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Dr Mike Gordon MDS (Endo) MRACDS (Endo)

Hamilton

 
What is an Endodontist?

An Endodontist is a dentist who has undergone a minimum of 2 years of extra postgraduate training. In NZ, admission to the Endodontic Specialist List and the status of Specialist in Endodontics is given by the Dental Council of New Zealand after a rigorous assessment procedure. This Specialist training allows an Endodontist to:

1. deal with diseases of the dental pulp and supporting structures
2. diagnose facial pain and related problems

Your general dentist sometimes refers patients for consultation when the diagnosis is complicated or when treatment is more difficult than normal. Aside from providing treatment, Dr. Gordon's role is also that of an educator. It is important that patients understand why they require treatment, what treatment involves and what they can do to ensure the best possible outcome. Dr. Gordon believes that a properly informed patient has the best chance of achieving the optimal result.

 

 

What is Endodontics?

Endodontics is a specialty of Dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are Dentists with special post-graduate training in this field. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

Although General Dentists can perform Endodontic treatment, patients are often referred to an Endodontist when the case is complicated or more difficult than usual.

In order to understand Endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called Enamel. Enamel is supported by an inner layer called Dentin, which has at its center a soft tissue known as the Pulp.

The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding Dentin and Enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.

 

 

 

Why would I need Endodontic treatment?

Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Signs and Symptoms

Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gums. Sometimes there are no symptoms.

How can Endodontic Treatment help me?

The Endodontist removes the inflammed or infected pulp, carefully cleans and shapes the canal system and then seals the prepared space. Most treatment is now performed in two appointments ranging from 30-90 minutes (depending on the number of canals). Once treatment is completed, you may be instructed to return to your dentist for a permanent crown. The restoration of the tooth is an important part of treatment because it seals the cleaned canals from the oral environment, protects the tooth and restores it to function.
 
 

 

Endodontic Re-treatment

Do you have a failing root canal?

First, Dr Gordon will discuss your treatment options. If you and Dr Gordon choose retreatment, he will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post and core material—must be disassembled and removed to permit access to the root canals.
After removing the canal filling, Dr Gordon can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.
After cleaning the canals, Dr Gordon will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision to allow the other end of the root to be sealed.
After Dr Gordon completes retreatment, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to its full function.


Is retreatment the best choice for me?
Whenever possible, it is best to save your natural tooth. Retreated teeth can function well for years, even for a lifetime.
Advances in technology are constantly changing the way root canal treatment is performed, so Dr Gordon may use new techniques that were not available when you had your first procedure. As with any dental or medical procedure, there are no guarantees. Dr Gordon will discuss your options and the chances of success before beginning retreatment.


How much will the procedure cost?
The cost varies depending on how complicated the procedure will be. The procedure will probably be more complex than your first root canal treatment, because your restoration and filling material may need to be removed to accomplish the new procedure. In addition, Dr Gordon may need to spend extra time searching for unusual canal anatomy. Therefore, you can generally expect retreatment to cost more than the initial endodontic treatment.
While dental insurance may cover part or all of the cost for retreatment, some policies limit coverage to a single procedure on a tooth in a given period of time. Check with your insurance company prior to retreatment to be sure of your coverage.


What are the alternatives to retreatment?
If nonsurgical retreatment is not an option, then endodontic surgery should be considered. This surgery involves making an incision to allow access to the tip of the root. Endodontic surgery may also be recommended in conjunction with retreatment or as an alternative. Dr Gordon will discuss your options and recommend appropriate treatment.


What are the alternatives to endodontic retreatment and/or endodontic surgery?
The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth.
No matter how effective tooth replacements are—nothing is as good as your own natural tooth. You’ve already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth for many years to come.

 

 

Will I feel pain during or after the procedure?

Toothache pain is the main reason for patients seeking treatment. Fortunately, modern anesthetics can make the procedure pain free in most cases. Seeking treatment early makes the procedure more comfortable, so don't wait. When caught early, treatment should feel no different than having a regular filling. For the first few days after treatment, there may be some sensitivity to biting pressure, especially if there was pain or infection before the procedure. Sometimes over-the-counter anti-inflammatory medications (like Neurofen) are recommended for a day or two. Dr. Gordon can prescribe other medications but they are rarely required.