Dr. Urban on Today’s Dentistry / What is a Root Canal? #What is a root canal?

I sure get a little nervous when my doctor combines treatments and canals in the same sentence. Justifiably my patients react the same way when I recommend a root canal treatment.

When it becomes impossible to restore a severely decayed or fractured tooth merely with a filling or crown I have to recommend root canal therapy or extraction. I still get people fidgeting and wincing at the thought.

The vast majority of root canal treatments are successful and are provided with minimal discomfort. Just like the TV news and printed newspapers we only hear about tragic events, crumbling economies and horrible acts done by man. In other words no news is good news. So the uneventful successful root canal fillings go by unnoticed.

There are a few failures. It ranges between 2% to 5%. Some teeth are just untreatable or not worth the time and expense due to predictable unfavorable outcomes.

Root canal myths abound. Root canal treatments remove the roots, pulling a tooth is better than a root canal filling, pregnant women can’t have root canals, root canals cause illness, and if it doesn’t hurt don’t fix it with a root canal. These are just myths. Let me explain.

Anatomically, the teeth are formed with a hard outer enamel shell covering a less dense dentin core. This core protects the pulp of the tooth which has a nerve and blood supply. When trauma or bacterial invasion penetrates through the enamel and into the dentin core the living tissues of the pulp will die off leaking out into the bone through the end of the root and causing an abscess to form.

 Pain may not be present when the dentist examines the x-rays and finds a latent abscess or dead tooth. The tooth is best treated before a severely painful infection develops. Infections will compromise pain control and the outcome of the treatment. Do not delay.

Root canal fillings obliterate the space that was once occupied by the nerve. It takes a lot of clinical know-how and patience to place these fillings. Once placed the fillings need protection from the mouth fluids with a restoration like a crown or sealed filling.

Root canal fillings can be placed during pregnancy without any special precautions. Also, there is no evidence to suggest that root canal treatments will develop into an illness.  Save your teeth if you can. In the long run it is far easier the alternatives.

Do all crowns need root canal fillings first? No. Only about 20% of crowned teeth will need root canal fillings later on in normal situations. Do most root canal fillings need crowns? Yes. Root canal filled teeth become brittle and may fracture later so they require full coverage of the chewing surface. Once properly restored the tooth should perform like a normal tooth for a long time.

For answers to your dental questions, contact
 Douglas Urban DDS 
Cerritos Southcoast Dental
(562)924-1523. 
Or visit our website at www.DrDouglasUrban.com

How often should I see the dentist or hygienist?

   
     TV advertisements or commercials do not always give the right information.  How often we visit our dentist or hygienist is one of them.  I once heard an advertisement say that we should visit the dentist once or twice a year and that’s enough.  Well, that’s not true for everyone!

     In general, children and adults with a healthy mouth should see their dentist at least two times a year.  For those who have high decay (cavity) risk and people with periodontitis, they need to see the dentist more often.  People who have been diagnosed with periodontal disease usually need a periodontal therapy treatment (scaling & root planing).  After its completion, periodontal maintenance is recommended in a 3 or 4 month recall interval.  This is imperative to help maintain a healthy status.  A recall interval is suggested based on the patient’s home care.  Better home care could mean fewer visits with the hygienist.  People with high decay rate should also see the dentist more often.  Radiographs are taken once a year, sometimes twice.  Decay can start fast and spread quickly, depending on the part of the tooth.  The root of the tooth has no enamel so the decay can get big much faster.  With this in mind, the dentist/hygienist can give preventive treatments to those in- need: in-office fluoride treatments, oral hygiene instructions, prescribing pastes that would help remineralize decalcifying tooth surfaces, and nutritional counseling.

     Visiting the dentist is very important.  It is essential to either maintain or attain a healthy mouth.