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Partial Root canal. What is it?

  
  

I’ve been seeing this question reoccurring in twitter so I’ve decided to make this the 1st in a long line of “Ask Dr. Pierson” blogs. The question was “why did my dentist give me a partial root canal”?

First I’m assuming a partial root canal is an incomplete root canal. With that assumption, there are several clinical reasons why you would receive a partial root canal, but the number one reason as to why a partial root canal: INFECTION!

Let’s begin with what is a root canal? A root canal removes the nerve(s), arteries, veins, and infection from a tooth. Most patients’ missinterpute a root canal as removing the root from a tooth, but the root actually remains, just without nerves in it. During the root canal process, the canals are reshaped, cleansed, and filled with a replacement material called gutta percha.  Gutta percha is the predominant material used to fill the empty space inside the root of a tooth after it has undergone endodontic therapy (root canal therapy).

Why can’t this procedure be completed in one visit? The number one reason is tooth infection. Usually an infected tooth is extremely difficult to numb, thus making the root canal more uncomfortable. Why is an infected tooth so difficult to numb? The human body during its healthy state has a pH of 7. Dental anesthetic is set to work at pH 7. When there is an infection present, depending on the level of infection, the pH shifts away from pH7. The further away from pH7, the more infected you are. Therefore, the more infected you are, the less the anesthesia will work. In these cases, a patient will need to take antibiotics. Antibiotics, will “kill the infection” and bring the pH back to normal (pH 7).This is why an infected tooth usually can’t be completed with one visit.

After removing the nerve, and canal reshaping, we dry the tooth with a white, canal shaped instrument. If this instrument goes into the canal and comes out of the canal with its color white, the tooth is now ready to receive the gutta percha filling material and complete the root canal. However, if the instrument does not come out white, the canal is still infected and therefore cannot be completed in one visit. At this point, a temporary filling material is placed in the tooth, and the patient is usually given a regiment of antibiotics.

Here is another common misconception regarding root canals. When your dentist completes the root canal, and says “Your root canal is now finished”, the actual restoration of the tooth is not complete. Once a root canal is completed it is imperative, that you receive permanent restoration on that tooth. A root canaled tooth is very fragile and highly susceptible to breakage or fracture. The permanent restoration (usually a crown or an onlay) is needed to preserve and protect the tooth. Depending on your dentist, the permanent restoration may be done while you wait, or may require two visits. If your dentist uses Cerac, these restorations can be made in a little more than an hour while the patient waits. No more temporary crowns, and no more unpleasant tasting impressions. To find out more about what CERAC restorations click here.

Comments

A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth. 
Root canal 
Posted @ Wednesday, March 07, 2012 12:51 AM by root canal
I had had periodontal lazer surgery done about 1 1/2 years ago. The dentist (#1) apparently missed a spot and told me it was my tooth and it needed a root canal, he does not to them,and to go get one done. 
 
 
 
I went to supposedly one of the top notch referals in town who was a root canal specialist; dentist #2. He tested my tooth and said it did not need one, that the other dentist (#1) obviously missed a spot. So I went back and made him retreat. He had put a temp filling in one of the teeth, (tooth #18), were he retreated.  
 
 
 
About a year later, I was not really having any pain, but the temp filling began to come out so I went to another dentist (#3), had the temp filling all removed and a new permanent filling put in; tooth #18.  
 
 
 
As soon as the deading wore off, any liquid I put in my mouth sent shock waves all over that side of my lower teeth!  
 
 
 
I went back to the dentist (#3), who said I needed a root canal, tested my teeth and said they still show normal feeling and didn't understand why, but the pain was unbearable. He determined there was a slight breach in an old filling, (tooth #19), and the cold test showed those nerves were reacting normally. He did not know what to do, so I told him to just remove that filling in #19 and put in a new filling. So he did. 
 
 
 
Next day, paind was still there. I went back to him (#3) and explained. He still did not know what to tell me, but the tooth's enamel had apparently worn down (probably from night grinding he said) and exposed a yellow layer of nerves. He said the tooth was too worn down for a filling (even though it already had one for years and there was NO pain) before replacing the filling in tooth #18.  
 
 
 
So I told him to put on a crown. He shaved the tooth prepping for the new crown and put on a temp one. Next day, my tooth and mouth had even more pain. I am not a pain killer taking type person, but I would up having to take 1,000 mg of Hrydocordone every 4 hours as it was so intense. 
 
 
 
Went back and explained. He did not see anything wrong.  
 
 
 
What do I do? Crown is due in next week, but I am afraid to have it installed and the pain not going away. Again, the pain is intense!  
 
 
 
So I have two dentists telling me I need a root canal on a tooth (#19) that has all normal feeling, and one dentist (a specialist) who says I don't need a root canal as the feeling has normal reaction to cold testing, BUT I should come to an associate in his office to have it pulled anyway and spend between $4,000 and $8,000 for an implant just in case.... 
 
 
 
What am I missing here? What should I do? I did not see an actual explaination of what exactly a "partial root canal" is. I was thinking it would be just some of the tooth being canaled, but is sounded a partial root canal is just a tooth done in stages.  
 
 
 
Can just part of a tooth receive a canal? If a tooth has a complete root canal, I assume it is dead. Will it then decay and result in infection? Or will it continue to last?  
 
 
 
Should I have a root canal on a tooth with LOTS of pain, but showing normal feelings before I have my permanent crown intalled?  
 
 
 
If I take a regiment of antibiotics NOW (before the crown arrives), could the root canal be performed in that same day's treatment? 
 
 
 
Need help! 
 
 
 
 
 
What are my
Posted @ Thursday, March 15, 2012 8:34 PM by Tom
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