Category: Blog

The Importance of Early Detection and Treatment for a Cracked Tooth

Recurring tooth pain when eating, whether sharp and shooting or throbbing pain , could be an indication of a cracked tooth.. If you experience pain when biting or chewing food or even experience a sharp sensation when you eat hot or cold food, then it is important to visit an endodontist before the issue gets worse. This article explores the importance of early detection and appropriate treatment options for a cracked tooth.

What is a Cracked Tooth?

Beyond the surface of your tooth lies a complex structure consisting of a tooth, pulp, and nerves. A tooth becomes painful when a crack extends down into the tooth’s root, compromising the sensitive and delicate pulp and nerves inside. A chipped or cracked tooth may initially seem minor, but this damage can extend deep within the tooth structure. Detecting a cracked tooth can be difficult as the signs may not be visible and you may not experience significant symptoms until the damage has worsened. This makes early detection crucial to prevent further complications and protect the tooth from more serious damage.

Why Do Teeth Crack?

  • Cracks in a tooth can occur for a variety of reasons, such as:
  • Trauma to the tooth
  • Pressure from grinding or clenching a tooth
  • Previously done dental procedures, such as a large filling

These factors can weaken the tooth’s structure, making it quite prone to damage. If this issue is left untreated, it can lead to:

  • Infections
  • Bone loss
  • Eventual loss of tooth

In this instance, it helps to seek the advice of a root canal specialist as soon as possible, to ensure proper diagnosis and appropriate treatment to manage the issue.

Risks of Delaying Treatment for a Cracked Tooth

Many individuals might dismiss tooth pain or acute discomfort, attributing its due to minor issues like sensitivity or irritation. However, when it comes to cracked tooth, delaying treatment can be a huge and costly mistake. The longer a cracked tooth remains untreated, the higher the likelihood of irreversible damage.

Cracks in the tooth create an entryway for bacteria to enter thus leading to infection. This can result in the formation of an abscess, which is a buildup of pus that forms when the body’s immune system tries to fight off the bacteria. If left unchecked, a severe infection can spread, not only causing worse pain but also affecting the nearby bone and gums.

Tooth extraction may be the only solution in certain cases where the tooth becomes too damaged. This not only results in tooth loss but can also lead to extensive restorative procedures such as implants or bridges.

Benefits of Early Intervention

Early detection and intervention can help prevent many tooth complications in addition to increasing the chances of saving the cracked tooth. Listed below are some significant benefits of early detection for cracked tooth:

Less Invasive Treatments: Early detection may prevent the need for a root canal treatment and instead a crown may suffice. Consult an endodontist early to discuss your treatment options for a cracked tooth.

Prevents Spread of Infection: Detecting the cracked tooth early helps treat infections before it affects the surrounding bone and gums. The quicker the bacteria is removed from the root canal, the less likely it is that you will experience worse complications such as an abscess or bone loss.

Tooth Preservation: Early detection of a cracked tooth increases the chances of saving the tooth through root canal treatment before the crack propagates deep into the tooth and extraction becomes the only option.

Cost-Effective: Early detection and timely treatment reduces the need for expensive procedures such as extractions, bone grafting, or tooth replacements. The cost of root canal therapy, while quite significant, is minimal compared to the costs of tooth extraction, bone grafting, and tooth replacement.

Managing the Pain: Tooth pain can be excruciating and uncomfortable, especially when there is an infection. Early detection and treatment alleviates pain quickly and effectively, ensuring your comfort and quality of life.

By visiting a root canal specialist as soon as symptoms arise or before they become severe, you can avoid the painful complications of an untreated cracked tooth.

Root Canal Therapy by The Endodontic Office

As our life expectancy increases, cracked teeth are increasingly common due to a variety of stressors in modern day life. This poses a serious threat to your oral health, and delaying treatment can lead to plenty of unnecessary complications – from infection and bone loss to tooth loss and extensive dental procedures. Early detection and timely treatment by a root canal specialist can prevent the issue from worsening.

The Endodontic Office is a dental practice specialising in diagnosing cracked teeth and providing appropriate root canal treatments with a focus on patient comfort and care. Established in 2007, our dental practice now comprises a team of eleven endodontists, with three clinics conveniently located in the central areas of Orchard, Novena, and Jurong East.

If you’re experiencing any signs of tooth pain or sensitivity, don’t wait for the situation to escalate and schedule an appointment with a root canal specialist at one of our clinics today.

Understanding the Root Canal Procedure: A Step-by-Step Guide

Understanding the Root Canal Procedure: A Step-by-Step Guide

The thought of a root canal often brings up a series of questions: Will it be painful? Will it be uncomfortable? How long will it take? Contrary to popular belief, a root canal treatment procedure is not as terrifying as you would imagine. In fact, this is a common dental procedure that is meant to relieve your toothache. This article explores what happens during a root canal treatment in addition to clearing some common myths surrounding the treatment. 

What is a Root Canal Treatment Procedure? 

A root canal treatment is a procedure performed to save a tooth that has been damaged by decay or trauma. The soft tissue inside the tooth is known as the pulp which consists of nerves, blood vessels and connective tissues. When the pulp tissues become  infected or inflamed, it can lead to excruciating pain and even loss of the tooth if it’s not treated in time. 

