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Root Canal Therapy

Treatment of Dying Nerves (pulpitis) and Infections

Diagnosis of a dying or dead nerve can at times be difficult due to pre-existing conditions found with the tooth.  Extensive decay, large deep fillings, crowns, cracked or fractured teeth or trauma can all contribute to a nerve pulpitis and eventual nerve necrosis.  Testing the tooth with ice, heat or electronic stimulus all help to determine the problematic area.  We also utilize x-rays and percussion or tapping tests and palpation or pushing tests to locate the nerve causing the symptoms.  When a nerve is dying or has died the options for treatment become very limited.  In order to maintain the tooth, root canal therapy must be considered.  If a patient decides against a root canal procedure, then an extraction is the only other option.  Unfortunately, depending upon the diagnosis,  there are times when a tooth cannot be saved with a root canal. 


Root Canal Therapy

Many people flinch when their dentists tell them they need root canal therapy. While dentists are sympathetic to fears of pain, at Randolph Dental we also want you to know that root canal therapy has three purposes:

  • Stop the toothache

  • Prevent bacteria and pain from spreading into the jaw

  • Maintain the original tooth instead of replacing it with a implant or bridge

Most root canals can be completed in one appointment. For teeth with difficult root formation or extensive infection more than one visit may be necessary. Our office will also at times refer to an Endodontic Specialist to complete the more difficult  cases. A root canal procedure limits the infection and keeps it from destroying the tooth and adjacent bone. It eliminates the pain and gives the ability to keep the tooth even though no nerve remains.  During the root canal treatment procedure, the dentist removes the inflamed or infected tissue, carefully cleans, disinfects, and shapes the canal space inside the tooth root, and then fills and seals this space. The nerve of a tooth is centrally located in the portion of the tooth that you can see and extends through the root into the bone of the jaw.  The canals contains blood vessels, nerves, and cells that make up the living tissue inside the tooth. Depending upon the amount of damage the tooth has received, most posterior teeth that have completed root canal therapy also require crown coverage to help protect the tooth.


What are the most common symptoms of a nerve dying in a tooth?

Nerve pulpitis or nerve necrosis can manifest itself with a wide variety and combination of symptoms. Common symptoms of root canal disease include:

  • Lingering sensitivity to cold liquids

  • Lingering sensitivity to hot liquids

  • Sensitivity to sweets

  • Pain to biting pressure

  • Pain that is referred from a tooth to another area, such as the neck, temple, or the ear

  • Spontaneous toothache, such as that experienced while reading a magazine, watching television, etc.

  • Constant or intermittent pain

  • Severe pain

  • Throbbing pain

  • Pain that may occur in response to atmospheric pressure changes, such as when flying or scuba diving

  • Pain that may occur in response to postural changes, such as when going from a standing to a reclining position

  • Swelling

If you have any of these symptoms, it would be wise to visit us at Randolph Dental because you might have root canal disease or another dental problem. Some of these symptoms may also be attributable to decay, defective fillings, periodontal diseases, cracked teeth, or other tooth or bite-related problems. On other occasions, the symptoms may even be caused by disorders that are not related to the teeth.

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