Root Canal Dentist in Park Slope, Brooklyn

Why getting the proper root canal treatment is essential if you wish to save your tooth.

When the nerve and live tissue of a tooth is infected due to decay, a root canal treatment is indicated in order to clean the canals of the roots from of all the inflamed and infected tissue. This usually saves the tooth by removing the pulp, nerve tissue, and bacteria inside the tooth. Then the cleaned canals are replaced with medicated dental materials that fill the space of original pulp and nerve tissue. 

Patients choose to have root canals treatment preformed when they wish to save a tooth that would otherwise have to be removed. Most patients believe that extracting the tooth is the best idea. However, removing a tooth is costly and leaves a space that may cause problems for other adjacent and opposing teeth.  To avoid this problem, the removed tooth should be replaced by a dental implants, bridge, or removable partial denture, which is also costly.

Root canals performed at Advanced Gentle Dentistry of Park Slope are 90% successful and will usually last a lifetime. On occasion a tooth may have to be treated for new infections.

Possible signs of a root canal needed:

  • There may be an abscess or pimple on the gums.
  • The tooth may be become sensitive to hot and cold.
  • The patient may experience severe tooth ache.
  • There may be swelling or tenderness around the tooth.

 

Reasons for root canal therapy:

First reason is extensive tooth decay. When the decay inside the tooth reaches the pulp of the tooth (the living tissue inside the tooth), it causes inflammation and infection of the pulp. This leads to an abscess at the root tip.

Second reason is injury or trauma to the tooth which involves the pulp or is very close to the pulp.

Third, when tooth becomes symptomatic and painful.

What happens during a root canal therapy?

The root canal procedure will require one or more appointments that can be performed by one of our dentists at Advanced Gentle Dentistry of Park Slope.

When the area is anesthetized, our dentist may place a rubber dam (rubber protection) around the tooth to keep it dry and free of saliva.  An opening is made at the top of the tooth and a series of root canal files are used through the opening one at a time. These remove the pulp, the nerve tissue and any bacteria inside the canals.   If there is any decay inside the tooth, it will be removed with a special dental instrument.

Once the tooth is thoroughly cleaned of all bacteria and debris, the canal is then sealed with a permanent root canal filling.

The patient may need additional appointments to restore the access opening and broken or decayed part of the tooth. This may be a permanent filling, onlay, inlay, or a crown. The final restoration protects and prevents the tooth from breaking and restores the tooth to its full function. Our dentist will discuss the treatment of choice for each patient with him or her.

 Once the root canal treatment has finished the tooth may still be sensitive for a while. Eventually this sensitivity will subside as the inflammation inside the tooth reduces and the tooth begins to heal. 

If the patient practices good oral hygiene routines and regular dental visits, it will aid the life of the root canal.

If problems arise after a procedure, we are of course reachable for our clients outside of office hours! In this case, we will give you an emergency number.

 

Root canal therapy on a tooth with an existing crown – Dr Sarji explains a common procedure.

This is actually a common procedure and we decided to write this article to explain the process to our patients . This often occurs when a tooth has had a previous root canal which has failed. When the first root canal was done a crown was placed over the tooth on the part that was not decayed with a post being inserted into the tooth so that the crown can be attached properly. Now that the root canal has failed and needs to be retreated the dentist is presented with a choice as to how he should progress.

The dentist has two choices

First Option -  Ideally the dentist will remove the crown before he drills the access cavity, however this is not always possible. There may be the possibility that he will damage the existing structure of the tooth.

Second Option – If the dentist determines that the crown will not come off then an  access cavity must be drilled. In most cases the crown will be replaced although the tooth structure may have changed so it will not be possible to use it again. If the dentist has had to drill through it then this may weaken the crown.

In most instances a new crown is needed as the structure and integrity of the crown will have been changed or may be compromised.  The root canal could become re-infected very easily if the previous crown is used.  It is almost always advisable to remove the crown therefore protecting the integrity of the crowns and allowing the root canal procedure to take place;

For a dentist to remove  a crown in a manner that  it remains fully intact and unscathed can be very difficult if not impossible. During the attempt it's still possible that the crown will be damaged or worse yet the tooth damaged too and maybe significantly.