Here’s a detailed step-by-step breakdown of a root canal treatment procedure: 

  1. Diagnosis and X-rays: 

Those experiencing severe toothache and discomfort should visit a dental clinic where a dentist will conduct an examination to identify the source of pain. An X-ray may be taken to assess the extent of the damage and detect any infection in the surrounding bone. 

  1. Administering Local Anaesthetic: 

Before starting the treatment, a root canal specialist will numb the area with a local anaesthetic to ensure that you’re comfortable throughout the procedure. The process typically involves an injection during which patients may experience a mild prick from the needle. Once the anaesthesia kicks in, you should experience little to no pain during the root canal treatment procedure. 

  1. Isolation of the Tooth: 

To keep the area clean and free from saliva, a dental dam (a thin sheet of rubber) is placed over the tooth. This helps create a sterile environment and prevents any contamination during the procedure. 

  1. Creating an Access Hole: 

Once the tooth is numbed and isolated, the root canal specialist will drill a small hole into the crown of the tooth. This allows them to reach the infected or damaged pulp inside the tooth’s canal. 

  1. Cleaning and Shaping the Root Canals: 

With the little access hole created, the endodontist uses tiny file-like instruments to clean out the infected pulp. These files are designed to remove debris and shape the inside of the root canals so they can be sealed properly. 

  1. Filling the Canals: 

Once the canals are clean and shaped, they are filled with a rubbery material called gutta-percha. This filling helps seal the tooth and prevent any future infections from occurring. 

  1. Sealing the Tooth: 

After the canals are filled, the root canal specialist will seal the access hole with a temporary or permanent filling. You may also be required to do a crown for the tooth with your referring dentist depending on how much tooth structure remains. The crown helps protect the tooth and restores its strength, allowing it to function like a natural tooth again. 

Common Misconceptions about a Root Canal Treatment

Despite the many benefits of a root canal treatment procedure, the idea of undergoing one still causes anxiety for many people. This is often due to misconceptions that have persisted over time. Below are some common myths and the reality behind them: 

  • “Root canal treatments are painful” 

Many individuals think that a root canal treatment is one of the most painful dental procedures. On the contrary, the purpose of a root canal is to reduce or eliminate  pain caused by an infected or damaged tooth. With modern techniques and anaesthetics, most patients feel little to no pain during the procedure and usually feel relieved of the dental pain after the treatment. 

Root canal treatments are not surgical procedures because the treatments do not involve any soft tissue incisions or bone guttering. Besides recovery from the anaesthetic effect, patients can continue their daily routine and even eat and drink after the procedure. 

A minority of patients may experience flare-ups after the treatment, which is accompanied by  severe pain and swelling. This is due to the inflammation process as a result of the prior root canal infection and not the root canal procedure per se. Such severe inflammation may require several days to recover despite initiation of root canal treatment. Fortunately such cases are uncommon and can be effectively managed by an endodontist. 

  • “It’s better to extract the tooth” 

While extraction might seem like a quick and easy solution, it’s always better to save your natural tooth if possible. A missing tooth can lead to other dental issues, such as shifting of teeth, difficulty in chewing and loss of gum bone in the jaw. A root canal treatment preserves your natural tooth and its functionality, which is often a better and cost-effective option in the long run. 

  • “Root canals cause illness” 

Today’s root canal treatment procedures are safe and effective, and there’s no actual evidence to suggest that getting this treatment leads to other illnesses. The infection inside the tooth is what poses a risk to your health and not the procedure itself. 

Root Canal Treatment at The Endodontic Office 

A root canal treatment procedure is a relatively straightforward solution that can save teeth, relieve pain, and prevent any further damage from occurring. Owing to progressive dental techniques, this procedure can be a comfortable and smooth experience for patients who may experience anxiety before the treatment. 

Established in 2007, The Endodontic Office is a dental clinic that specialises in root canal treatments, focusing on modern care practices with an emphasis on patient comfort. Our clinics are located in Orchard, Novena, and Jurong East. 

Please do not hesitate to get in touch with us today to schedule an appointment with a root canal specialist.

Factors to Consider When Selecting a Root Canal Specialist

Factors to Consider When Selecting a Root Canal Specialist 

A root canal treatment is often perceived as one of the most dreaded dental procedures but it doesn’t have to be a painful or an overwhelming experience if you have the right specialist. A skilled dentist, such as a root canal specialist, can play a key role in enhancing patient comfort, supporting recovery, and contributing to the success of the root canal treatment. However with so many dental professionals out there, how can you select the correct one to serve your needs? This article explores some important factors to consider when choosing a root canal treatment specialist. 

The Role Played by a Root Canal Specialist 

Also referred to as an endodontist, a root canal specialist not only has to complete three  years of postgraduate training, they also have to take a specialist board exam in order to be a qualified dental specialist. They are well-trained and competent in diagnosing  and treating dental pain arising from diseased teeth. In particular, an endodontist is proficient in managing disease that arises from the inside of the tooth (“endo” means inside and “dontics” means tooth). The inside of the tooth is a complex structure consisting of the pulp tissues and dentine which can become infected or damaged due to decay or trauma. 

Endodontists then perform procedures to eradicate pulp disease so that patients can retain their natural teeth. Their specialised knowledge ensures that patients receive appropriate care for these intricate and technically challenging treatments. 

