墨尔本根管治疗 | 根管问题解答


墨尔本根管治疗 | 根管问题解答

墨尔本根管治疗专家:阳光微笑牙科中心是墨尔本最大的连锁经营的牙医专科门诊之一,也是由华人控股的最大的牙医联合集团。

拨打中文尊享咨询热线:+61 0404 081 777,3CW 主讲牙医24/7为您在线答疑!

 

根管治疗是否适合您?

您是否有以下症状?

  • 牙齿持续对冷热敏感
  • 咀嚼或咬合时的牙痛
  • 隐痛
  • 自发性疼痛
  • 搏动性或跳动性疼痛
  • 让您晚上醒来的疼痛
  • 牙龈上的水泡或疙瘩,挤压时会出现脓液或血(大多情况下不会疼痛)
  • 在补牙或更换补牙后持续4至6周的牙痛
  • 可能延伸至耳朵、眼睛或颈部的慢行疼痛与/或压迫感
  • 牙齿松动
  • 出现比其他牙齿更明显、更持续的敏感
  • 牙医会通过临床检查或X光片来诊断您是否需要进行根管治疗。

如果您出现以上的任何症状,您很有可能需要根管治疗。

想要进行检查,请联系我们

请注意,并不是所有需要根管治疗的牙齿都会引起牙痛。有些牙齿并未造成牙痛,但仍需要进行根管治疗。

什么是根管治疗?

根管是“业外人士”称牙髓治疗或根管治疗的名称。通常,细菌进入被称作牙髓(“神经”)的牙齿中心,牙齿内部的神经受到不可逆地损伤或感染,因而根管治疗十分必要。根管治疗包括去除整个神经系统、清洗、塑形并使用牙胶与牙科封闭剂填充三维根管系统。

澳洲专业牙医的扎实理论知识和极强的职业责任心,都让整套根管治疗进行的非常严谨专业。阳光微笑牙医团队并不是有意厚此薄彼想自吹自擂,只是确实在看过很多曾在国内做过根管治疗却又复发的患者的X光片,都让我们感到无比无奈。大部分病患的牙根管并没有被完全清理干净,有些甚至只清理了一半,而剩下的深部份则还在继续恶化;还有些病患的牙胶填充、封闭做得不到位导致术后继续感染等等。 

什么是牙胶填充?

牙胶是一种俗称“梅泽木”的树木分泌液的提纯凝结物,产自马来西亚群岛。该物质类似于橡胶树分泌物,通过加工可制成牙印模胶。这是唯一一种经ADA批准的可用于根管填充的物质。

牙髓咨询中会有哪些事宜?

医师会查看您过去的牙科治疗史与病史。即使您已在推荐牙医那里拍摄了X光片,您仍需拍摄牙科X光片。不同的X射线角度对呈现可能出现的问题来说是必要的,如龋齿或脓肿。此外,医师还会在多颗牙齿上进行一系列的测试,如冷热反应、咬合、叩诊(轻敲)等。通过这些测试,牙医试图重现您的症状,从而作出正确诊断,并判断您是否需要根管治疗。

牙髓如何受到损伤或感染?

牙髓损伤或感染由细菌感染引起。细菌是存在于口腔与唾液中的正常宿主,但当细菌进入牙齿内部并进入牙髓中(通过龋齿、牙齿断裂、老补牙材料损坏、牙间缝隙或已存在的牙冠),则会产生病理变化,但时间长短因人而异。有些情况下,牙髓病会发生的十分快,且十分疼痛。但有些时候,牙髓病不知不觉地缓慢发展,患者并未感到显著疼痛,直到该病严重恶化。

根管治疗过程是否疼痛?

通常不会。在现代科技与局部麻醉技术的帮助下,手术过程通常是无痛的,且进行得十分快。全科牙医使用的简单麻醉技术将会用于根管治疗中,其最大的不同则是麻醉量。牙医通常会使用更深层次的麻醉来使该治疗变得无痛。在许多情况下,患者不会感到任何疼痛。为了减轻术后的正常不适感,牙医会建议您在治疗后的几天内服用止痛药。

根管治疗会需要多长时间?

根据牙齿情况、牙根数量、病牙的当前情况、可及性、牙本质管、预约时间的不同,根管治疗可通过一次、两次或多次就诊完成。每次就诊或预约从不到一小时至超过两小时不等。

什么是脓肿?

