Fillings & Root Canal Treatment

A Dental filling is a way to restore teeth that are damaged by decay back to their normal function and shape. When any dentist gives the filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a specific filling material.
Dentists consider a number of factors when choosing which type of filling material is best for you. These factors include the extent of the repair, where in your mouth the filling is needed and the cost.
They help restoring teeth that are damaged, back to their normal function, and prevents further decay.
If we talk about types of filling materials there is no limit, these days several dental filling materials are available like gold, porcelain, silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper), or tooth-colored, plastic, and materials called composite resin fillings. There is also a material that contains glass particles and is known as glass ionomer. This material is used in ways similar to the use of composite resin fillings.
However ,We at Dr.Mohan Dental clinic in Kukatpally strictly follow the policy of ‘No mercury fillings’ Silver amalgam fillings have been the oldest way of filling a tooth, it has a number of flaws and drawbacks that even includes mercury poisoning

PROCEDURE OF FILLINGS

  • Local anesthesia – Once you visit a dental clinic, at the start of filling procedure, Local anesthesia might be given if required to make the procedure hassle-free.
  • Tooth decay removal – After that the dentist will cut through the enamel using a drill to remove any decay. After the dentist removes the decay, the dentist will create the shape of the space to ready it for the filling
  • Etching – Before placing the material a tooth is etched for a bonded filling, so the dentist will etch the tooth with an acid gel
  • Resin application – For some types of fillings the dentist will layer on the resin and cure it using a bright light. This makes it strong
  • Polishing – This is the last and final step after the filling has been placed. The filling is polished

WHAT IS A ROOT CANAL?
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.
“Root canal” is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s nerve lies within the root canal.
A tooth’s nerve is not vitally important to a tooth’s health and function after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

Why does Tooth Pulp need to be removed?
When a tooth’s nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:

  • Swelling that may spread to other areas of the face, neck, or head
  • Bone loss around the tip of the root
  • Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin

What happens during a Root Canal procedure? or Step By step procedure of Root Canal Treatment?
A root canal requires one or more office visits and can be performed by a dentist or Endodontist. An Endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice of which type of dentist to use depends to some degree on the difficulty of the root canal procedure needed in your particular tooth and the general dentist’s comfort level in working on your tooth. Your dentist will discuss who might be best suited to perform the work in your particular case.

The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Your dentist or Endodontist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetize the area to make the patient more relaxed and at ease.
Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth.

An access hole will then be drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.

Once the tooth is thoroughly cleaned, it is sealed. Some dentists like to wait a week before sealing the tooth. For instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep out contaminants like saliva and food between appointments.

What signs and symptoms show that you require Endodontic Treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gum tissues. Sometimes, however, there may be no symptoms.

How does Endodontic Treatment save the tooth?

The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Afterwards, a crown will be placed or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.

Will the patient feel pain during or after the procedure?
Many Endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients 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. This discomfort can be relieved with over-the-counter or prescription medications. 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. However, if you have severe pain or pressure or pain that lasts more than a few days, call your Endodontist

Need any special care or additional treatment after Endodontic Treatment?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration(crown) as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings. Most endodontically treated teeth once crowned last as long as other natural teeth.

Can all teeth be treated endodontically ?
Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in Endodontics are making it possible to save teeth that even a few years ago would have been lost. When Endodontic Treatment is not effective, Endodontic Surgery may be able to save the tooth.

How successful are Root Canal procedures ?
Root canal treatment is highly successful, the procedure has more than a 95% success rate. Many teeth fixed with a root canal can last a lifetime.
Also, because the final step of the root canal procedure is application of a restoration such as a crown or a filling, it will not be obvious to onlookers that a root canal was performed.

Complications of a Root Canal procedure
Despite your dentist’s best efforts to clean and seal a tooth, new infections might emerge after a root canal. Among the likely reasons for this include:

  • More than the normally anticipated number of root canals in a tooth (leaving one of them uncleaned)
  • An undetected crack in the root of a tooth
  • A defective or inadequate dental restoration that has allowed bacteria to get past the restoration into the inner aspects of the tooth and decontaminate the area
  • A breakdown of the inner sealing material over time, allowing bacteria to decontaminate the inner aspects of the tooth
  • Sometimes retreatment can be successful, other times Endodontic surgery can be tried in order to save the tooth. The most common Endodontic surgical procedure is an Apicoectomy or root-end resection. This procedure relieves the inflammation or infection in the bony area around the end of your tooth that continues after Endodontic Treatment. In this procedure, the gum tissue is opened, the infected tissue is removed, and sometimes the very end of the root is removed. A small filling may be placed to seal the root canal.