General practitioner dentists may not possess the specialised skillset or have the necessary equipment to perform the more complex root canal procedures and will therefore refer to an endodontist for management. In some dental practices, patients can be referred to their in-house endodontists. You may also choose to be seen by an external endodontist. Seeking treatment from an endodontist will ensure that you receive the highest quality of care for an optimum treatment outcome. 

Choosing a good endodontist can be challenging so here are some factors that one can consider when selecting a root canal specialist or clinic. 

  • Experience and Qualifications 

A  root canal specialist has significantly more training and experience in performing root canal treatment. In addition,  they are required to stay up-to-date with modern techniques and innovations so that they can provide the most appropriate and contemporary treatment. To find a root canal specialist, one may refer to Society of Endodontists Singapore (SES) or Singapore Dental Council (SDC). A professional with years of practical experience will not only make patients feel comfortable but also ensure a smooth and efficient treatment process. 

  • Reputation and Patient Reviews 

A good way to assess an endodontist’s reputation is by going through patients’ reviews. These reviews can provide valuable insights into how the specialist interacts with patients, the quality of care provided, and whether previous patients were satisfied with their results. Read testimonials on Google or on the clinic’s website. Furthermore, if a friend or family member has had a root canal treatment recently, ask for their recommendations as well. 

  • Clinic Facilities and Technology 

Modern dental procedures have come a long way with the progression in technology, and this is especially true for root canal treatment. When evaluating a root canal clinic, take note of the facilities and the technology they use. A dental clinic that is adequately equipped with modern tools will not only enhance the quality of care but can also lead to a comfortable experience. 

Another factor to consider is the overall environment of the clinic and whether it is hygienic and welcoming to patients. The staff should be friendly, patient, and ready to answer any questions patients may have regarding the treatment. A well-maintained, organised clinic reflects the specialist’s attention to detail, which can be a good indicator of the care you’ll receive. 

  • Ease for Follow-Up Visits and Treatment

While most root canal treatment takes just one to two visits to complete, sometimes, the procedure can be more complicated due to the tooth’s anatomy or a severe infection which may necessitate multiple visits. Follow up reviews are also important to ensure that treatment is effective and the disease is healing. Endodontists are proficient in picking up and managing post-treatment disease. It is therefore important to consider treatment with an endodontist where follow up is convenient in order to receive the best possible treatment. 

  • Seeking Treatment with External Endodontists 

In certain dental practices, you may be referred to an in-house endodontist, however, the option of seeing an external endodontist is always available. Rest assured that your care will not be compromised and the necessary records will be sent back to your general practitioner dentists for follow up treatment. If you have questions about this, feel free to contact us for clarifications. 

root canal clinic, root canal therapy Singapore

Root Canal Treatment at The Endodontic Office

Choosing the right root canal specialist involves more than just finding someone to perform the procedure. It’s about selecting a professional who possesses the necessary experience and qualifications, and a clinic that is equipped with modern technology to ensure a favourable treatment outcome. 

Your search for a root canal specialist stops here. With extensive experience and expertise, The Endodontic Office focuses on delivering root canal treatment that meet modern care standards, all while ensuring patient comfort remains a priority. Since our founding in 2007, we have a proven record of patient satisfaction. With three clinics conveniently located in Orchard, Novena and Jurong East and a team of eleven highly skilled and experienced endodontists, your root canal treatment needs will be met in a timely and efficient manner. 

If you’re considering a root canal treatment, do not hesitate to get in touch with The Endodontic Office to discuss your options or schedule a consultation with one of our specialists.

Modern Techniques in Root Canal Therapy: Minimising Discomfort and Maximising Success

Modern Techniques in Root Canal Therapy: Minimising Discomfort and Maximising Success

Root canal therapy has long been associated with pain, discomfort, and anxiety. For many individuals, the thought of undergoing a root canal treatment can be stressful and worrying. However, advancement  in modern dental technology has changed how this treatment is done, making it far less daunting and allows for optimal patient outcomes. In Singapore, where dental care is known for its impeccable quality, these dental techniques are paving the way for comfortable and effective root canal treatments. This article explores some innovative practices with regard to root canal treatments in Singapore and how they can benefit patients. 

What Is Root Canal Therapy? 

Root canal therapy is a dental procedure aimed at treating infection within the tooth’s pulp, which consists of nerves, blood vessels, and connective tissue. When this pulp becomes infected or inflamed due to deep decay, repeated dental procedures, or injury, it causes intense pain and could lead to tooth loss if left untreated. Root canal therapy removes the damaged or diseased pulp, cleans and disinfects the canal walls,  and then fills and seals the space to prevent further infection from occurring. 

Modern Techniques in Root Canal Therapy 

Over the years, root canal therapy has become increasingly precise, efficient, and less uncomfortable for patients. Let’s take a look at some modern techniques that have significantly enhanced this treatment: 

dentist with patient, root canal treatment specialist

Digital X-Rays 

Digital X-rays are a modern imaging technique used in dentistry that allows for the capture and viewing of X-ray images on a computer screen. Unlike traditional film-based X-rays, digital X-rays provide detailed images of your teeth and other bony structures with the use of technology. These images provide dentists with clear and accurate information about the underlying cause of the dental disease, thus diagnosing your dental conditions efficiently. 

