Dear Doctor. I have a dental abscess. Which treatment is better: a root canal or tooth extraction?

6.11.2016 19:01:00 - Kadir DURSUNOĞLU

A dental abscess is a painful infection at the root or in gum of the tooth. It occurs when the pulp, the soft inner part of the tooth that contains nerves, blood vessels and tissue, becomes inflamed or infected and left untreated. Some of the common causes of dental abscess include untreated tooth decay, gum disease, traumatic injury, and deep cavities. A tooth abscess will always require professional dental treatment. Following are some of the common treatment options for dental abscess Antibiotics: It helps to kill the germs which are responsible for dental abscess. Most of the symptoms will be alleviated within two days after taking antibiotics. However it doesn’t treat the tooth. After the alleviate of symptoms, you should treat th tooth. Over the Counter Medication: Painkillers can help to heal the area and alleviate the discomfort caused due to tooth abscess. Root Canal Treatment: This treatment will help to eliminate the infection and save your infected tooth. The root canal procedure involves removal of the infected pulp and draining of the abscess. It is mostly recommended by dentists to go for root canal treatment if enough tooth structure is left.

26.11.2016 12:15:00 - Uzm. Dt. Hakan AYDIN

Mr AYDIN, I have got some trouble in my teeth. How do I determine root canal damage to my tooth?

16.01.2017 10:05:00 - Mert KARAL

Following are some of the signs, that you may need to see, which might need a root canal treatment: • Severe toothache pain upon chewing or application of pressure • Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed) • Discoloration (a darkening) of the tooth • Swelling and tenderness in the nearby gums • A persistent or recurring pimple on the gums

17.01.2017 12:03:00 - Uzm. Dt. Hakan AYDIN

I had performed a root canal treatment and doctor suggested a crown restoration to my tooth. Why are dental crowns recommended after a root canal?

4.03.2017 15:11:00 - Semra YALÇIN

Not all endodontically treated teeth need need dental crowns, but most do. Since; 1. Tooth structure (enamel & dentin) is lost due to caries or during the endodontic treatment. The remaining tooth structure is compromised and may not be able to withstand masticatory function and tends to fracture. 2. There is always a potential for bacterial to re-contaminate and leak into the restoration placed over the root canal filling material. And ultimately cause an endodontic failure. This has been shown in in-vitro studies, but one does not see much of this in practice. 3. After endodontic treatment teeth loose their pulp (loose nurturing odontoblast), hence dentin deceases in its water content and becomes brittle. This has not been proven. But this is an older concept. Personally, I have found endodontically treated teeth to be brittle during extractions. I would be more likely to crown a posterior root canal treated tooth, than an anterior one. Owing to higher forces in the posterior region and difficulty in mimicking the esthetics of a natural tooth in a crown in the anterior. Unfortunately, evidence based dentistry still has some way to go before we can practice strictly from an evidence based perspective. If you ask many clinicians, anecdotally they will tell you that posterior teeth (premolars and molars) after root canals are more likely to fracture if unrestored. The reasons for this are likely due to a loss of mechanical support internally. I personally have already seen many patients who come in months to years after a root canal was started/completed and the tooth was not structurally protected, with a broken tooth. Unfortunately this cannot be applied generally to every patient in a strict sense. For example, I can't say "You need to get a crown in less than 6 months, because on the next day this tooth will break. One main reason to discuss crowns after root canals on posterior teeth is to prevent more costly dental treatment in the future. In general, no dental procedure will strengthen your teeth. Teeth with root canals are structurally weaker than identical teeth with no dental treatment. Fractured teeth pose a difficult treatment choice. If a fracture occurs vertically, extending below the bone level that supports the tooth, two scenarios are possible: If the fracture takes a molar and splits it into two halves (similar to a walnut shell), the tooth is not salvageable. There is no way to recement the root portions of the tooth, and we cannot reseal this area. Eventually, these teeth will end up with infections or abscesses and will need to be extracted. If the fracture is near or slightly below the bone level, a procedure called crown lengthening is possible, albeit at a risk of weakening the tooth further. We have to take multiple factors into account, including the procedures needed to retain this tooth versus the expected prognosis and remaining useful life of this tooth. We try to prevent us from getting to this point by protecting teeth with root canals as soon as physically and financially possible.

5.03.2017 10:21:00 - Uzm. Dt. Hakan AYDIN

Doctor AYDIN, my tooth before performed root canal treatment ache again. Why is a tooth extracted after a root canal?

10.09.2017 09:09:00 - Aydın KORKMAZ

A tooth after a root canal treatment goes for extraction when the root canal treatment fails (persistence of pain, swelling or sensitivity) and other treatment options like re-treatment or a tooth surgery are practically not viable. Re-treatment holds questionable prognosis due to microbial factors and secondly something wrong done in the initial treatment which cannot be set right. Your doctor might themselves decide against a re-root canal treatment and advise extraction or sometimes the patient is not willing for higher expenses on a tooth whose outcome is questionable. (Re-treatments cost more and judging the prognosis is a bit tricky). Some patients do not go for surgery due to medical conditions, age considerations and physcological reason. A flap surgery to save a tooth looks too big to them specially after one failed treatment. So, in such unfortunate cases a tooth has to be extracted to relieve patients symptoms. The initial treatment fails most commonly due to iatrogenic factors. Also, if the patient fails to get a crown after canal treatment, the tooth might fracture or split into segments which is beyond restoration. The tooth becomes briitle after canal treatment due to moisture loss and dessication and needs to be protected by a crown. Failure to protect the tooths structure in this way would also lead to extraction even after a successful canal treatment.

12.09.2017 19:03:00 - Uzm. Dt. Hakan AYDIN

I’m a pregnant and I have toothache. Is dental work during pregnancy safe?

3.02.2018 10:35:00 - Yeşim CİVELEK

Dental treatment can be done at any time during pregnancy. However, the best time to perform elective dental treatment during pregnancy is in the second trimester, weeks 14 through 20. By this time, the development of the fetal organs is complete and the risk of side effects is lower. Research also suggests that women who receive fillings, undergo tooth extractions or have root canal treatment during the second trimester don't experience higher rates of problems at birth. In addition, nausea and postural discomfort are often less of an issue during the second trimester. Keep in mind that if you have oral pain or swelling, you might need immediate treatment. The consequences of not treating an infection during pregnancy outweigh the possible risks of the medications used during dental treatment. Your health care provider will carefully monitor the use of any antibiotics or pain medications. If you have questions or concerns about dental care during pregnancy, talk to your health care provider.

5.02.2018 20:15:00 - Uzm. Dt. Hakan AYDIN