Alternatives to a Root Canal procedure
Saving your natural teeth is the very best option, if possible. Your natural teeth allow you to eat a wide variety of foods necessary to maintain proper nutrition. The root canal procedure is the treatment of choice.

The only alternative to a root canal procedure is having the tooth extracted and replaced with a bridge, implant, or removable partial denture to restore chewing function and prevent adjacent teeth from shifting. These alternatives not only are more expensive than a root canal procedure but require more treatment time and additional procedures to adjacent teeth and supporting tissues.

How many sittings does it take?
Root Canal Treatment can be done in one or more visits, depending on the situation. An infected tooth will need several appointments to make sure that the infection is eliminated. Some teeth may be more difficult to treat because of the position of the tooth, because they have many and curved root canals that are difficult to locate, or for other reasons. An uncomplicated root canal treatment often can be completed in one visit. Once the root canal treatment is finished, you will need to see your general dentist to have the tooth restored with a crown or filling

Will I need to return to clinic for follow-ups after the procedure?
A follow-up examination is done after six months and you need to come to the clinic. Treatment outcome is evaluated, to see whether the tooth gets back the normal function again, and the extent of healing of bone.

Is there a need for cap after Root Canal Treatment?
After RCT, the tooth becomes non-vital and strength is reduced and becomes brittle with time & cannot withstand biting forces. Caps are very essential as they withstand the forces on tooth while chewing, otherwise they may fracture the tooth.

Can I go back to work after treatment?
Root canal treatment is similar to any other restorative procedure, but you will be having numbness. You can do your daily activities normally as there will be no inconvenience.

LASER Root Canal Treatment (RCT)

What Is A LASER Root Canal?
The invention of the  Dental LASERs has changed the way some dentists perform root canals. LASER RCT uses high energy beam and high-pressure water system to remove dead tissue and infection from the root’s canal. LASER system produces enough heat and pressure to remove debris without using drills or hand files, cutting down the time spent in the dental chair.

The LASER RCT cleans the root more thoroughly than conventional root canal techniques. Microorganisms can hide in the dentinal tubules, or tiny holes, of the dentin surrounding the root. With conventional root canals, the cleaning process doesn’t always reach all of the tubules, leaving behind some of the bacteria well after the root canal is filled and sealed.
The LASER penetrates deep into the porous tubules, removing bacteria without damaging the surrounding tissue. While traditional root canal instruments only clean out the tooth’s root, it actually sterilizes it, increasing your chances of a successful procedure.

LASER RCT

Conventional Root canal
Produces enough heat and pressure to remove debris without using drills or hand files, cutting down the time spent in the dental chair. Microorganisms can hide in the dentinal tubules, or tiny holes, of the dentin surrounding the root.
Cleans root more thoroughly than conventional root canal technique. With conventional root canals, the cleaning process doesn’t always reach all of the tubules, leaving behind some of the bacteria well after the root canal is filled and sealed.

 

The laser penetrates deep into the porous tubules, removing bacteria without damaging the surrounding tissue. Traditional root canal instruments only clean out the tooth’s root.

 

The laser actually sterilizes it, increasing your chances of a successful procedure.  

What Are The Benefits of LASER Root Canal Therapy?
LASER technology also reduces possible side effects from the root canal procedure. There’s no need to worry about files breaking off or getting stuck in the canal. LASER also limits the amount of bleeding during dental treatment, and can be used with minimal or no local anesthesia. Post-operative problems of traditional root canals are practically eliminated — LASER reduces the amount of inflammation, swelling and discomfort often felt as the anesthesia wears off. Patients may not even need pain medication often prescribed following dental surgery.
LASER is perfect for reaching areas that metal instruments don’t. Some dentists are combining both the laser and traditional hand pieces for optimal effects. Remember, your dentist’s goal is to save your tooth and get you out of pain, so regardless of what type of procedure you choose, root canal therapy is an important treatment to preserve your dental health.


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