Significant benefits of digital X-rays include: 

  • Lower Radiation Exposure: Digital X-rays significantly reduce radiation exposure compared to traditional film X-rays. This makes the procedure safer for patients, especially for those who need multiple X-rays during complex dental procedures such as root canal treatment. 
  • Instant and Enhanced Image Quality: A notable advantage of a digital X-ray is the immediate availability of high-quality images. Dentists can view the images in real-time, zoom in for enhanced detail, and make accurate diagnoses. This is particularly beneficial in detecting small cavities, bone loss, or infections. 
  • Environmentally-Friendly: Since digital X-rays eliminate the need for film and chemical processing, they are an environmentally-friendly option. This reduces waste and avoids the disposal of harmful chemicals used for the processing of X-ray films.
  • Enhanced Patient Communication: With digital X-rays, dentists can easily show patients the images on a computer screen, helping them visualise any dental issues. This enhanced communication helps patients understand their treatment plans better, thus allowing patients to make  informed decisions. 

Rubber Dam Isolation 

Rubber dam isolation is a technique used in dental procedures to create a clean, dry, and sterile working area. A thin sheet of latex or non-latex material, known as a rubber dam, is placed over the patient’s teeth, exposing only the teeth that are being treated. This isolation method is commonly used in procedures such as restorative work, fillings, and root canal therapy in Singapore. By sealing off the rest of the mouth, it ensures that the treatment area is free from saliva, blood, and other contaminants, which may interfere with dental work. 

Some significant benefits of rubber dam isolation include: 

  • Enhanced Treatment Quality: Rubber dam isolation provides a dry and controlled environment, which allows dentists to perform accurate work. Moisture, often present in the mouth, can compromise dental materials like composite resins or interfere with the curing process. By keeping the area dry, rubber dam isolation enhances the quality and durability of the dental restoration. 
  • Reduced Risk of Infection: The sterile environment created by rubber dam isolation helps reduce the risk of cross-contamination. It prevents bacteria from saliva or blood from entering the treated area, thereby minimising the risk of post-operative infections. This is particularly important during procedures like root canal therapy, where maintaining a clean space is of utmost importance. 
  • Increased Patient Safety: Dental procedures, such as root canal therapy or fillings frequently require small tools or chemicals/ Rubber dam isolation thus acts as a barrier to prevent materials from being accidentally ingested or inhaled. It enhances patient safety and reduces the risk of any harmful incidents occurring during the procedure. 
  • Enhanced Patient Comfort: While the rubber dam might feel slightly odd for the patient at first, it actually enhances comfort by preventing liquids, dental debris, or chemical substances from coming into contact with the tongue or throat. It also helps reduce gagging sensations during treatment, making the experience comfortable for patients. 
  • Faster and Efficient Procedures: Rubber dam isolation enables the dentist to focus solely on the treatment area without worrying about saliva contamination or tongue movement. This allows for a quicker and streamlined procedure, ultimately reducing chair time and discomfort for the patient. 

Root Canal Therapy in Singapore at The Endodontic Office 

Staying up-to-date with advancements  in endodontics is crucial for ensuring good care, minimising discomfort, and achieving optimal patient outcomes in root canal therapy. Modern techniques, such as digital X-rays and rubber dam isolation are beneficial to patients as they enhance the quality of root canal treatments but also provide enhanced safety, comfort, and protection. 

With many years of experience and expertise, The Endodontic Office specialises in root canal treatments that adhere to modern standards of care, while prioritising patient comfort and care. Established in 2007, we have since grown to three clinics and a team of eleven endodontists. Our clinics are conveniently located in easily accessible areas such as Orchard, Novena, and Jurong East. 

If you have been putting off a root canal out of fear or anxiety, now is the time to reconsider. With our experienced endodontists and modern techniques at The Endodontic Office, you can expect a comfortable, efficient, and relatively pain-free experience. Contact us today to schedule your consultation and experience the difference that modern technology can make in your dental care.

Should I Get a Root Canal Treatment or a Dental Implant?

Should I Get a Root Canal Treatment or a Dental Implant?

What is the Difference Between a Root Canal Treatment and a Dental Implant?

Root canal treatment, also known as endodontic therapy, is a procedure performed to save a tooth that has an inflamed or infected pulp – the tooth pulp consists of the nerves and blood vessels in the innermost part of the tooth. The procedure involves removing the diseased pulp, cleaning and disinfecting the root canals, and then sealing them with dental materials to prevent further infection. This procedure is typically recommended when a tooth can be preserved and the surrounding bone is healthy enough to support it. Hence, root canal treatment is aimed at preserving the natural tooth, addressing the issue of infection while keeping the natural tooth structure. For more information, feel free to browse our blog posts: “Root Canal Treatment Procedure: What Should You Expect?” and “I Am Having a Toothache – What Should I Do?”.

Dental implant treatment, on the other hand, is a restorative option for replacing a missing tooth. For the implant to be placed, the diseased tooth has to be removed. The dental implant procedure involves the surgical placement of a titanium implant into the jawbone, which serves as an artificial tooth root. After a period of osseointegration, during which the implant fuses with the surrounding bone, an artificial crown is placed on top to simulate a natural tooth.

A radiograph illustrating an implant prosthesis that replaced an upper front tooth.

How Does the Longevity of a Root Canal Treated Tooth Compare with a Dental Implant?

