Additional Information

About your Tooth

Your tooth consists of two main parts: the crown, which is that part of the tooth above the gum and visible in your mouth; and the root or roots, which is that part of the tooth that lies beneath the gum and is surrounded by bone. Inside each root is a channel that runs the length of the tooth. This channel is the root canal and contains the pulp (nerves, blood vessels, and soft tissue), which is often referred to as the “nerve” of the tooth. The pulp may be irreversibly damaged by bacteria associated with decay, very deep restorations, fractures, trauma, or periodontal disease.

In order to preserve a tooth in which this has occurred, it is necessary to remove the diseased pulp tissue. This procedure is known as endodontic therapy. Since endodontic therapy is concerned with removing only the pulp from the root canal, the root will continue to function normally because the supporting tissues remain intact. It is advisable to remove the injured pulp because it may become infected or act as an irritant to the tissues surrounding the tooth.

Tooth Pain Guide

The information provided here is only meant as a guide, you will need to consult with your dentist for a definitive diagnosis.

Symptom: Momentary sensitivity to hot or cold foods
Possible Problem

If the discomfort lasts only moments, sensitivity to hot and cold foods generally does not signal a problem. The sensitivity may be caused by a loose filling or by minimal gum recession which exposes small areas of the root surface.

What To Do

Try using toothpastes made for sensitive teeth. Brush up and down with a soft brush; brushing sideways wears away exposed root surfaces. If this is unsuccessful, see your dentist.

Symptom: Sensitivity to hot or cold foods after dental treatment
Possible Problem

Dental work may inflame the pulp, inside the tooth, causing temporary sensitivity.

What To Do

Wait four to six weeks. If the pain persists or worsens, see your dentist.

Symptom: Sharp pain when biting down on food
Possible Problem

There are several possible causes of this type of pain: decay, a loose filling, or a crack in the tooth. There may be damage to the pulp tissue inside the tooth.

What To Do

See a dentist for evaluation. If the problem is a cracked tooth, your dentist may send you to an endodontist. Cracked tooth pain comes from damage to the inner soft tissue of the tooth, the pulp. Endodontists are dentists who specialize in pulp-related procedures. Endodontic treatment, also known as root canal treatment, can relieve that pain.

Symptom: Lingering pain after eating hot or cold foods
Possible Problem

This probably means the pulp has been damaged by deep decay or physical trauma.

What To Do

See your endodontist to save the tooth with root canal treatment.

Symptom: Constant and severe pain and pressure, swelling of gum, and sensitivity to touch
Possible Problem

A tooth may have become abscessed, causing the surrounding bone to become infected.

What To Do

See you endodontist for evaluation and treatment to relieve the pain and save the tooth. Take over-the-counter analgesics until you see the endodontist.

Symptom: Dull ache and pressure in upper teeth and jaw
Possible Problem

The pain of a sinus headache is often felt in the face and teeth. Grinding of teeth, a condition known as bruxism, can also cause this type of ache.

What To Do

For sinus headache, try over-the-counter analgesics or sinus medicine. For bruxism, consult your dentist. If pain is severe and chronic, see your physician or endodontist for evaluation.

Symptom: Chronic pain in head, neck, or ear
Possible Problem

Sometimes pulp-damaged teeth cause pain in other parts of the head and neck, but other dental or medical problems may be responsible.

What To Do

See your endodontist for evaluation. If the problem is not related to the tooth, your endodontist will refer you to an appropriate dental specialist or a physician.

About Dental Implants

Over the last ten years, the use of dental implants has become a popular option to replace missing teeth. The advancements in implant technology have assured patients that implants are, in most cases, sound treatment modalities for tooth replacement. Recently, university studies have shown a dental implant can last as long as a properly restored endodontically treated tooth.

Implants, like any dental therapy, have a lifespan, need routine maintenance, and require continual care to function optimally. Root canal therapy has also progressed in leaps and bounds over the last ten years. The use of advanced technology, such as surgical operating microscopes and automated instruments, have made patient comfort and the success rate higher than ever.

