Dentistry and Root Canal

The bacteria dentists use to determine whether treatment of a root canal infection has been successful, namely the absence of discomfort and pain; x-ray evidence that abscessed areas, granulomas and cysts have completely filled in with new bone; and trust that the medicaments used in producing these results completely eradicated bacteria, all proved inadequate when such teeth were subjected to further testing by Dr. Price and his group.
Testing for the preseence of bacteria in root canal, after the use of disinfectants which appeared to have controlled the infections, proved that the organisms had not been eradicated.

Dr. Price, in making cultures after the use of over 100 different medicaments, including different strengths of each, found only eight which had negative responses after 24 hours, and only two after 48 hours of incubation; longer periods were found to be ineffective as medicaments lost their disinfecting power.

The two most efficient medicaments proved to be objectionable - silver nitrate because it turned teeth black and formalin because it was very irritating and painful to patients and destructive to surrounding tissues.

Though culturing to determine whether bacteria had been killed was formerly taught and practiced, I know of no dentists using such a testing procedure today.

Dr. Price in another series of tests took extracted infected teeth and treated them (much easier to do aseptically outside of the mouth) and found when these teeth were sectioned their dentin and cementum were still infected.

In still another investigation, Dr. Price made biopsy sections at and below the gum line and found bacteria present not only in the root of the teeth and their protective cementum but also in the first millimeter or two of adjacent bone. The importance of this factor in causing cavitations in bone after extractions will be discussed in a later chapter.

Dr. Price noted future developments might bring forth medicaments which are more successful. You will all be thinking that antibiotics are certainly the answer. However, antibiotics have not proven able to effectively penetrate the dentin tubules, cementum and adjacent bone sufficiently to eradicate these bacteria.

Testing of new medicaments, and current efforts such as new laser treatment methods, are of course necessary and were anticipated by Dr. Price.

All of these root canal side-effect problems should not deter the profession from continuing to explore new methods of how to save teeth. While we cannot learn how to save teeth by extracting them, Dr. Price fortunately has shown us ways to test procedures to prove whether infection has been eradicated in teeth we think we have saved.

Root Canal Dentistry

Root Canal

It’s a term that you probably
first heard at a young age: the widely feared “root canal.” You may not have
experienced it personally, but rumors of its existence may have reached your
impressionable ears before your first visit from the tooth fairy.
This misunderstood but advantageous procedure has been unnecessarily
scaring children (and adults) for years. The Pennsylvania Dental Association
(PDA) would like to help unveil the mystery that keeps the root canal cloaked
in fear.
Root canal therapy refers to the treatment of the inner tooth,
specifically the pulp tissue surrounding the root of the tooth. This internal
tissue consisting of blood vessels and nerves is what becomes inflamed and
infected when a root canal is necessary. The most common causes of
inflammation or infection are deep cavities, repeated dental procedures,
cracks or chips.
During root canal treatment, an endodontist removes the inflamed or
infected pulp, carefully cleans and shapes the inside of the canal (a channel
inside the root of the tooth), then fills and seals the space. After the
procedure, the patient returns to his or her general dentist for crown
placement or other restorative work.
Many people might think that this pulp tissue is a necessary part of the
tooth, but in fact it’s not. It does play an integral part in the growth and
development of the tooth, but after maturity its function is only sensory.
Unfortunately, it is this sensory function that puts most people in knots.
“Painful root canal treatment is a thing of the past, thanks to the
expertise of today’s endodontists - and to the technologies they use,” said
Dr. Bruce Terry, a PDA member endodontist from Wayne, Pa. “Using the latest
dental technologies, endodontists have transformed the standard root canal
into modern microsurgery, increasing precision and effectiveness.”
Digital imaging has replaced the traditional X-ray, allowing for a far
more comprehensive image of the tooth. It is 30 times the size of a normal X-
ray without as much radiation. With the application of the operating
microscope, endodontists are now able to magnify the surgical area up to 32
times compared to the 3.5 magnification of surgical binoculars used
previously.
Today’s ultrasonic, handheld instruments are one-quarter the size of
traditional dental equipment, enabling smaller, better-contoured incisions and
quicker, more aesthetic healing.
Tiny surgical mirrors allow endodontists to see each root channel with
more clarity and microsurgical irrigators provide precise directional control
of air and water, allowing teeth to be completely rinsed, dried and inspected
before applying filling material.
In addition to the technological advances, endodontists’ skill in
performing root canals and their advanced training in administering anesthesia
result in a more positive experience, making root canal treatment more
effective and predictable, said Dr. Terry.
If you need root canal treatment, ask your PDA member dentist for a
referral to an endodontist in your area. For more information on root canals
and other oral health topics

Root Canal