Conventional Root Canal Treatment
The need for root canal treatment comes about when the soft tissues within the canal become damaged, diseased, or infected from tooth decay or fracture, or from other trauma to the tooth. Conventional root canal treatment involved cleaning the diseased or infected tissue from inside the “canals” within the tooth root, followed by sterilization of the canals and sealing with a material to inhibit recurring infection in the area.
Root Canal Retreatment
Root canal treatments are estimated to be about 95% successful. That is a good success rate for any medical procedure, but it also means that some root canal procedures fail, either immediately or years after the treatment. When this happens, retreatment of the canals is often an option. This process is not too much different from the initial treatment, but involves the additional step of removing all of the original root canal filler in order to gain access to the canal. Some of the older endodontic techniques involved using metallic fillers in the canals, and these can be very difficult to remove, making retreatment of the canal a slower process that was the initial treatment.
There are times when conventional root canal treatment will not suffice. Many times a surgical treatment known as “apicoectomy” is required to remove a lesion that has formed within the jaw bone around the tip, or apex, of the tooth root. This procedure is a little more invasive, but usually no more difficult than conventional root canal treatment, and is performed in the dental office. As seen in the diagram below, the process involves making a very small incision in the gum tissue over the tooth root, reflecting that tissue to gain access to the infection or lesion, and removing the lesion. This usually involves removing a small portion (2-3millimeters) of the tip of the tooth root to gain full access to the lesion.
The Abernathy Difference
There are many ways to go about performing root canal treatments. Dr. Abernathy has maintained a dental practice for more than thirty years, and during that time he has noticed that various aspects of root canal treatment techniques were either good for the long-term health of individual teeth, or were not so good. After analyzing the many materials, instruments, and techniques available for endodontic treatment, he has chosen the methodologies that he is certain will be beneficial not only for the root canal treatment, but also for the general dental treatment that will follow, and for the long-term health of the tooth.
Dr. Abernathy has always believed he could provide a better service for his patients if he made a conscious effort to “learn from the very best.” To that end, he has been persistent and very blessed to learn endodontic techniques from several of the very best practitioners in the world, some of whom teach their secrets to only a very few select individuals each year. In his own practice, Dr. Abernathy uses a combination of only the best techniques from only the best practitioners. This “best of the best” approach allows him to provide a very unique service about which both patients and referring doctors rave.
Treatment Well Worth the Trip
Dr. Abernathy endeavors to maintain a state-of-the-art practice in all respects…techniques, materials, dental equipment, and staff. All of his treatments are performed under a dental surgical microscope, which allows him to see all of the intricate anatomy with the canal system of each tooth. He utilizes a digital xray system, which allows him to view a larger and more detailed xray of your tooth than can be seen with the smaller conventional dental film. Dental lasers, precise electronic measuring devices that evaluate root lengths to tenths of millimeters, micro-instrumentation, and much more, allow him to perform treatments that are far more delicate and precise than can be accomplished with conventional techniques. This translates into a higher quality treatment, and a gentler, more pain free, more enjoyable treatment experience for you, the patient.
If you are interested in learning more about your impending root canal treatment, Dr. Abernathy is author of two related ebooks that you can download at no cost by clicking the links below. The first, What is a Root Canal Anyway, and Why Does it Hurt So Much? is an explanation of how root canal treatment has changed for the better in recent years, and offers reasons why there is no need to fear the treatment any more. The second ebook, How Do I Deal With Dental Pain When I Can’t Find a Dentist? offers suggestions for what to do, and what not to do when a toothache starts on Saturday morning and you can’t find a dentist anywhere.
The PIPS Difference:
Laser Root Canal Treatment
In the field of dentistry, the introduction of Photon Induced Photoacoustic Streaming, or PIPS for short, ranks up there with the invention of the wheel, the airplane, or nanobots (a field in which one of my sons works) to cure cancer. PIPS is so drastically different from other root canal treatment modalities I believe it should be treated as completely separate specialty.
The difference between PIPS and conventional root canal treatment can be explained quite simply:
In conventional root canal therapy, metal files with sharp edges are inserted into the canal and worked back and forth to scrape diseased tissue out of the tooth. In the process, these metal files remove part of the internal structure of the root, structure that may be important for the long-term strength of the tooth. PIPS is an entirely different process. I still use a few of the very smallest metal files just to measure length of the canal and establish what is called a “glidepath” down which the PIPS medications can travel. I emphasize the fact that these are the tiniest of metal instruments…not the large ones that strip away important internal structure from the root.
The PIPS process involves pulsed laser light at very low power. As the light pulses into sterilizing medications in the tooth, it causes waves to form within the root canal which clean the bacteria and other debris that have adhered to the walls of the canal. Beyond the initial measurements, nothing metallic touches the walls of the canal. When the PIPS process is complete, the canal is clean and sterilized without destroying important internal structure.
All that is what is important to me…I want the tooth to be strong and functional long-term. The more natural tooth I can leave in place means a stronger, longer-lasting tooth.
What is important to YOU is this:
- The PIPS process creates gentle removal of diseased nerve tissue. There is no ripping or tearing, as happens with metal files. There are only gentle pulses of light and liquid bubbles. This kinder, gentler treatment leads to a more comfortable healing process.
- The PIPS process cleans the canal around curved areas, canal connection areas, and microscopic areas known as dentinal tubules, where bacteria can hide out for years before becoming active once more and causing failure of an otherwise good looking root canal treatment.
- The PIPS treatment is virtually painless. Local anesthetic is used for the procedure, but a separate laser treatment known as PALT is used before any injections to anesthetize tissues before any injection is given. Laser energy is known to have an anesthetic effect on the teeth an surrounding tissues, a fact that helps the entire process to proceed painlessly as the bacteria and diseased nerves are dissolved away from the canals.