脓肿是组织或体腔内的局限性脓液(感染)积聚。

每个牙床脓肿都会疼吗?

不。有些脓肿的牙齿会是无痛的,通常由牙医通过牙科X光片与口腔检查中无意发现诊断的。在可能的情况下,牙医会推荐患者进行根管治疗。

如果感染的牙髓未经治疗会怎么样?

如果感染等牙髓未经治疗,感染会继续发展,从牙髓延伸至周围组织,如牙根、骨骼、牙龈等。继续发展的感染可容易地影响面部组织,患者的面部会出现肿胀的症状。如果仍旧不及时治疗,此类情况会危及生命。

什么是蜂窝组织炎?

蜂窝组织炎是一种通过结缔组织传播的疼痛炎症,主要症状为肿胀与浮肿。该病通常与细菌感染有关。

经过根管治疗的牙齿会变色吗?

不会。通过手术过程中使用的新型材料与现代科技,您的牙齿在治疗后不会变色。如果您的牙齿经过了不良的根管治疗术且已变色,您最好让牙医进行检查,因为细菌也许已进入老的补牙填充物,您或许需要重新补牙了。

根管治疗包括什么?

在牙齿麻醉后,牙医会为您戴上橡皮障。之后,牙医会从牙齿(后牙)咬合面或舌面(前牙)钻开一个小洞,从而进入牙髓腔。牙医通过使用根管锉手动去除牙神经。通过使用一些手持器械与/或机械仪器,交替注入不同根管冲洗剂,牙根管将会被彻底清洗。当牙根管被充分塑形后,牙医将会用牙胶与牙髓封闭剂填补牙齿,并使用临时填充材料封好牙齿上的钻洞。

根管治疗后的随访护理包括什么?

请您避免使用该牙咀嚼食物。当您按压或触摸该牙时,很有可能感到压痛与敏感。当您喝冷或热的饮品时,您不应该有任何不适感。请您遵循医嘱服药,如止痛药和消炎药。服用任何一种药或两种同时服用,通常会减轻术后的不适感。如果最初服药后无法控制您的疼痛,请联系您的牙医。有时您需要服用药效更强的止痛药和/或消炎药。最终,当该牙不会有任何痛感时,您必须要预约全科牙医进行必要的牙冠修复治疗。最后一项步骤十分重要,应该在根管治疗完成后立即进行。

每次根管治疗后都需要服用抗生素吗?

不总是。现如今我们在确定是否需要抗生素方面持保守态度。牙医一般会根据您的个人情况、牙齿的情况来决定您是否需要服用抗生素。通常,如果您有肿胀、发烧、普通不适感(不舒服)和/或淋巴结压痛,医师会为您开具抗生素。普通的牙痛,包括与小型局部感染或脓肿有关,也并不一定需要抗生素。因为很多牙科问题都可以通过治疗解决,医师无法以预防为目的开出抗生素。

根管治疗后我会有什么感觉?

大多情况下,根管治疗后的痛感会在24至48小时内逐渐消退。在患者完成根管治疗的第一阶段后,任何对冷、热、吸气时的敏感都会消失。不过,您在术后的几天内仍会感到轻度到中度疼痛。服用非处方药通常会缓解疼痛,如阿司匹林、艾德维尔、布洛芬或萘普生。研究证明泰勒诺没有阿司匹林等药物有效,因为泰勒诺不像其他药物含有抗炎成分。大多患者在术后反应触摸、咬合、轻敲该牙或用其咀嚼时有压痛感。医师会建议您在该牙永久修复前避免以上活动。您应给予自己两至四周的全面恢复时间。

如果术后我的牙齿不再疼痛,我可以使用该牙咀嚼吗?

医师不建议患者在根管治疗后立即使用该牙咀嚼。大多数情况下,该牙会有压痛感。但即使使用该牙咀嚼时未有痛感,您也应该在牙医为其安装修复牙冠前避免用其咀嚼。您越早去看全科牙医,您的牙齿就越早地可以恢复正常功能。

在根管治疗后,我应该等待多久去看全科牙医?

根管治疗后,除非有特殊医嘱,您应在该牙齿的不适感消失后立即去看全科牙医(通常是两至四周内)。在此期间,为了保护剩下的牙齿结构,全科牙医为您进行的永久性修复(特别是牙冠)十分重要。在永久性修复治疗前,请不要使用该牙咀嚼。

如果我未在推荐期内进行永久性牙冠修复会怎么样?