A successful root canal treatment can extend the life of a natural tooth for many years, even decades, if proper oral hygiene is maintained and the tooth is adequately protected with a crown where it is deemed necessary.

Long-term studies have shown that root canal-treated teeth and dental implants have comparable longevity, with dental implants potentially needing more maintenance procedures than root canal-treated natural teeth. It is important to note that dental implants are not immune to developing gum disease around them, which might lead to progressive inflammation or infection of the gums and bone around the implant and may result in the eventual failure of the implant. Studies have shown that smokers, who are at higher risk of developing gum disease, are more likely to suffer a dental implant failure than to lose a natural tooth to gum disease. 

dental implant vs root canal

A radiograph illustrating an implant prosthesis and a root canal treated tooth.

Am I Suitable For Root Canal Treatment Or Dental Implant Treatment?

Both procedures require careful consideration of the patient’s overall oral health and specific circumstances. Root canal treatment is generally more conservative, as it aims to preserve the natural tooth, and should always be considered as a first-line treatment approach to managing a diseased tooth whenever possible. However, should the diseased tooth be severely compromised, such as having very deep cracks or fractures that make the tooth unsalvageable, then extraction of the tooth needs to be carried out, and a dental implant may be considered as a tooth replacement option following the loss of the tooth.

Dental implant treatment requires adequate jaw bone thickness and density for proper integration and may not be suitable for everyone or every jaw site. In addition, there are some medical conditions that may make a patient unsuitable to receive dental implants, such as osteoporosis, as well as the use of antiresorptive medications, a history of radiation therapy to the head and neck, and uncontrolled diabetes. 

Conclusion

In conclusion, root canal treatment and dental implant treatment are two distinct procedures with different objectives. Root canal treatment aims to preserve the natural tooth by treating the diseased pulp, while a dental implant is an artificial tooth that is installed in the jaw bone after a diseased tooth is extracted. Both procedures, when performed by skilled professionals and maintained well with good oral hygiene practices, can be equally successful.

Generally, root canal treatment may be considered as a first-line treatment for a diseased tooth, whereas tooth extraction followed by a dental implant should be viewed as an alternative or last resort for individuals with a tooth that is severely compromised or unsalvageable. It is important to note that not all patients or jaw sites may be suitable for dental implants. Additionally, if a dental implant should fail subsequently, the patient will often need to consider other prostheses, such as a dental bridge or a removable denture, since a repeat implant procedure at a previously failed site is unpredictable.

I am having pain from my tooth – what should I do?

I am having pain from my tooth – what should I do?

Clinical Signs and Symptoms of a Toothache

A toothache is oftentimes an excruciating experience that may affect your quality of life and daily function. It may be difficult for you to chew properly, get through the day or even sleep at night when there is untriggered, throbbing pain. When this occurs, it is important to see your dentist for immediate attention.

Possible Causes of Tooth Pain and What You Can Do

Below is a list of common pain symptoms, possible causes and some steps you can take to temporarily alleviate any discomfort prior to your dental visit. 

  1. Momentary sensitivity to hot or cold foods
    Possible cause: When the underlying dentine of the tooth is exposed due to enamel wear or initial decay, you may be experiencing dentine hypersensitivity. It is sharp and brief in nature and is triggered by temperature changes in foods or brushing and flossing. It does not linger once the stimulus is removed and does not occur spontaneously.What to do: You can try to apply a desensitizing toothpaste with a soft-bristled toothbrush in the sensitive areas. You may also wish to seek a consultation with your dentist to check for any possible tooth decay or loose fillings.
  1. Sensitivity to hot or cold after a dental filling
    Possible cause: After a recent dental filling, there may be heightened sensitivity of the pulp. This is what dentists diagnose as reversible pulpal inflammation. The symptoms are characterized by a short and sharp sensitivity when triggered by temperature changes in foods and do not linger.What to do: Monitor the sensitivity for two to four weeks. If the sensitivity worsens in intensity or has evolved into a dull and lingering ache, see your dentist or an endodontist for a consult.
  1. Sharp pain or dull ache when biting
    Possible cause: Sharp pain on biting on foods may be due to decay, loose filling or crack. A dull pain on biting may also signal periapical infection due to pulp necrosis of the tooth.What to do: Seek evaluation by a dentist, who may refer you to an endodontist to determine if there is any pulp disease which will necessitate root canal treatment. If it is just a decay or loose filling, it can be treated with a dental filling. If it is a deep decay or a crack, the tooth may need a root canal treatment.
  1. Lingering, throbbing pain (more than 20 seconds) after eating hot or cold foods and spontaneous pain at night
    Possible cause: Lingering ache after a thermal stimulus or unprovoked pain at night (when lying down) may signal irreversible damage of the pulp caused by deep decay, crack or even severe gum disease.What to do: See your dentist or an endodontist as soon as possible to identify the problem tooth. They can remove the inflamed pulpal tissues and retain the tooth with root canal treatment. You may take over-the-counter painkillers in the meantime to break the pain cycle for temporary relief.
  1. Swelling or pus around gums
    Possible cause: There may be a dental abscess caused by the surrounding periodontal tissues of the tooth. This may be due to a root canal infection or periodontal (gum) disease. It is not common, but the swelling can progress to the cheeks and the jaw.What to do: Seek a clinical evaluation with your dentist to diagnose the source of the infection. If the abscess is caused by a root canal infection, your endodontist may perform root canal treatment. If the swelling is due to periodontal disease, your dentist will carry out a deep cleaning around the gum region.