I have been doing root canal treatments in my office since 1979 and can say without equivocation that it is the most amazing improvement to root canal treatment I have seen in my career. In the six years since I have been providing PIPS treatment in my office and teaching it in various classes around the nation, I am still impressed every day with the fantastic results achieved for patients.
One more amazing fact with which you might be interested:
I am the ONLY dentist in all of Northeast Arkansas providing PIPS endodontic treatment to my patients! In fact, there are, to my knowledge, there are no PIPS dentists closer than St. Louis, Missouri or Nashville, Tennessee. I can’t explain why this is a fact. I know many excellent PIPS dentists on both the east and west coasts, but for some reason it is still quite a secret in middle America. For those of you who desire gentle, predictable root canal treatment that is a shame.
On the other hand, if you live in an area where there are no laser or PIPS dentists, you are welcome at my office whenever we can schedule you. Laser dentistry and PIPS is the future of endodontic therapy. The future is NOW!
Regardless of what you may think, lasers are no longer just for TV and movies anymore. Laser technology has overtaken medicine, optometry, surgery and many other aspects of our lives, in most cases improving our treatments and outcomes. For some reason dentistry has been slow to embrace laser technology as the greatest advancement in patient care in decades, but it is slowly working its way into dental practice.
“But how does that affect me, the patient?” you may ask.
Laser technology is working its way into just about all aspects of dental care. With the proper laser and a trained dentist, simple cavities can be filled with no anesthetic (and no pain). Many periodontal treatments (gum disease treatments) can be performed without invasive surgeries. TMJ treatments, migraine headache, mouth ulcers, tooth bleaching, even cosmetic procedures, can all be performed with dental lasers.
In my practice, we concentrate on the treatment of endodontic (root canal) diseases and infections. PIPS treatment with the laser has been a boon for me as the treating doctor, as it provides me with an avenue to treat more complex endodontic cases with much more predictability. Even more important, PIPS and the adjunctive laser treatments provide great benefit to the patients. Particularly in complex cases, the treatment proceeds faster, with the vast majority being completed in about an hour. Post treatment discomfort is greatly reduced, sometimes even eliminated, because of the gentle nature of the PIPS cleaning and sterilization process.
But PIPS is not all we do with the laser. When you sit in my dental chair for treatment, here is what you can expect:
- Fear the “Shot” No More… with Pain Attenuating Laser Therapy, or PALT Most patients are almost as afraid of the dreaded “shot” as they are of the root canal process proper. The first thing I do is aim the laser directly at the spot to be injected for local anesthesia. The laser, at particular wavelengths and pulse settings, delivers energy to the site that will pre-anesthetize the area long enough that I can administer local anesthetic without the usual sharp sting associated with the “shot.” As PALT is administered all the patient feels, if anything at all, is slight warmth of the gum tissues. Over the years I have asked many patients how much discomfort, on a 1 to 10 scale, they experienced during the “shot.” Before PALT, patients commonly reported 6 to 10 on the scale, with 10 being the worst. Now that we use PALT, the patients usually report 0 to3.
- But My Teeth Are Tough to Numb, Doc
Some teeth are, in fact, difficult to completely anesthetize. This is particularly true when the nerve within the tooth is inflamed and hypersensitive, which is probably the reason you scheduled a root canal treatment in the first case. Since we deal with this condition on almost a daily basis, we figured out a way to make the anesthetic more effective and profound using…you guessed it…dental laser technology. At slightly different settings than are used for PALT, the laser has a direct anesthetic effect on the sensitive tooth. At the same time, the laser energy increases blood flow all around the tooth, allowing more of the local anesthetic to be delivered to the inflamed areas, thereby putting the tooth to sleep for treatment.
- Now to the Root Canal Treatment
Now that the tooth is asleep, root canal treatment can proceed in comfort. Opening the tooth is much like having a filling done, accomplished with the conventional, whiny, drill you doubtless remember from other dental treatments. This only takes a few minutes. After a few measurements of the canal, we are ready for PIPS. During the PIPS process you will feel nothing, and you will hear only the “beeping” of the laser and a quiet “tapping” noise as the laser energy pulses through the root canal.
- Time for the Magic Once the endodontic treatment is finished, the laser has two more tasks to complete in order to ensure the rest of your day is as comfortable and productive as possible. A process known as photobiomodulation is accomplished around the treated tooth in the areas known to be most sensitive after root canal treatment. This process, which only takes a minute or two, hastens healing and diminishes discomfort in any areas where the tissues have been irritated or inflamed by conventional or surgical treatment. Once photobiomodulation of the tooth has been completed, the laser is retuned one more time to deliver deeper photobiomodulation to the muscles around the jaw joint. During root canal treatment you will have been open for nearly an hour. The jaw muscles get tense, and can be sore for a day or two after treatment. This deep “muscle massage” with the laser relieves the tension and usually eliminates any post treatment muscle soreness.
Photobiomodulation is probably the most impressive treatment the laser can provide, but currently its mechanism of action is little understood and taught in very few places. I am one of only a very few instructors around the nation who teach this laser process to dentists and endodontic students. It is such a quick and painless treatment, and delivers so much benefit to areas of pain or inflammation, I am always amazed to think that it is virtually unknown to most dentists, endodontists, and surgeons, but is commonplace in my practice.
Call, email, or visit… However you get in touch, Dr. Abernathy is looking forward to hearing from you! Click the map to the right to find our office, or CLICK HERE to get directions from your location.
2919 Browns Lane
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