Emergency Procedures

Root Canals

The Inside Story

What's inside your teeth? Behind the tough, shiny enamel of the tooth's visible crown lies the sturdy inner tissue called dentin. Dentin is also found behind the cementum that forms the outer layer of the tooth's roots — in fact, it makes up the bulk of the tooth's structure. Similar in many ways to bone tissue, dentin is composed of many tiny tubules which can transmit sensations to nerve cells when it is stimulated.

At the core of the tooth, inside small, branching chambers called the root canals, we find the soft pulp tissue. This consists of nerves, connective tissues and blood vessels which extend into the center of the tooth and exit through canals near the apex (tip) of the tooth's roots. When problems (such as infection and inflammation) develop in the pulp tissue, your first indication of trouble may be tooth sensitivity — or intense pain. In time, as the nerves die, the pain may go away… but the problem won't. In fact, if left untreated, the end result may be tooth loss.

The “Root” of the Problem

What could cause the pulp tissue to become diseased and lead to root canal problems? One potential source of infection is untreated tooth decay, which can allow bacteria from the tooth's surface to work its way deep inside. A crack or fracture in a tooth could offer another pathway for microorganisms to infect the pulp.

Dental trauma — from a sports injury, for example — may also damage dentin or pulp, or expose it to infection. Extensive dental procedures (such as multiple fillings or restorations on the same tooth) may cause trouble; occasionally, even routine procedures like orthodontics may eventually lead to root canal problems.

Root Canal Treatment

The old gag line “I'd rather have a root canal” may still get a laugh — but root canal problems are no joke. It's important to remember that root canal treatment doesn't cause pain; it relieves pain. A typical root canal procedure is performed with local anesthetics and doesn't cause any more discomfort than having a filling. Here's what to expect:

First, you will receive anesthesia (usually a numbing shot) — and for many patients, the worst is now over. Next, a small opening is made in the tooth surface to give access to the pulp chamber and root canals. Then, tiny instruments are used — often with the aid of a microscope — to remove dead and dying tissue from inside the narrow passages. These passages are then cleaned, disinfected, and filled with a safe, inert material. Finally, the opening in the tooth is sealed to prevent contamination.

Other treatments may be recommended for removing sources of infection and preventing future problems. Following the procedure, it may be necessary to have a restoration (such as a crown) placed on the tooth to restore it to full function and aesthetic appearance. After that, with proper care the restored tooth should last for many years.

Oral Surgery Procedures

Oral surgery procedures may be performed to relieve pain, treat an infection or trauma, restore function or improve a person's appearance. Procedures and conditions treated include:

• Tooth Extractions. There are a variety of reasons why you may need a tooth or teeth removed. You may have a wisdom tooth that is impacted; a diseased tooth that can't be saved; or overcrowded teeth that need to be removed so more room can be created to facilitate proper alignment during orthodontics.
• Dental Implants. Today's preferred method of tooth replacement is a titanium dental implant, which is placed beneath the gum line and into the jawbone during a minor surgical procedure. The implant is then attached to a realistic-looking dental crown that is visible above the gum line and indistinguishable from a natural tooth.
• Oral Diagnosis & Biopsies. When a suspicious oral lesion is found, a biopsy is often used to detect or rule out oral cancer — a disease that is treatable if caught early. A biopsy involves removing a very small tissue sample for laboratory analysis.
• Corrective Jaw Surgery. Sometimes a person's jaws don't fit together properly. This can affect both jaw function and appearance.
• Snoring & Sleep Apnea. Excess tissue in the back of the throat may need to be removed in certain individuals with sleep apnea.
• TMD. When conservative remedies fail to relieve chronic jaw pain over a long period of time, surgery may be considered.
• Facial Trauma & Reconstructive Surgery. Facial injuries can affect not only a person's ability to carry on basic life functions such as eating, but also his or her appearance. Knocked-out teeth can sometimes be re-implanted, or replaced with dental implants.
• Cleft Lip/Palate. These birth defects are among the most common, estimated to affect around one in 700-800 babies born in North America. With proper surgical treatment, the child has an excellent chance of leading a healthy, normal life.

What to expect

Before your oral surgery is performed, x-rays will often be taken to aid in diagnosis and treatment planning. A step-by-step explanation of the procedure along with your anesthesia options will be discussed, and you should feel free to ask any questions you have. Your recovery experience will depend on what procedure you are having as well as your general state of health. It's always important to let your healthcare providers know what medications you are taking (both prescription and over-the-counter), any chronic health conditions you have, and whether you smoke. This will help ensure your safety and comfort — always the paramount concerns.

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