 Other reason for a crown failing is because  of tooth decay at the edge of the crown where it meets the gumline.   The crown obviously does not decay but the underlying tooth gets decayed.  In a situation like this when it this happens, the decay quickly spreads underneath the crown. 

If the decay is significant there may be very little tooth structure left under the crown before the pulp (nerve) becomes destroyed by the decay. In a case like this a new crown will not fix the tooth and a root canal will be needed along with the new crown assuming we can actually save the existing tooth structure. When a dentist places a new crown on a tooth that already has had a crown it will take more work and will be more difficult to do that the first crown. This is due to the fact that the margins or edges of the crown will need to be deeper in order to cover up the area where the decay was removed after the old crown was taken off. This is often a complicated procedure but we have a lot of experience in dealing with these.

   Crown are long lasting cosmetic restorations that for the most part will give a cosmetic appearance and perform a fuction but they will eventually wear out. Decay under the crown causes the crown to eventually fail. It is important that a dentist can detect early signs of decay at the edge of a crown. It takes a high degree of artistic skill to detect early decay on the edges of a crown. It must be replaced quickly in order to prevent a root canal or infection. Ask us when you come to see us about how you can take more care of your crowns.   

Root Canal Re-treatment - What is the process

Many a time a root canal will fail and a patient tooth may not heal as was expected and after the first root canal  treatment. This can happen for  a number of different reasons and in such cases the dentist will have to open the tooth again and readdress the infection. It may have failed for the following reasons: 

  • The root canals were to narrow and caused problems for the endodontist or dentist performing the initial procedure. 
  • The patient had a complicated pattern of root canal (imagine the roots of a plant) and some parts were undetected in the initial procedure.
  • While the replacement of the crown or restoration being used in the initial treatment was delayed the interior part of the tooth became infected which resulted in reinfection of the root canals.
  • The seal that was made around the restoration (crown) or filling was not adequate and the tooth became recontaminated. 

The worrying part is that not all of these will cause symptoms but they can still lie dormant and they can cause serious infection. In a dental x-ray this usually appears as a blackened area at the bottom of the affected root. There are other factors also that could cause a successful endodontic treatment to go wrong. 

Some of these root canal issues that could cause a need for further  root canal treatment are as follows: 

 

  • New decay around the tooth could expose the inside of the  root canal filling to bacteria. this could cause a whole new infection to the root canals.
  • A crown that has become loose, or broken could expose the tooth structure  and cause decay resulting in a new infection.
  • The root becomes fractured or the actual tooth becomes fractured. 

What is the process during pre-treatment for a root canal. 

It is important to review all options before undergoing root canal re-treatment and weigh up the benefits and the alternatives. It is usually always possible to re-treat the tooth but  Dr Sarji will have to re-open the tooth. Dr Sarji will create a small hole into the biting surface of the tooth which will allow him access to the root canal. In the majority of cases the restorative materials will be removed and the root canals will be cleaned and carefully examined using microscope technology and high intensity illumination. Dr Saji will search for root canals and look for unusual canals that will require extra treatment. Once Dr Sarji has cleaned and shaped the canals they will be resealed with 'gutta percha' and he will create a dental dam around the area so as not to get any infection into the newly cleaned root canals. Once the canals have been sealed he will add the restoration 'crown' and the will make sure that the tooth and surrounding structure is completely sealed.  The tooth is now sealed and will function properly with the new crown. 

Is root canal re-treatment the best alternative and do I have any other options?

It is always best to save a tooth where possible. After a root canal re-treatment teeth can fiction properly for many years, even for the rest of your life. These days endodontic technology is changing constantly and the technology that was available when you had  your first procedure may be different from the technology now.

If Dr Sarji cannot re-treat the root canals using non-surgical treatment then endodontic treatment may have to be done. Here he will make a cut in the gums to allow access to the root. 