Above are the common situations when toothache occurs. There are instances where the patient perceives the pain as toothache, but it is actually caused by structures other than the teeth or the gums. To name a few: Sinusitis, Temporomandibular Disorder (jaw-joint issue) and Myalgia (pain involving the muscles).

root canal clinic, root canal therapy Singapore

Proper Examination and Correct Diagnosis

To treat the toothache, the dentist or the endodontist have to first arrive at the correct diagnosis. 

The diagnosis of a toothache will require a proper understanding of the patient’s pain and careful examination of the tooth. During the examination, the dentist or endodontist will have to conduct a few tests to find out the triggering factors and attempt to reproduce the pain. In addition, they will take radiograph/s to assess the extent of disease and the health of the surrounding structures.

To understand Root Canal Treatment Procedures, you can refer to our other Blog articles.

How can Endodontic Surgery Save Your Tooth?

How can Endodontic Surgery Save Your Tooth?

A non-surgical root canal treatment alone may sometimes be inadequate to save your tooth. In such cases, your endodontists may recommend a surgical treatment. 

What are the instances that require Endodontic Surgery? 

For further diagnosis purpose. Sometimes exploratory surgery may be indicated to locate cracks or possible fractures that could not be detected during non-surgical treatment. During the surgery, your endodontist will be able to examine the surface of the root to arrive at a diagnosis to provide appropriate treatment. 

Non-healing disease. Occasionally, despite adequate non-surgical treatment, a tooth may not heal or have persistent symptoms. The reason for the teeth not responding to previous root canal treatment could be that there are bacteria inside the root or around the root tip that cannot be eradicated by root canal cleaning. And hence, your endodontist may recommend a surgical approach to increase the possibility of saving your tooth. 

When non-surgical retreatment is not possible. In cases where extensive restorative work such as a large post in the canal, has been done, non-surgical root canal retreatment maybe more damaging. A surgical treatment can be a better alternative to save your tooth. 

Remove cysts and perform biopsies. Surgical treatment will be recommended in cases suspicious of a cyst. A cyst can be more sinister than inflammed tissues. The suspected cyst tissue that is removed during surgery will be sent to a laboratory for histological reporting. 

There are other less common scenarios whereby a surgical procedure may be indicated such as repair of a damaged tooth due to resorption (tooth eaten up by the own cells) or perforation (cavity unintentionally created by dentist).

What Is an Endodontic Surgery? 

Endodontic surgery is a day surgery typically performed under local anaesthesia. The most common endodontic surgery is an apicoectomy. In this procedure, the endodontist will lift the gum to expose the underlying bone and remove any diseased tissue. This tissue may be sent for biopsy. The end of the root will then be trimmed off and a small filling will be placed to seal the end of the root canal. Stitches will be placed on the gum to help the tissue heal. 

There are other types of surgical procedures that can be performed such as removal of a root, repairing damaged root surfaces or even removing the tooth and replanting it back in its socket after performing the endodontic procedure outside of the mouth. Depending on your case, your endodontist will be able to recommend the appropriate surgical treatment. 

What precautions do I need to take for the surgery? 

If you’re medically fit, no special precautions will be required prior to the surgery unless otherwise mentioned by your endodontist. 

However, please inform your endodontist if you have any medical illness (e.g.bleeding or clotting disorders), taking any drugs (e.g. blood thinners) or drug allergies. 

What are the risks and complications of Endodontic Surgery?

If the surgery is performed near other vital anatomical structures, there is a risk in injurying these vital structures. The injuries can be sinus perforation which may result in sinusuits. There may be cases of nerve injury that can result in transient numbness. These risks should be discussed with your endodontist prior to your surgery. 

What to expect after Endodontic Surgery?

Slight bleeding is expected immediately after surgery. Pain, swelling and bruising will also be experienced around the operated site. After the swelling subsides, there may be bruise-like mark on the face near the operated site that will recede. 

Painkiller are prescribed to alleviate the pain and swelling. Because we advised against brushing around the wound site, we prescribe  antiseptic mouth rinse for patient to maintain oral hygiene. Antibiotics are commonly prescribed to prevent secondary infection of the wound site. Gauzes are also given to patient for then to stop the bleeding at the wound site. 

Stitches will be removed in 5-7 days. Review appointments will be scheduled thereafter to monitor for healing. 

For more information on post-operative care instructions, you may refer to post-operation advice after endodontic surgery.

Are there alternatives to Endodontic Surgery?

Oftentimes, the only viable alternative to surgery is extraction of the tooth. You may then opt for an implant, bridge, or removable partial denture to replace the extracted tooth. Choosing not to replace the missing tooth is also possible but may result in a decrease in chewing function or shifting of adjacent teeth.  

You may also choose not to defer any treatment but this could lead to potential pain and further loss of surrounding bone which may compromise future treatment. 

Reasons Why You Should Never Ignore A Cracked Tooth

Reasons Why You Should Never Ignore A Cracked Tooth

What is a cracked tooth? 

A cracked tooth is an incomplete fracture of the tooth that often manifests as “cracked tooth syndrome”. This is characterized by sharp pain triggered when chewing (biting or release) of tough, grainy foods and heightened sensitivity to hot or cold temperatures. Oftentimes, the pain is erratic and it may be difficult for your dentist to localize the tooth causing the discomfort. 

