Root Canal Treatment (RCT)
As a Holistic/Biological dentist I am so happy that I found a more holistic approach on how to perform a root canal for those who want to buy more time for their teeth. Fotona Laser Lightwalker offers a better way to disinfect the canals removing the biofilm from even the minuscules accessory canals present in the teeth. Watch the videos above!
A lot of people ask me what my thoughts are on root canal treatment. I have done many root canal treatments in my career and I continue to do so even though there is controversy from some quarters on the practice. The origin of the controversy lies in the question of remnant populations of microbes in the dentinal tubules in root canal treated teeth and whether or not endodontic techniques adequately disinfect them or keep them disinfected.
The American Dental Association position on RCT is: "The effectiveness of root canal treatment is well-established. However, misinformation continues to circulate on the Internet that may cause patients to question the safety of endodontics." The IAOMT position is more nuanced, and asks whether alternative materials and techniques can yield a more biologically acceptable outcome for those that wish to keep their teeth through RCT. Either way, it is important for a dentist to provide informed consent about the benefits and risks of RCT.
I work with each patient to find the right treatment for him/her and always start with the question: "How important is for you to keep that tooth?" I ask that question because each individual has different values. Decisions will affect people's emotions, and emotions affect people’s health.
When the pulp (nerve) of a tooth is damaged, there are only two options: RCT or Extraction. An extraction is an amputation, the person can be affected emotionally if for them it is important to keep their teeth. On the other hand, there are some people that would rather have the tooth extracted and replaced with a bridge, removable or an implant. I educate my patients about both procedures and their pros and cons and then let them choose the best treatment for their needs.
What is a Root Canal?
The root canal is a natural chamber inside of the tooth that houses the dental pulp, which is known as the tooth nerve. The pulp is responsible for nourishing the tooth and transmitting pain and sensitivity signals to the brain.
When do you need a Root Canal Treatment(RCT)?
Deep dental decay exists near the pulp or pulp is exposed.
Traumatic tooth injuries have created fractures or cracks and compromised the root canal.
The pulp(nerve) is infected.
Previous dental work, such as deep fillings, have created irritation.
Once the nerve is irreversibly damaged and you want to save the tooth, a RCT should be performed. There are different ways to clean the canal and different options on which material to use to fill the cleaned canal.
What does Root Canal Therapy involve at Family Holistic Dentistry?
A root canal treatment requires at least two appointments to be sure that the infection is fought properly.
We want to make sure our patient is comfortable and with low stress without neither medications nor Nitrous Oxide. We recommend some homeopathic remedies, NuCalm and BLAST technology using TouchPoints instead.
We apply local anesthesia (either with or without epinephrine based on your needs), we have some simple distraction technique that helps to achieve painless anesthesia.
A Non latex rubber dam (a sheet of rubber) is be placed around the tooth to keep it dry and free of saliva.
If tooth decay is present, it will be removed with burs and dental instruments.
An access opening is made on top of the tooth, and if you have a zirconia or a porcelain crown I can remove with our laser and be able to cement it again. If you have a PFM( porcelain fused to metal )crown, I can do the access on the top through it, we can keep the crown if no recurrent decay is present.
Series of hand and rotary files are placed into the canal to shape it and clean it with constant irrigation.
Then irrigation and disinfection is done with ozone therapy and using SWEEPS Photoacoustic Endodontics laser which improves debridement and disinfection in the main and accessory canals and it is more patient friendly (no heat involved).
Canals are dried. Once the tooth is thoroughly cleaned, it will be sealed temporarily with Calcium hydroxide (an alkaline material), and a temporary filling with neither Fluoride nor eugenol will be placed.
At the next appointment, usually a week later, calcium hydroxide is rinsed. The roots are filled and sealed . A temporary filling is then placed to cover the opening on top of the tooth. One week later, if there is not evidence of infection, either a Bioclear composite restoration or a one day crown (cap) will be placed. This will protect the tooth and prevent it from breaking, and restore it to its full function. After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed. Many times the patient will need to take antibiotics and analgesics. You will be given care instructions after each appointment. Good oral hygiene and regular dental visits will aid in the life of your root canal treatment.
Complications. There are many things which can compromise the result, including:
Unknown factors, that nobody can explain
Fracture in the root
A broken instrument lodged in the root canal (a rare occurrence)
Further treatment could be necessary which means repeating the process of cleaning and filling the root, or it can involve surgery to treat the ends of the roots directly (Apicoectomy). On some occasions, the tooth must be extracted.
If you decide to have a root canal at Family Holistic Dentistry, we will explain the procedure in detail. If you want to have the root canal with a specialist, we would be more than happy to refer you.