如果剩下的牙齿结构未能适当地被永久性覆盖、保护,该牙可能会断裂且无法修复。唾液中的细菌与食物残渣可能会进入牙齿表面与临时填充物中,破坏根管治疗的效果,导致治疗失败。如果感染再次发生,根管治疗需再次进行(根管再治疗)。如果情况严重,您应考虑将该牙拔除。

根管治疗相对于拔牙术,有哪些好处?

根管治疗最重要的好处就是保存您自己的牙齿,而拔牙可能会引发其他口腔问题,如牙齿移位、咬合问题、颌骨关节疼痛,您可能需要治疗邻牙或进行其他牙科治疗来修复缺牙。

根管治疗的成功率有多大?

如果根管治疗由受过培训、技术过硬的专业人士来完成,该治疗的成功率会很高。根管治疗的成功取决于医生的专业技能,以及患者是否遵循医嘱立即为该牙进行永久性修复。

如果补牙填充下已经敷药,该牙仍旧对热和/或冷敏感,我应该怎么办?

如果牙齿持续地对热和/或冷敏感,通常表明该牙的神经已出现不可逆的发炎,您可能需要进行根管治疗。牙医或牙髓病医生的必要及时关注可预防剧痛与脓肿的发生。

什么是吸收?

吸收是一种与骨质、牙骨质和/或牙本质流失有关的生理或病理状态。不同类型的吸收包括外吸收、内吸收、炎性吸收、替代性与表面吸收。吸收的变因不明,虽然通常被认为与创伤有关。

  • 外吸收: 病理过程起于影响牙齿外表面的牙周组织。外吸收可根据部位进一步分为:牙颈、侧面或根尖吸收,或根据类型分为:表面、炎性或替代性吸收。
  • 内吸收: 病理过程由牙髓内部的牙本质损失引起,有时伴随着牙骨质的损失。此类内吸收可能会或不会穿过牙根外表面。
  • 炎性吸收: 牙根部的骨质、牙骨质与牙本质的病理性流失。
  • 替代性吸收:被称为关节僵硬,是一种牙骨质、牙本质与牙周韧带的病理性流失,同时伴随着牙齿表面的骨质生长与融合。失去生理机动性十分常见。
  • 表面吸收: 引起牙骨质与牙本质内小型表面损坏的生理条件,通常可由损坏内的新牙骨质的堆积作用进行自我修复。

什么是根尖切除术?

这是一种针对接受过根管治疗牙齿的牙髓微型手术,其目的是去除牙根尖部的持续感染,防止细菌再次进入。该手术还可检查牙根折断的可能性。

为什么在根管治疗中要使用橡皮障?

使用橡皮障的目的是防止患者在根管治疗过程中吞入所用的小型器具,在手术过程中保持牙齿清洁干燥。因医疗/法律原因,医护人员需要使用橡皮障来保护患者安全。

什么是根管再治疗?

“再治疗” 一词用于描述根管治疗需要重新进行。根管再治疗是由口腔细菌再次进入牙齿而引起的,大多是由龋齿造成的。患者可能会在咬合时感到疼痛,或出现肿胀现象。有时患者也许并未出现任何症状,而牙医通过X光片看到根管区域未愈合,并会建议患者咨询根管治疗医生。

什么是牙齿漂白?

漂白诊疗用于提升变黑变暗的牙齿颜色。漂白技术包括两种不同的方法,内漂白与外漂白:

  • 内漂白: 医师可以在接受过根管治疗的牙齿上进行无髓牙(内)漂白术。将化学氧化剂涂于牙冠部分内来去除牙齿着色。根据牙齿的着色情况,这项诊疗可以通过在诊所内的一或两次预约中完成。该诊疗还被称作“诊室漂白”,医师将漂白药物涂于牙齿内部,一段时间后再清除。另一种方法被称为“诊间漂白”,是将漂白药物涂于牙齿内部,在其中保持几天。这些诊疗一般由牙髓病医生进行。
  • 外漂白: 外漂白:活髓牙(外)漂白术是一项由全科牙医在牙齿外部、活髓牙或未接受过根管治疗的牙齿上进行的诊疗。外漂白术包括不同疗法,如激光或化学药剂(30%过氧化氢与过氧化脲)。该诊疗中,医师通常需要取牙印模,制作可以盛药剂的牙齿托盘。患者需要每天几个小时或睡觉时戴着该托盘。其他方法无需托盘,但会使用漂白带。

根管治疗后,麻醉感会维持多久?

