03 3553247

Welcome to Christchurch Endodontic Practice.

We are a specialist dental practice registered with the dental council of New Zealand www.dcnz.org.nz.

Below is a list of the common problems we see and a explanation of the treatments available.  We offer the very best of care to help people keep their teeth or if needed to replace those teeth that need to be extracted. We are also involved in managing some of the complications of dental trauma, especially for younger people.

If you would like to see us, we require a referral from your dentist or health professional.

Christchurch Endodontic Practice is in a modern purpose-built premises including parking, in Normans Road, Strowan.  (Go to the bottom of this page for a map which shows where we are).

 

Your problem

Unfortunately, there are many problems that can affect teeth. Below is a list of the problems that we are asked to see and below this is a list of the services we provide for these.

Problems (click into each for a full description)

Tooth ache

Either decay in a tooth or leakage from around a restoration causes the dental pulp (nerve) to become inflamed. Such a tooth can be painful, especially to temperature changes, pressure from biting, touching the tooth, or sometimes the pain is spontaneous. If the episodes of pain have been present for days, is severe or continuous, then most probably the tooth is suffering from an irreversible pulpitis. Root canal treatment for these teeth. (Go to Root Canal Treatment)

Dental infection

When the dental pulp (nerve) inside the tooth dies then the space inside the roots (root canals) will inevitably become contaminated by bacteria. The bacteria in root canals will leak out the end of the root causing an abscess. This may occur rapidly within days, or it may be slow taking a year or longer for an abscess to appear. The symptoms from a tooth like this may vary from severe pain, swelling of the face, systemic illness including a fever, difficulty in swallowing, to no symptoms at all other than a draining point beside the tooth. Dental infections are a major cause or hospitalisation and need to be thoroughly investigated and treated. Sometimes a tooth has already received a root filling but the inside of tooth has not been cleaned adequately or the root filling and/or the restoration is leaking. These teeth can also develop a dental infection. (Go to either Root Canal Treatment or Root Canal Retreatment).

Dental trauma

Teeth getting a knock (trauma) may cause a piece of tooth breaking away, to a tooth being knocked out completely out of its socket position, around teeth, in more severe cases a broken jaw. Usually the hospital will take care of more severe injuries but a general dentist will see the common problems. Complications that may require further care are an exposed pulp ( exposure of the nerve in the tooth), to pulp necrosis (the nerve inside the root dying) which may cause a dental infection. An avulsed tooth, a poorly positioned tooth, or complications of the attachment of the root to the bone (periodontal complications), or an abnormal attachment of the root to the bone (ankylosis) can all be complications of dental trauma. The treatment available to these problems range from respositioning the tooth in the correct position, to root canal treatment, to replacement of a missing tooth (Go to Root Canal Treatment or Pulpotomy, or Dental Implant).

Cracked cusp

When a restoration (filling) is placed into a tooth then one corner or more may move independently when biting on the tooth. Not very commonly, this also occurs in a tooth with no restorations. The common complaint is a sharp pain when biting on hard food. This pain usually lasts only when biting down or releasing the bite. Sometimes a cracked tooth may cause irreversible pulpitis (an inflamed nerve) or even pulp necrosis (a dead nerve inside the roots). These cases with require either root canal treatment or extraction. ( Go to Root Canal Treatment or Dental Implant).

Chronic pain

Like other areas of the body, long lasting pain can affect the mouth with the muscles of the jaw may also be contributing to this pain. Often the pain is not related to any particular damaged or diseased tissue. It is important to eliminate inflammation or infections around teeth as a source of this pain. It is also important to avoid doing unnecessary treatment on teeth in the hope that this will resolve chronic pain as it may make it worse. There are other dental specialists who may manage this type of pain, but it is important to eliminate other possible causes of this pain. (See picture of healthy tooth).

Our Services

Generally, a consultation appointment is required before treatment is started so that a discussion on possible treatment options, the likely success of any treatment, possible problems that may occur along the process, and the cost of treatment. Click on the following headings below to view  the list of treatments offered.

Root canal treatment

Root canal treatment removes the inflamed pulp (nerve) or infection from with the root canals to remove the cause or source of the problem. The root canals are widened, cleaned with an antiseptic solution, usually dressed with a different antiseptic solution for 1-2 weeks, and then permanently sealed. Usually the tooth is sealed with a permanent restoration to give the tooth some protection. The root canals are sometimes very fine or occasionally calcified or blocked completely. It can be difficult to find and negotiate these fine canals and an operating microscope is of great help. Any associated abscess usually does not need to be removed but heals by itself once the root canals have been properly cleaned.
Root Can treat1 Root Can treat2

Periapical surgery

In some cases, surgery to remove a persistent lesion (abscess) around the end of the root is necessary. This is generally only done if root canal treatment has been completed to a high standard or if retreatment of the root canal is not possible due to a post or obstruction in the tooth.
The procedure involves making the area numb with local anaesthetic, lifting back the gum to access the end of the root. The lesion, generally an abscess or a cyst, is then removed and the end of the root sealed with an extra filling.
Per Sur 1 Per Sur 2 Per Sur 3

