South West Implant Centre

Root fillings.

Ilustration of teeth and root fillings. What are they?

Teeth are held in the jaw by their roots. Front teeth normally have one root, but teeth further back in your mouth will have two, three or four.

Inside, there are nerves and a blood supply in the 'root canal'. When the tooth is healthy the nerves are alive but decay or injury can cause the nerves to die. A dead nerve inside a tooth can cause an abscess at the end of a root.

'Root filling' means removing damaged or dead nerves and filling the space left. The remaining tooth can then be repaired.

What does the dentist do?

    • An x-ray will show the shape of the root canals and whether there are any signs of infection in the surrounding bone. Some tooth roots are easier to fill than others because of their shape. Sometimes the x-ray will suggest that a root filling is unlikely to be successful. Your dentist will discuss this with you;
    • The area near the tooth is numbed first so that the root filing is painless;
    • To keep root canals dry during treatment the dentist may stretch a sheet of thin rubber around the tooth, on a metal or plastic frame outside the mouth. This shouldn't be uncomfortable;
    • A hole is made in the tooth and enlarged until the dentist can see the opening to the root canal;
    • Narrow files are used to find all the root canals and remove the dead nerves;
    • Further x-rays may be taken to measure the length of the root canals or the dentist may do this using an electronic device;
    • Roots are filled with rubbery materials and with pastes which set hard.

A root filling often needs more than one visit.

The tooth could still be tender for a day or two afterwards and you might need to take a mild pain killer.

What are the benefits?

    • Nerve damage can cause severe toothache but the pain will usually end very quickly when the root canal is cleaned out;
    • Without a root filling a tooth with a dead nerve would probably have to be extracted;
    • Root fillings are usually successful and can last for many years;
    • Sometimes infection returns (the tooth will ache and become painful to bite on), but re-treatment can be successful.

Apicectomy

Illustration of an abscess at the root of a tooth and an apicectomy and repair. What is it?

Sometimes there can be a painful infection (an abscess) at the end of the tooth root, in the surrounding bone. An 'apicectomy' gives the dentist surgical access to the infected area so that the infection can be cleaned up and the tooth saved.

An apicectomy will usually be carried out on a tooth which has already been root-filled.

What does the dentist do?

    • A local anaesthetic numbs the mouth around the infected tooth so that the procedure is painless;
    • A small incision is made in the gum, well away from the tooth so that any scar tissue afterwards will be invisible, or around the neck of the infected tooth on the other side;
    • A small flap of gum is then moved to one side to uncover the infected area;
    • The dentist cleans out the infection;
    • A small filling may be put at the end of the root canal to stop further infection;
    • The gum can then be stitched back into place.

You may feel some pressure and hear instruments being used, but you should not feel any pain during an apicectomy.

After treatment you will need to keep the area clean:

    • For the first day, rinse with warm salt water several times a day, especially after meals. Use half a teaspoon of salt in a tumbler of water;
    • Brush the teeth normally but be very careful not to disturb the incision;
    • On the next day, continue rinsing and begin gently to brush the teeth beside the incision.

There may be some bruising and swelling ofr two to three days afterwards. There will also be some discomfort but it shouldn't be severe, an ice-pack or a packet of frozen peas can help. It usually takes about a week for an apicectomy to heal.

What are the benefits?

    • An apicectomy stops pain;
    • This is a way of saving a tooth which would otherwise have to be extracted.
A Centre of Excellence in Dentistry

Address

South West
Implant Centre,

37 Badminton Road,
Downend,
Bristol BS16 6BP

Telephone

07731 579 726

Email

nigel.reynolds
@oasis-healthcare
.com

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