cosmetic & anti-aging dentistry
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by Dr Chan Joon Yee
It is the pulp that is responsible for conveying symptoms of sensitivity when a tooth is decayed or worn down by abrasive forces or acidic foods. It was also cells in the pulp that laid down the enamel and dentine during the formation of the tooth when we were babies. Once the tooth has fully formed, the pulp shrinks down and serves the sole purpose of forming secondary dentine as the tooth wears down. The older the tooth, the thicker the dentine layer and the smaller the pulp becomes as it closes in on itself. Arguably, the pulp serves little function (except to warn us that our tooth has decayed) after the tooth is fully formed and "matured". The inside of the tooth does not need a blood supply anymore. The surrounding alveolar bone and periodontal ligaments are the structures that hold the tooth in its socket, not the pulp. In fact, in many cases, the pulp is a liability. Being the sensitive tissue that it is, the pulp sends out strong signals to the brain when it is irritated. If the source of irritation is removed quickly enough, the pulp will stop sending signals and the individual sleeps well again. But if the source of irritation is not removed or if it's removed too late, the pulp may suffer irreversible damage. The signal the pulp sends out becomes continuous and unbearable. We call this condition acute pulpitis. What to do? See your dentist immediately! Say it's an emergency. Basically, you have two choices - either to extract the tooth or to do root canal treatment to save it. The process will take several visits and cost considerably more than a tooth extraction. If it's a useful tooth, it'll be well worth the time and money. The first step in root canal treatment is to gain access to the diseased pulp by drilling a hole into the tooth. The pulp is then "sacrificed". Note from the diagram that the extent of the pulp goes beyond the pulp chamber into the interior of the roots. The trick is to clean the tight and tiny canals inside each individual root. It may sound frightening to the patient but for the dentist, it's a painstaking, finger-cramping, eye and back-straining procedure.
  X-rays have to be taken to see the inside of the roots. The length of the tooth beneath the gums has to be determined to avoid poking through. Knowing the length of the root, the dentist will then be able to create enough space for the filling material. view view After cleaning and widening, the root canal is dried and medicated. A temporary filling is placed over the canal to allow easy access on the next visit. The tooth is then allowed to rest. After all that poking and tugging, the tooth may feel a bit sore. If there's infection, antibiotics and painkillers may be prescribed. With the source of inflammation removed, pain will gradually subside. It's normal for the pain to persist for a couple of days and then gradually fade away. view view On the next visit, the temporary filling is first removed. Further cleaning may be needed depending on the case. Once the dentist is satisfied that all the canals are clean, the canal is filled up with a rubbery material called gutta percha. The purpose of sealing the canal is to prevent the accumulation of bacteria at the root tip. After root filling has been completed, a temporary filling is again placed over the pulp chamber. view Because the process of root canal weakens the tooth structure internally and also because dead (pulpless) teeth look darker with time, crowning is indicated for root canal treated teeth. view Does root canal always work? The answer is no. Sometimes, as when the infection at the root tip is so advanced that it has become a cyst, root canal treatment will not work. Sometimes, even with the best efforts of the dentist, the pain still persists somehow. In these cases, it might be best to extract the tooth and do an implant.
Costs (incl xrays, medication, temp fillings)
Please call 62358316 for appointments or email us |
Our teeth are actually very tough and well-protected structures. The outermost layer is enamel - the hardest known organic substance. The next layer is bone-like dentine and further down, is the highly sensitive pulp which is made up of blood vessels and nerves.
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