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Root canals

This used to be a major portion of my practice. However, due to the availability of implants, root canals are becoming less frequent.

Symptoms of infection within a tooth include extreme sensitivity to heat and cold, pain on chewing, and/or swelling of gum tissue at the base of the tooth.

Root canal involves the removal of the pulp of the tooth, which includes blood vessels, nerves, and connective tissues.

root canal
Illustration of the root canal process
  • Root canal vs. implants—Sometimes, I have a patient who comes in and says he or she wants a tooth removed. If I think the tooth can be saved, I suggest that s/he keep the tooth and not risk the possibility of bone loss. Actually, I’ve been very successful in saving teeth by means of root canal whenever long-term viability seems likely.

    To make a recommendation, I look at the bone structure, checking the movement of the tooth and the support it’s getting from the jawbone. I consider what would be left after the decay is removed.

    Only if survival of the tooth is questionable, or if its long-term viability seems unlikely do I advise patients to have an implant made. Otherwise, I suggest proceeding with the root canal treatment.

  • Referral to a specialist—There are cases in which I may not perform a root canal procedure on a patient. For example, there may be loss of bone at the tip of the root. Or root canal may fracture the tooth. In those cases, I’ll recommend that the patient see a specialist for what’s called an apicoectomy, which requires cutting the gum, thoroughly cleaning the whole area of disease around the root, and putting filling in the root end of the tooth.

    That filling is called a retrograde filling. I do some. But I also feel that the process sometimes is too complex—e.g., the filling is too close to a nerve or a sinus cavity. If I’m concerned about possible complications, I refer the patient to a specialist.

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