swelling or drainage next to the treated tooth.
  • You want a second opinion from an impartial, board certified endodontic specialist.

Endodontic treatment (or root canal treatment) is performed to save the natural tooth. In spite of the many advanced restorations available, most dentists agree that there is no substitute for healthy, natural teeth.

Here are some of the main causes of endodontic disease:

Bacterial infections – Oral bacteria is the most common cause of endodontic problems. Bacteria invade the tooth pulp through tiny channels in the teeth caused by tooth decay or injury. The resulting irritation to the pulp is called pulpitis. If the pulp disease is more severe, a bacterial infection will jeopardize the affected tooth and may cause an abscess to form.

Fractures and chips – When a large part of the surface or crown of the tooth has become completely detached, root canal therapy may be required. The removal of the crown portion leaves the pulp exposed, which can be painful and the patient should call .

Traumatic Injuries – Injuries to the teeth can be caused by a direct or indirect blow to the mouth area.  Some injuries cause a tooth to become moved in, moved back or dislodged from its socket. Root canal treatment is often needed after the endodontist has successfully stabilized the injured tooth.

Teeth Forced Out of Mouth – If a tooth has been knocked clean out of the socket, it is important to pick it up only by the part covered with enamel, gently rinse it, without touching the tissue covering the root, and place it back into the socket as quickly as possible. If this is impossible, place the tooth in special dental solution (available at pharmacies) or in milk. These steps will keep the soft tissue on the root surface moist and alive while emergency dental treatment is sought. The tooth will be replaced in its socket, stabilized with a flexible splint and, based on the age of the patient, the level of tooth development, and the other factors, determine whether the patient should return within ten days to have root canal treatment performed and the splint removed.

What does a root canal procedure involve? See our Video collection for a visual demonstration.

Root canal treatment usually takes between one and two visits to complete. Low radiation digital x-ray images are captured to reveal decay, bone irritation, and infection. Diagnostic tests are performed to locate the tooth pain source.

Initially, a local anesthetic will be administered, and a dental dam (protective sheet) will be placed to ensure that the surgical area remains free of saliva during the treatment. An opening will be created in the surface of the tooth, and the pulp will be completely removed using small handheld and flexible motor-driven instruments.

The root canals will then be shaped, cleaned, and packed with gutta-percha and a sealer interface.  Gutta-percha is a biocompatible material that is somewhat similar to rubber. The Access opening to the root canals must be completely sealed off. Usually, a temporary filling will be placed to restore functionality to the tooth prior to the permanent restoration procedure. During the final visit, a permanent restoration or crown will be placed.

If you have questions or concerns about endodontic procedures, please contact our office.

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