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Marathon
Man by
Dr. Pietrini
A few years ago in a popular movie, "The
Marathon Man," actor Duston Hoffman played
the role of a character that was tortured in a
dental chair. To often, dental treatment is portrayed
unfavorably in movies or as part of comedic routines.
Just to mention the words "root canal,"
sometimes will strike fear in the heart of many
people. When I started my practice in 1972, most
patients were unwilling to undergo root canal
treatment unless it was to prevent the loss of
one of the front teeth.
Teeth are composed of three distinct layers. The
outer shell that is visible is called enamel.
This is the hardest structure in the body. Underneath
the enamel is the dentin and in the center if
the tooth pulp, which is a network of one to four,
canals that is composed of tiny nerves and blood
vessels. There are several reasons why it is necessary
to perform root canal treatment:
· A live pulp is exposed by decay or injury
· A tooth with a large filling or crown
becomes very sensitive to hot and cold
· The pulp becomes infected (a dental abscess)
· A tooth fractures near the gum line with
a healthy root remaining
General
dentists perform more than half of the millions
root canal treatments completed each year with
specialists who are called endodontists completing
the remainder of the treatments. When conventional
root canal treatment is necessary, a small opening
is made in the top or back of the tooth to gain
access top the root canals. Various sized instruments
are used to shape, enlarge and cleanse the inside
of each canal to the end of the root. Recent development
of mechanical devices has made treatment faster
and more predictable. Eventually the canals are
filled, most often with a plastic-like material
called gutta percha. About one hundred years ago
golf balls called "gutties" were made
of this material.
When
a root canal has been successfully completed,
a filling and/or a crown must be placed. If the
tooth has been weakened or fractured it might
be necessary to anchor a post into the root before
a crown is made. A tooth with healthy bone and
gum support can survive a lifetime. While serving
in the army in 1943, my father had an injury to
one of his front teeth. Fortunately for him a
military dentist performed root canal treatment
and placed a crown and today he still has a healthy,
functioning tooth.
Occasionally
an abscess or cyst will develop at the end of
the root, often years after treatment has been
completed. An endodontist or an oral surgeon can
perform a surgical procedure called an apicoectomy.
Many offices use a surgical microscope to perform
this delicate surgery, which can be done quickly
and efficiently under magnification.
With
proper pain management, the "dreaded root
canal" can be completed as easily as most
other dental treatment preventing the unnecessary
lose of millions of teeth.
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