When the crack has propagated into the pulp space, more severe symptoms such as spontaneous toothache at night and swelling or pus may result.

Diagnosing Cracked Teeth

The provisional diagnosis of a cracked tooth has to be affirmed before any definitive treatment is prescribed. Diagnosing a cracked tooth is more complex than detecting a decayed tooth due to various confounding signs and symptoms. It requires a thorough understanding of the patient’s pain history as well as a detailed clinical examination of the tooth. Endodontists have the expertise and equipment to carry out clinical investigation of cracked teeth to determine the most appropriate course of treatment. 

Cuspal Protection of Cracked Teeth

The type of treatment for cracked teeth depends on the patient’s signs and symptoms, risk factors and extent and location of the crack. 

The hard tissues of a tooth have no regenerative capacity. Thus, a crack in the tooth cannot heal by itself. Elimination or removal of the crack through drilling is also not an option as it will only exacerbate the condition of the tooth. The aim of cracked tooth treatment is to mechanically control the crack and prevent its progression. The only way to control a crack is to place a crown over the cracked tooth.  A crown is a rigid prosthesis that covers the tooth to brace and protect it from further crack progression. 

A picture of an extracted tooth with a crack seen on the root

For cracked teeth with mild and reversible symptoms, an option of crowning the tooth without root canal treatment may be possible. In such cases, a metal band is used to simulate a crown and it is temporarily placed around the tooth. If the symptoms upon biting are alleviated, the band may be replaced by a crown without the need for root canal treatment. 

Root Canal Treatment of Cracked Teeth

Root canal treatment will be required if the tooth presents with severe and persistent signs or symptoms that are not alleviated with banding or crowning. The patient can have persistent symptoms with biting and have severe sensitivity to cold and hot. In some advanced cases, the pulp may be irreversibly damaged due to bacterial progression through the pathway of the crack and the root canal space infected, leading to swelling or abscess formation.

Root canal treatment aims to remove the inflamed or infected pulp from the tooth. During the root canal treatment procedure, the crack can be visualized internally under high magnification using a microscope. This allows the Endodontist to perform a crack assessment to determine the severity of the crack. The deeper the extent of the crack, the poorer the prognosis of the tooth. Following the crack assessment, the Endodontist will present and discuss the objective findings to the patient and an informed decision can be made by the patient after weighing the pros and cons of retaining the cracked tooth. If the patient opts to retain the cracked tooth, completion of root canal treatment will be planned and followed by a crown.

A clinical picture of a tooth during treatment.

Alternative Options for Cracked Teeth

When the crack is too deep and the tooth prognosis deemed poor, extraction will be presented as an alternative option. In spite of cuspal protection from the crown, a tooth with a deep crack may still continue to crack and eventually lead to vertical root fracture. Hence, extraction of teeth with deep and unrestorable cracks is a viable option. After the extraction, a discussion can be made with the dentist regarding possible tooth replacement options – such as implant-supported prosthesis, bridge or removable denture.

Final Advice About Cracked teeth

A cracked tooth diagnosis can be elusive and requires a multi-disciplinary team consisting of an Endodontist and the General Dentist to confirm the diagnosis and treat the tooth. With function and time, a crack on a tooth will propagate further. However, if the cracked tooth is diagnosed and treated promptly, the tooth will have a reasonable long-term prognosis. 

Root Canal Treatment Procedure: What Should You Expect?

ROOT CANAL TREATMENT PROCEDURE: WHAT SHOULD YOU EXPECT?

Why would I need Root Canal Treatment?

Root canal treatment is a procedure that helps to relieve patients’ toothaches and to clear the infection present inside a tooth. The common reasons for toothaches or infection is tooth decay and cracks. 

How does a toothache come about? A tooth has a chamber and root canal spaces within the center of the tooth, which is where the soft tissues of the pulp are located. Pulps have nerve tissues and when the tooth is damaged by decay or a crack, bacteria can infiltrate into these tissues. It can then become inflamed or infected, giving rise to severe pain commonly known as a toothache. When no treatment is rendered, the infected pulp will affect other tissues such as the jaw bone and the gums. This can potentially cause severe pain of the jaw bone and sometimes swelling of the gums, cheeks or the lips. Root canal treatment is necessary to eliminate the infection and spare the tooth from an extraction. 

It is unfortunate that many people think that root canal treatment is a painful procedure. In fact, the experience of severe pain during and after root canal treatment is unlikely. The fear for root canal treatment usually stems from the lack of knowledge of the procedure itself. With reassurance and explanation from the dentist or the Endodontist, the patient can understand why they need root canal treatment and what can be done to resolve their dental issues and pain.  

Root Canal Treatment Procedure 

Before the Procedure: The dentist or the Endodontist has to make a thorough examination of the teeth so that the painful tooth is correctly identified. There are several examination procedures and some are done to reproduce the symptoms of the painful tooth. A radiograph is also taken to check the tooth and the surrounding tissues. 

Demonstration of Rubber Dam Isolation with a Dummy Training Head.