Dental trauma

Generally, the three dental structures that can be damaged in dental trauma are:
1. the hard structure of the tooth (dentine, enamel, root) which may suffer a crack through it or is broken off completely. Broken teeth are usually restored by a general dentist
2. the dental pulp (nerve) may get damaged and sometimes dies completely. A pulpotomy is required in some cases and root canal treatment in others. Other times the space of the dental pulp closes over (calcified). If root canal treatment is required for these teeth then a microscope is generally required
3. the structures, mostly the periodontal ligament but also the bone and gum tissue around a tooth, may all get damaged if a tooth is pushed out of its normal position. Careful repositioning of these teeth is required to give these tissues a good chance of healing well
These are sudden and often traumatic events which need to be dealt with quickly and carefully to give the teeth the best chance of remaining. We will do our best for those that those that we see
Den Tra 1 Den Tra 2 Den Tra 3

Pulpotomy

If a tooth is broken and the dental pulp exposed (the nerve visible through the broken part) then the nerves is at risk of becoming more infected and eventually die. Partial removal of the pulp and protection of this surface can be done.
The surface of the nerve is carefully prepared and then a non-toxic material is placed (MTA material). This is over done until a microscope and then a protective restoration placed. Usually the dental pulp survives following this and remains healthy, allowing the tooth to continue to develop.
Pulp 1 Pulp 2 Pulp 3

Root canal retreatment

Root canal retreatment involves removing the existing root filling, finding all of the root canals, and then continues the root canal treatment. Special attention needs to be given to the cause of the failure of the original treatment and resolve this. It may be extra canals in the tooth containing either inflamed nerve tissue or infection, flexing cusps causing leakage, decay around the restoration, or a leaking root filling.
There is more time needed to treat these teeth so the cost is usually greater. As well, the tooth is weaker than other teeth so your specialist will discuss this with you before treatment is started.
Root Can1 Root Can2 Root Can3

Sedation

Sedation is offered for those who are very anxious about dental treatment. Midazolam is usually the agent used which is administered orally or intravenously (injection in the arm).
Sedation is safe for most people but there is a strict protocol used for the administration of the agent.
It is a very useful addition during treatment, but there is a residual effect after the appointment. People cannot continue with their normal activities on the day of receiving sedation. This option and costs can be discussed at the consultation appointment.

Restoration

A restoration may be made in amalgam, composite, ceramic (porcelain), gold, or may be a temporary material. Each has their benefits and potential problems.
A tooth that is vital (nerve still alive) may experience some sensitivity especially to cold following a restoration. This is normal but should settle within 1-2 weeks. A tooth with early stages of inflammation may also settle with a restoration alone.
If root canal treatment is necessary, then a protective restoration is placed following this. While this restoration is generally placed immediately, the referring dentist will need to carefully check this restoration over time. The general dentist over time will then decide if a crown or further protection of the tooth is required.
Rest 1Rest 2

Dental Implant

Sometimes a tooth needs to be extracted to resolve an infection, or due to complications from dental trauma, or because the tooth is too weak to keep.
A dental implant can be used to replace a tooth. This involves placing a titanium implant into the bone where the root was. This then acts as a foundation for a porcelain crown.
Dental implants are not suitable in all cases or for all patients but it is a valuable option to replace a missing tooth. Dental implant treatment is a significant development in dentistry in the last 40 years. Some of the original cases from over 40 years ago are still healthy and functioning well.
The success of dental implant treatment is generally very good. The key part to this treatment is to get a sound “attachment” between the bone and the implant – osseointegration. Osseointegration occurs in above 95% of cases so long as there are no underlying health problems or current smoking.
Long term, dental implants offer a good success rate but over time another 5-10% may develop some inflammation and bone loss around the implant. The risk factors for this have not been completely identified but smoking, poor cleaning around the implant, and a history of periodontal (gum) disease have been linked. Careful maintenance and regular visits with your dentist are required of these cases.
Dent Imp 1 Dent imp 2 Dent imp 3 Dent imp 4

Stephen Manning

Stephen Manning

Steve Manning graduated from University of Otago in 1984 and completed specialist training at the University of Melbourne in 1988. After working in specialist practices in Perth and London he returned to New Zealand in 1990 to start the Christchurch Endodontic Practice.

Steve has been president of the Canterbury Branch of the NZDA, president of the NZ Society of Endodontics, has been involved in organising or participating in many conferences and courses throughout New Zealand, as well as speaking in meetings in Australia, Canada and England. He maintains a strong interest in managing dental trauma or the complications from this. As part of the endodontic practice he offers dental implant treatment for those patients who have lost or need to loose a tooth.

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Stephen Manning

Karen Lam Li Ann

Karen Lam Li Ann

Karen Lam Li Ann graduated from Malaysia in 1997 and then completed her specialist training in Singapore in 2002. After working in the Alexandra Hospital in Singapore she moved to New Zealand in 2004 and joined the Christchurch Endodontic Practice soon after.

Karen has been active with local dentists in small group seminars and group discussions on endodontic treatment. Karen is fluent in a number of asian languages and her understanding of the cultures of these groups is a valuable asset in the practice.

Karen offers similar services as Steve and they discuss cases regularly and if appropriate will occasionally refer cases to each other for the best outcome.

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Karen Lam Li Ann

Staff

Staff

The excellent staff of the Christchurch Endododontic Practice consist of Lynn, Michelle and Vicky.

Vicky will usually be the first point of contact, answering any queries – by phone, txt, or email, making appointments, and following up on our patients. Michelle and Lynn are qualified Dental Chairside Assistants and are responsible for assisting the Endodontists, maintaining the clinical areas, and cleaning and sterilising the instruments we use.

It is truly a team approach to provide the care for our patients and we are very fortunate with the high calibre of our staff.

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Staff

Where to find us

11 Normans Road
Strowan
Christchurch
New Zealand 805