术后麻醉感会持续几个小时。在局部麻醉感未完全消失前,您最好避免咀嚼食物,防止意外咬伤嘴唇、脸颊或舌头。您可以在术后使用吸管或饮用饮品。

我可以在根管治疗后去上班吗?

可以。大部分患者可以在根管治疗后回去上班。您可以在接受治疗后减轻安排并适当休息。

在接受根管治疗后,我为什么还可以感受到该牙齿?我以为那颗牙齿已经死了。

接受过根管治疗的牙齿并没有“死”,它仍旧“活着”,是您身体的活体部分。存在于颌骨的神经末梢处于牙齿底部,还有一些神经连接颌骨与牙齿。这就是为什么您在根管治疗后仍就可以感受到该牙齿的原因了。


Root Canal Treatment FAQs

Is a root canal for you?

Do you have any of the following symptoms?

  • Sensitivity to hot or cold that lingers
  • Pain when chewing or biting
  • Dull ache
  • Spontaneous pain
  • Throbbing or pulsing pain
  • Pain that wakes you up at night
  • A bubble or pimple on your gum that when pressed may release pus or blood (most likely, not painful)
  • Pain that persists four to six weeks following a filling or replacement of a filling
  • Chronic pain and/or pressure that may extend to the ear, eye or neck
  • A tooth that feels loose
  • One tooth is distinctly and consistently more sensitive than the other teeth
  • Your dentist has diagnosed the need for root canal therapy, either by clinical exam or x-ray

If you answered yes to any of the above, you might very well need a root canal.

Please call and schedule for an evaluation.

Be aware not all teeth that ARE in need of root canal therapy will cause pain. It is possible to be pain-free and still need a root canal.

What is Endodontics?

It is a branch of dentistry that deals with the cause, prevention, diagnosis and treatment of diseases of the human dental pulp and the surrounding tissues.

What is the Dental Pulp?

It is what we commonly know as the “nerve” of the tooth. It is a soft connective tissue that is highly vascularised (tiny blood and lymph vessels), and innervated (nerve fibers). It is located inside the dentin of the tooth in the pulp chamber. Its main function is formative, nutritive and sensory.

What is a Root Canal?

ROOT CANAL is a “lay persons” term for endodontic therapy or root canal therapy. Root canal therapy is necessary when the nerve inside the tooth becomes irreversibly damaged or infected. This is usually due to the entry of bacteria into the center most part of the tooth called the dental pulp (“nerve”). Root canal therapy involves the removal of the entire nerve system, as well as cleaning, shaping and filling 3-dimensionally the canal system with gutta-percha and a dental sealer.

What is Gutta-Percha?

Gutta-percha is the purified coagulated exudate from a tree, commonly called the “mazer wood” tree, of the Malaysian archipelagos. The substance is similar to that of the rubber tree, which is then processed to obtain the dental compound. This is the only ADA approved material to be used as a filling in root canals.

What Happens at an Endodontic Consultation?

Your doctor will review your past dental and medical history. A dental x-ray will be taken even if you have one from your referring dentist. Different x-ray angles are necessary to reveal possible problems such as decay or an abscess. Also, a series of test, such as hot, cold, biting and percussion (tapping) can be performed on several teeth. Through these tests the dentist will attempt to reproduce your symptoms that will enable him/her to make a proper diagnosis and decide if you do, or do not, need a root canal.

How Does the Dental Pulp Become Damaged or Infected?

The reason is bacterial contamination. Bacteria are a normal host present in the mouth and saliva, but when it gets inside the tooth and enters the pulp (through decay, or a fracture in the tooth, broken down old filling, or a gap between your tooth and an existing crown), then it becomes pathologic. The time frame for this to occur can vary significantly. Sometimes it is very fast and usually painful, but also, it could be a very slow process in which the patient is unaware and no pain is manifested until it is significantly advanced.

Is the Root Canal Procedure Painful?

Usually not. With modern technology and local anaesthetics, the procedure is usually much faster and more painless than it has ever been. A similar anaesthetic, as the one used in the general dentist office, will be used for a root canal. The main difference is the quantity. A deeper level of anaesthesia is necessary for this procedure to be painless. In many occasions, it can be a completely pain-free procedure. Painkillers are usually recommended for a few days after treatment, in order to control normal post-treatment discomfort.

How Much Time Will A Root Canal Take?

