A Parent’s Guide to Emergency Dental Care

Posted on: 9 July 2018

Endodontic therapy is a procedure where your dentist removes infected pulp—the living portion of a tooth—out of the root canal. The lay person may think that every tooth has a single root and a single adjoining canal. While this is true for your front teeth, many maxillary molars have three roots. If you need to get a root canal for one of these teeth, it can sometimes be difficult to contain the infection because of the multiple roots.

Furthermore, some teeth have hidden canals. Even though root canal therapy has a good success rate, some people have hidden secondary canals in their incisors or four canals in their molars. Hidden canals can easily become infected, thus causing the endodontic therapy to fail. If your previous treatments have failed, here are some other options at your disposal.

Root Amputation

If your pulp was infected because of a tooth fracture, then root amputation (also known as root resection) can be a good option. The goal is to not only remove infection but also to prevent bone loss in the area that's been fractured.

A root amputation has six basic steps:

• Anesthetic is applied

• Vessels and nerves are removed

• The root canal is cleaned and disinfected

• The gums and enamel are cut near the infected root and the canal is removed

• Bone grafts are placed to support the tooth and gum tissue

• A crown is placed on top of the tooth 

This procedure could take a couple of visits. In one visit, your canal may be removed, and the next visit may be for the bone grafts. Root amputation is an ideal procedure if your surrounding jaw bone is in good health and the infection is contained to only one tooth.

Root Apicoectomy (Endodontic Microsurgery)

If you had a root canal in the past but the area has become infected again, the problem usually lies in the apex, or tip, of a root.

During this treatment, your dentist will only excise a few millimeters of the root's tip. This procedure is sometimes called endodontic microsurgery, since your dentist will need to use a microscope to cut such a small amount. Your dentist will then take an x-ray of the area before stitching tissues back into place.

Once the root tip is cut, your dentist will clean the root and seal the area with gutta percha, similar to a regular root canal treatment. Unlike a root amputation, you can get this procedure done in one appointment. Some procedures only take thirty to ninety minutes.

Tooth Extractions

While your dentist will do everything in his or her power to save your natural teeth, it's sometimes not possible. If the infection is severe and antibiotics aren't helping, it may be better to have the tooth extracted so that the infection does not spread to other oral tissues. If you don't get the tooth extracted, you could develop an abscess. A dental abscess causes a pocket of pus in the gums, which can then lead to bad breath, jaw pain, fever, and the loss of multiple teeth.

If a root canal keeps failing or cannot support a crown or filling, it is a waste of money to keep repairing it. Again, a tooth extraction is better in these cases.

Lastly, teeth that have been cracked down to the root cannot support root canal therapy, amputation, or apioectomy. Nothing can salvage these damaged teeth, so you need to have the tooth extracted.

A tooth extraction can prevent further infection and save you from severe toothaches. To fill in gaps, you can look at bridges, partial dentures, and permanent implants.

For more information on tooth extractions and other solutions for multiple root canals, contact a dentist in your area.