Root canal dentist Charlotte NC
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As some of you may know, I practice holistic and biological dentistry. For patients seeking holistic care, I do not perform root canal procedures. For patients seeking biological care, I perform biological root canals. With biological root canals I use oxygen-ozone , a biocompatible sealer and non-gutta percha filling material. Click to following link for more information about holistic and biological care:
Presently, we are avoiding root canal procedures in our Charlotte NC office. There are several reasons for this. These include:
1) We are performing highly successful pulp procedures.
2) We are comprehensively balancing our patient’s bites. By balancing bites, we can avoid stresses on the teeth that make the teeth more susceptible to nerve root canal procedures.
3) We are detecting dental disease earlier with our state-of-the-art techniques,which detect cavities and infection much sooner than before.
Sometimes new patients present to our Charlotte NC office with problems in a tooth that has already had a root canal procedure completed. The tooth may show signs of re-infection in the tooth. In these cases we recommend the removal of the tooth along with proper treatment of the extraction socket in the bone. Dental implants, bridges or dentures can be an alternative to replace the missing tooth.
What is a Root Canal?
A root canal is a procedure where the infected inside of the tooth (pulp tissue) is removed and the inside of tooth, the root canal space,is disinfected. The disinfected root canal space is then sealed and filled with a filling material. After a root canal is completed, the tooth then receives a filling and then a crown. The filling and crown seal the tooth from the oral cavity and strengthens the tooth to prevent fracture.
Cavity (bacterial) has spread into the pulp (L).
The root canal is cleaned and shaped (R).
Completed root canal with a temporary filling (L). Properly restored
tooth with a permanent filling (core buildup and post and a crown).
Root Canal Failure
Some teeth that had root canal procedures can become reinfected.
Here are some pictures of failed root canals. Falure of a root canal is determined by patient synptoms (pain, welling, etc.) and radiolucencies or "dark spots" on x-ray films which could indicate infection.
What contributes to root canal failure?
1) The complex anatomy of the root canal chamber.
The more complicated the root canal anatomy, the more likely that bacteria will be trapped in the root canal even after root canal anatomy.
Basic tooth anatomy
The following reveal how complex and convoluted root canal shape can be.
The following show how complex accessory canals can be:
Root Canal or Dentinal Tubules:
Section of a crown of a tooth. The dentinal tubules extend from the root canal space to the enamel. In the root, where there is n enamel covering, the tubules extend from the root canal space to the outer surface of the root.
Dentinal tubules with odontoblasts (cells) reside in the pulp in the root canal space. Odontoblasts are removed along with the rest of the pulp tissues when a root canal is completed.
Dentinal tubules (L), dentinal tubules with invading bacteria (R). Bacteria gets trapped in the dentinal tubules along the inner wall of the root canal space.
2) Occluso-muscle Disorder (an unbalanced bite)
An unbalanced bite can absolutely cause a tooth to need root canal.
3) Patient neglect
Sometimes the patient is responsible for the failure. There are several reasons for this:
a) The patient did not get a final crown on the tooth
After a root canal is completed, a permanent filling (core buildup or post and core) needs to be placed in the access opening to properly seal the root canal from the oral environment. Additionally. the tooth needs a permanent crown that fits over the filling and the tooth to give structural strength.
After a root canal is completed, if a permanent
filling (core-build-up or post-an-core is not
immediately placed, a temporary filling will be
placed in the access opening in the tooth.
A properly restored (fixed) tooth with a permanent
filling (core-build-up, post and crown)
b) The patient's home care was inadequate.
If a patients have consistently inadequate home care, decay can establish itself at the crown margins and progress to the root canal system and reinfect it.
c) The patient has not maintained regular exam and cleaning appointments.
Patients need to remember that they need to maintain recall cleaning and exam appointments. There are many patients who maintain their cars better than they do their mouths.
Decay around a crown margin.
4) Inadequate root canal root canal treatment by the dentist
In any profession things can be done inadequately or incorrectly. Dentistry is no different. We would be remiss in our explanation of root canal failures if we did not mention that occasionally it is the dentist technique that caused an eventual failure of a root canal. There are a number of things during the root canal process or the restorative process (filling and crown) that can jeopardize immediate or long term health of a tooth. The important thing is that if a dentist makes a mistake and is aware of it, they communicate this to you so the problem can be properly resolved. As a dentist develops experience, problems should be a very rare occurrence.