There are some instances that you might be faced with the choice of retaining your natural tooth involving endodontic retreatment or periapical surgery (see information under “Procedures” section) or extraction. Your dentist might recommend extraction and an implant. Please don’t hesitate to contact your endodontist to see if your natural tooth can be retained before opting to get an implant prosthetic. It is always better to try to retain your natural teeth rather than getting prosthetic replacements. We will work closely with your dentist to assess your particular situation and evaluate the practicality of retaining your own dentition.

Cracked Teeth

Cracked teeth demonstrate many types of symptoms, including pain when chewing, temperature sensitivities, or even upon the release of biting pressure. It is also common for pain to come and go, making it difficult to diagnose the cause of discomfort. Please call us at our Eagan or St. Paul, MN offices with any questions about cracked teeth.

Chewing can cause movement of the cracked pieces of your tooth, and the pulp within the tooth becomes irritated. At the same time, when biting pressure is released, the crack can close quickly, resulting in sharp pain. Eventually, the pulp will become damaged and tooth will consistently hurt, even when you are not chewing. It is possible that cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.

Types of Cracks
Craze Lines

These are tiny cracks that only affect the outer enamel of the tooth. These cracks are more common in adults. These types of cracks are superficial and are usually of no concern.

Fractured Cusp

When a cusp becomes weakened, a fracture may result. The cusp may break off or be removed by a dentist. A fractured cusp rarely damages the pulp, so root canal is not necessary. Your dentist will usually restore the tooth with a full crown.

Cracked Tooth

This type of crack extends from the chewing surface of the tooth and vertically migrates towards the root. In some cases, the crack may extend below the gum line. It is possible for the crack to extend further into the root. Damage to the pulp is commonplace. In this case, root canal treatment is usually necessary. A cracked tooth that is not treated will worsen, resulting in the loss of the tooth. Therefore, early detection is essential.

Split Tooth

A split tooth is usually the result of an untreated cracked tooth. It can be identified by a crack with distinct segments. This type of tooth can never be saved intact. Yet, the position and extent of the problem will dictate whether any portion of the tooth can be saved. Sometimes, endodontic retreatment by the doctors and restoration by your dentist can be used to save a portion of the tooth.

Vertical Root Fracture

A vertical root fracture begins at the root and extends towards the chewing surface of the tooth. Unfortunately, they show minimal symptoms and may go unnoticed. Treatment involves endodontic surgery if a portion of the tooth can be saved by removal of the fractured root. Otherwise the tooth will have to be extracted.

Traumatic Injuries


Dislodged Teeth

Injuries to the mouth can cause teeth to be pushed back into their sockets. Your endodontist or general dentist may reposition and stabilize your tooth. Root canal treatment is usually started within a few weeks of the injury and a medication, such as calcium hydroxide, will be placed inside the tooth. Eventually, a permanent root canal filling will be implanted.

Sometimes a tooth may be pushed partially out of the socket. Again, your endodontist or general dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. Yet, if the pulp becomes damaged or infected, root canal treatment will be required.

Avulsed Teeth

If an injury causes a tooth to be completely knocked out of your mouth, it is important that you are treated immediately! If this happens to you, keep the tooth moist. If possible, put it back into the socket. A tooth can be saved if it remains moist. You can even put the tooth in milk or a glass of water (add a pinch of salt.) Your endodontist may start root canal treatment based upon the stage of root development. The length of time the tooth was out of your mouth and the way the tooth was stored, may influence the type of treatment you receive.

Endodontic Treatment for Children

An injured or diseased immature tooth may need one of the following procedures to improve the chances of saving the tooth:

Apexogenesis

This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth.

Apexification

In this case, the unhealthy pulp is removed. The doctors place medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. So it is important to have the tooth properly restored by your dentist.

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