Preparing The Treatment Area: Anaesthetic injections are necessary for patients before the actual procedure. Patients with long-standing toothaches or severe infection require special attention so that the teeth are properly anaethesized. Endodontists are experienced in this aspect and will be able to employ the appropriate technique according to the severity of the patients’ pain or infection. Once the anaesthetic injection is successfully delivered, the patient should not feel any severe pain during the procedure. 

During root canal treatment, it is important to prevent further contamination of the root canal space. A rubber dam, which is a rubber sheet, is used to isolate the tooth from the rest of mouth, creating a clean environment. The rubber dam and the affected tooth will also be disinfected prior to starting the treatment. 

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Picture of a cleaning file fitted on a motor

Creating A Small Hole and Cleaning the Root Canals: After the rubber dam and the affected tooth has been disinfected, the dentist or Endodontist will then drill a small hole on the surface of the affected tooth to access the root canal spaces. If there was decay in the tooth, the decay should be removed before preparing the hole. Once entry to the canal is achieved, the dentist or the Endodontist will use small files and disinfecting solution to clean the canals and remove the infected or inflamed pulp tissues. The cleaning can typically take an hour. Medicament paste is commonly placed in the canal for at least a week and the hole is sealed up with a temporary filling. 

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Picture of gutta percha material

Applying Root Canal Fillings: Following the thorough cleaning of the root canal, the dentist or the Endodontist will fill the canal space with a rubber-like material known as gutta percha. Pressure and/or heat is applied to the gutta percha so that the material adapts to the walls of the root canal. A sealer, which is a cement, is placed together with the gutta percha so that it creates a better seal to prevent reinfection of the canals. 

Root Canal Treatment Aftercare: The numbness following anaesthesia can last for a few hours but patients can still consume their meals, with extra care to avoid hot food and eating on the affected side. Patients should also avoid any hard food which may cause fracture of the affected tooth. Daily brushing and flossing should be continued as per normal. 

Root canal treatment is less invasive than an extraction and an implant procedure and patients should not expect any severe pain or swelling. However, patients with severe infection and pain before the procedure should expect the symptoms to subside only after a few days. Painkillers may be prescribed if pain is expected to persist, while antibiotics are only warranted for some cases. 

After the root canal treatment has been completed, the tooth will need a permanent filling or a crown. This restores the tooth to full function. 

Reach Out To Our Root Canal Treatment Specialist Today

If you are currently worried about undergoing a root canal treatment, there is no need to fret. Our Endodontists, the root canal treatment specialists at The Endodontic Office can walk you through the procedure as well as the aftercare. If you have any further questions, please reach out to us through our Contact Page. 

By Dr Helena Koh
Dr Helena Koh is an Endodontist in The Endodontic Office and is accredited as a specialist by the Singapore Dental Council. She has 10 years’ of clinical experience in Root Canal Treatments. 

Root Canal vs Extraction: Which is Better For You?

Root Canal Vs. Extraction: Which Is Better For You?

dentist with patient, root canal treatment specialist

The dental pulp in teeth can become inflamed or infected as a result of deep caries, cracks, fractures or severe gum disease. Patients may present with pain or a swelling, although at times there may be no symptoms as well. When this occurs, dentists will recommend one of two options – a root canal treatment versus an extraction. The risks and benefits of either treatment option depend greatly on the specific conditions of the individual tooth and patient. Here we share some insight behind how a root canal treatment can save your tooth.

What is root canal treatment?

Root canal treatment involves the disinfection of the root canals in a diseased tooth followed by a filling with a biocompatible material. 

  • A thorough examination inclusive of a dental X-ray is performed to determine that a root canal treatment is required.
  • Local anaesthetic is administered to numb the affected tooth. 
  • A small opening is made through the crown of the tooth.
  • Instruments are used to clean the root canals and a medicament may be placed inside the tooth.
  • Depending on the complexity of the case, root canal treatment might be completed in a single or multiple visits.
  • Finally, biocompatible materials are used to fill the root canals and a permanent filling (core) is placed to close off the opening
  • If a crown is required to protect the tooth, we will refer you back to your general dentist for further management
  • The tooth is retained in the mouth and functional

When might the tooth be unsuitable for a root canal treatment?

In the following situations, we may recommend an extraction:

  • Assessment of the tooth confirms a deep crack
  • Decay or a fracture that is too extensive
  • Severe bone loss around the tooth
  • Signs and symptoms persist despite adequate root canal treatment

In patients with certain medical conditions, we might advise against an extraction even for teeth which are otherwise unsalvageable. These conditions include a history of radiotherapy to the head and neck region, bisphosphonate or anti-resorptive/anti-angiogenic drug use for the treatment of osteoporosis or certain cancers. Please inform your dentist if you have any of these conditions so that the safest treatment option can be planned for you. 

What should I do if I need an extraction?

After a thorough assessment of the diseased tooth, if an extraction is recommended, we will liaise with your referring dentist to complete the extraction for you in a timely manner. Generally, extraction involves the removal of the diseased tooth with forceps but sometimes a minor operation may be required to fully remove the tooth. Extractions are usually performed under local anaesthesia. If several teeth are indicated for extraction, it may be performed under sedation or general anaesthesia. Your dentist will also be able to provide a suitable replacement for your extracted tooth, for example, an implant. 

Our team of root canal specialists at The Endodontic Office are well trained in the diagnosis and treatment of painful teeth. If you are suffering from a toothache, make an appointment to see one of our dentists via appointment@endooffices.com today.