The last alternative to re-treatment or a failed endodontic procedure is the complete extraction of the tooth. Dr Sarji could replace this with an implant, a bridge or possibly a removable partial denture. Any of these procedures will restore a patients chewing ability, their ability to smile and will prevent neighboring teeth from shifting. However these procedures can be costly. They also require Dr Sarji to perform procedures on neighboring teeth. This can be a costly experience and time consuming - a dental implant may work out to be cheaper in the long run.

Dr Sarji answers some questions here about root canals.

Are root canals healthy?
How many root canals are in a tooth?
How do root canals get infected?
How much do root canals cost?
Why are root canals so painful?
What causes root canals to be needed?
Are root canals covered by dental insurance?
Can the procedure be done in one visit?
What causes root canals to fail?

BELOW IS AN ARTICLE ON ROOT CANALS TAKES FROM OUR BLOG

Root canal therapy on a tooth with an existing crown – Dr Sarji explains a common procedure.

 

Root canal therapy on a tooth with an existing crown – Dr Sarji explains a common procedure.

This is actually a common procedure and we decided to write this article to explain the process to our patients . This often occurs when a tooth has had a previous root canal which has failed. When the first root canal was done a crown was placed over the tooth on the part that was not decayed with a post being inserted into the tooth so that the crown can be attached properly. Now that the root canal has failed and needs to be retreated the dentist is presented with a choice as to how he should progress.

 

The dentist has two choices:

 

First Option -  Ideally the dentist will remove the crown before he drills the access cavity, however this is not always possible. There may be the possibility that he will damage the existing structure of the tooth.

 

Second Option – If the dentist determines that the crown will not come off then an  access caity must be drilled. In most cases the crown will be replaced although the tooth structure may have changed so it will not be possible to use it again. If the dentist has had to drill through it then this may weaken the crown.

 

In most instances a new crown is needed as the structure and integrity of the crown will have been changed or may be compromised.  The root canal could become re-infected very easily if the previous crown is used.  It is almost always advisable to remove the crown therefore protecting the integrity of the crowns and allowing the root canal procedure to take place;

For a dentist to remove  a crown in a manner that  it remains fully intact and unscathed can be very difficult if not impossible. During the attempt it's still possible that the crown will be damaged or worse yet the tooth damaged too and maybe significantly.

 Other reason for a crown failing is because  of tooth decay at the edge of the crown where it meets the gumline. The crown obviously does not decay but the underlying tooth gets decayed.  In a situation like this when it this happens, the decay quickly spreads underneath the crown. 

If the decay is significant there may be very little tooth structure left under the crown before the pulp (nerve) becomes destroyed by the decay. In a case like this a new crown will not fix the tooth and a root canal will be needed along with the new crown assuming we can actually save the existing tooth structure. When a dentist places a new crown on a tooth that already has had a crown it will take more work and will be more difficult to do that the first crown. This is due to the fact that the margins or edges of the crown will need to be deeper in order to cover up the area where the decay was removed after the old crown was taken off. This is often a complicated procedure but we have a lot of experience in dealing with these.

   Crowns are long lasting cosmetic restorations that for the most part will give a cosmetic appearance and perform a function but they will eventually wear out. Decay under the crown causes the crown to eventually fail. It is important that a dentist can detect early signs of decay at the edge of a crown. It takes a high degree of artistic skill to detect early decay on the edges of a crown. It must be replaced quickly in order to prevent a root canal or infection. Ask us when you come to see us about how you can take more care of your crowns. If you need a second opinion about a root canal needed underneath an existing crown then make an appointment to come and see us. 

Jim Sarji, DDS has been performing dentistry for nearly 20 years and divides his time between his children and his practice. He is passionate about dentistry and has upgraded all his equipment at his practice to the highest technology including a 2D and 3D EWOO Panoramic Low Radiation Cone Beam X-ray. This is used to measure bone density when placing a dental implant and to look for infection in the jawbone. If you have a dental emergency then call the practice and ask one of the receptionists to make see if you can get an emergency appointment. If not check ZOCDOC.

 

Get more facts on Root Canals at WEBMD.COM.

 Get the facts about root canals for AAE (American Association of Endodontists)

The facts on root canals from the ADA (American Dental Association

The facts on root canals from the Academy of General Dentistry ( AGD )

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