Treatment Types

Root canal treatment

The aim of root canal treatment is to remove inflamed and infected pulp tissue from within the root canals, to allow relief of pain initially and elimination of infection with ultimate retention of the tooth.

Dr John Bone performing root canal treatmentRoot Canal Diagram

The first step is to administer local anaesthetic to numb your tooth and surrounding area. A sheet of rubber (rubber dam) is applied to the tooth, which isolates it; preventing debris from within the tooth entering the mouth and preventing saliva and bacteria from the mouth entering the tooth.

A small hole is made in the top of the tooth to gain access to the pulp which is removed using fine, specially designed instruments. The root canals are then cleaned, reshaped and disinfected. Usually at the first treatment appointment an antibacterial/sedative dressing is placed in the canals followed by a temporary filling in the access opening.

The final stage of the root canal procedure is to seal (fill) the root canals with a filling material (gutta percha) to prevent reinfection ,after which a temporary filling is usually placed again in the access opening. After the root canal treatment has been completed you will need to schedule an appointment with your dentist to replace the temporary filling. Your dentist will discuss the appropriate permanent restoration with you. It is generally recommended that root filled teeth be restored with a crown, which replaces missing tooth structure and supports the tooth, protecting it from possible fracture.

At Macquarie Street Endodontics we routinely advise patients return to us for review 6-12 months after treatment. 

Bleaching Root Filled Teeth

When the dental pulp of a front tooth is damaged either by trauma, decay or a leaking filling it may result in a discoloured tooth. It is possible to improve the colour of the tooth by carrying out a bleaching procedure on completion of the endodontic treatment. This will involve one or two extra appointments, depending on the amount of discolouration.

Dental Radiographs (X-rays)

Endodontic treatment requires a number of radiographs to be taken prior, during and on completion of treatment. Since the roots are under the gum and in the bone, they can only be visualized using the assistance of radiographs. At Macquarie Street Endodontics we use digital radiography which provides superior images with 50-90% less radiation compared with traditional radiography using film.       

Endodontic Surgery (Apicectomy)

An apicectomy is a minor oral surgery procedure which is necessary when infection remaining within the root is contributing to an area of bony deterioration about the root apex . The tooth in the majority of cases will have been previously root filled. An apicectomy is indicated when:

  • retreatment of the root canal system is not possible without significantly weakening the remaining tooth structure.
  • Access to the apical part of the root canal is not possible due to the presence of a post in the canal
  • the apical part of the root canal has been unable to be prepared and filled adequately.
  • infection remains despite satisfactory endodontic treatment

 

The procedure is carried out in the dental surgery over a 1-2 hour period.

  • Local anaesthetic is administered to numb the tooth and surrounding area
  • An incision is made in the gum to allow access to the underlying bone and root tip
  • The root tip and surrounding infected tissue are removed and the area irrigated
  • A filling is placed in the remaining exposed end of the root
  • The gum tissue is replaced and sutured in place.

 

You will need to return for suture removal 5-7 days later. If you live remotely arrangements can be made for your local dentist to remove your sutures.

What can I expect after endodontic surgery :

  • possible swelling and bruising for 2-5 days
  • possible shrinkage of the gum margin
  • there may be some post-operative bleeding requiring the use of firm pressure with a cold compress for 4 minutes at least.

 

If bleeding is considered to be excessive the endodontist should be contacted.

It is recommended that you return for review 6 months after treatment.

Resorption

Resorption is the destruction or “eating away” of the tooth and /or surrounding bone, caused by the body’s defences. Infection of the dental pulp can affect the tissues around the root and cause resorption of bone at the root apex (tip of the root). This can also resorb some of the root tip itself. A knock to the teeth can result in resorption of the tooth root. Seeing a dentist for prompt attention is therefore very important. There are different types of resorption and some can be treated more effectively than others. Your endodontist is well trained to diagnose and look after these difficult problems. Treatment can be complex and on going, but will be well explained at your consultation visit. In some cases resorption can occur inside the tooth, within either the crown or the root, for no known reason and may only be detected on X-ray. Treatment is not always possible as too much of the tooth may have been destroyed. As specialist endodontists, we are able to make a clear appraisal with respect to the most appropriate treatment.

What to do if a tooth is knocked out

Quick action can save a tooth that has been knocked out of the mouth (avulsed). Putting the tooth straight back into place in the mouth (replanting) is the best course of action. It is critical that this is done quickly. Teeth that are replanted within 15 minutes have the best chance of surviving.

Follow these steps:

  1. If the tooth is clean, replant immediately and have the patient hold it in place with finger pressure.
    Seek immediate dental treatment
  2. If the tooth is dirty, rinse in milk and replant as soon as possible. If milk is not available, rinse briefly in cold water.
    Seek immediate dental treatment
  3. If unable to replant the tooth keep it moist by placing it fully submerged in milk, or sealed in plastic wrap.
    Seek immediate dental treatment

 

Do not store tooth in water or detergents

Emergency Information

If you have an emergency please contact the surgery.