Christchurch Endodontic Practice is a specialist dental practice as registered with the Dental Council of New Zealand. We take referrals from general dentists who seek expert care with the problems they face.
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. The following is 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 an antiseptic paste for 1-2 weeks, and then permanently sealed. Usually the tooth is sealed with a covering 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.
Root Canal Retreatment
Root canal re-treatment 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.
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 sealing material is placed. This is done under a microscope and then a protective restoration is placed. Usually the dental pulp survives following this and remains healthy, allowing the tooth to continue to develop.
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 re-treatment 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.
Generally, the three dental structures that can be damaged in dental trauma are: The hard structure of the tooth (dentine, enamel, root) which may suffer a crack through it or it is broken off completely. Broken teeth are usually restored by a general dentist 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).
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. This restoration, generally placed immediately, your dentist will need to carefully check this restoration over time.
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.
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 are 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.