Root canals can be done in one, two or multiple appointments, depending on the tooth, how many roots there are, the current conditions of the tooth, the accessibility to area, the canals, and time available. Each visit or appointment can take from under 1 hour, to over 2 hours.

What is an Abscess?

An abscess is a localized collection of pus (infection) within a tissue or a confined space.

Does Every Abscessed Tooth Hurt?

No. Some abscessed teeth can be pain-free, which are most commonly found and diagnosed accidentally by a dentist, usually through a dental x-ray and exam. Whenever possible, the recommended treatment is a root canal.

What Happens When an Infected Dental Pulp is not Treated?

The infection will continue its progress, extending from the confines of the dental pulp and involving the surrounding tissues, such as the root, the bone, the gums etc. A progressing infection could easily involve facial spaces and the patient would then start observing swelling of the face. Such condition could become life threatening if left unattended.

What is a Cellulitis?

Cellulitis is a painful inflammatory process that spreads through the connective tissue and is characterized by swelling and oedema. It is usually associated with a bacterial infection.

Will My Tooth Discolor After Root Canal Treatment?

No, with all the new materials and modern technology used during the procedure, your tooth should not discolor after the treatment. If you have a tooth that has had a root canal and it has discolored, it is best to have your dentist take a look. It may be that germs (bacteria) have penetrated underneath the old filling, and it is time for a new one.

What is involved in a Root Canal Procedure?

After the tooth is properly numbed, a rubber dam will be placed, and then the dentist will open a small cavity on the chewing surface (back tooth) or the back of the tooth (front tooth), to get into the nerve chamber. The nerve will be manually removed using small dental instruments called files. The canal(s) will then be completely cleansed using some hand and/or mechanical instruments, alternating with different irrigants. Once the canals are adequately shaped, then they will be filled with gutta-percha and an endodontic sealer. The small cavity on the tooth will then be closed with a temporary filling material.

What Follow-Up Care is Involved in a Root Canal Procedure?

Avoid chewing on the tooth. It will most likely feel very tender and sensitive to pressure or touch. There should not be any discomfort upon drinking hot or cold fluids. Follow any instructions given by your dentist in reference to drugs such as painkillers and anti-inflammatories. Any of these, or the combination of them, usually provide excellent results to alleviate the normal post-treatment discomfort. If your pain does not respond to the initial medicine, then you should call your dentist. Sometimes, there will be a need for stronger painkillers and/or antibiotics. Finally, once your tooth is pain free, you must see your general dentist who will complete the necessary dental reconstruction of the crown. This last item is very important and should happen as soon as possible after completion of the root canal.

Do I Need to Take Antibiotics Every Time a Root Canal is Done?

Not always, today we are very conservative in determining the need for an antibiotic. It is usually determined by the dentist on an individual basis, per case, per tooth. Usually, if there are systemic signs and symptoms such as swelling, fever, generalized sense of malaise (ill feeling), and/or lymph node tenderness, then an antibiotic will be prescribed. The common toothache even when it is associated with a minor localized infection or abscess will not automatically require an antibiotic. Since a high number of cases will respond favourably to the dental treatment, antibiotics are not prescribed on a preventive basis.

Will I Feel Anything After Root Canal Treatment?

In most cases the quantity and quality of pain will subside dramatically within the first 24-48 hours. Any sensitivity to cold, hot or even breathing air “in” will be gone after the first visit. Nevertheless, you will experience mild to moderate pain that will last for several days after treatment. This pain is usually relieved by taking over the counter medications such as aspirin, Advil, Motrin, or Aleve. Tylenol has been proven not to be as effective as aspirin, etc., because it does not have the anti-inflammatory component as these other medications. The most common complaint is tenderness to touch, bite, tapping or chewing on the tooth. It is recommended to refrain from any of the above until your tooth is permanently restored. You should realistically give yourself 2-4 weeks to fully recover.

Since Treatment Was Done, My Tooth No Longer Hurts. May I Start Chewing On It?

It is not recommended to start chewing on the tooth immediately after the root canal treatment. Most times it will be very tender, but even if it is not painful to chew, you should avoid chewing on it until the crown of the tooth is properly restored (repaired) by your regular dentist. The sooner you see your regular dentist; the sooner you will be able to re-start normal function on the tooth.

How Long Should I Wait to See My Regular Dentist After the Root Canal is Performed?

Unless otherwise directed, you should see your regular dentist as soon as your treated tooth feels comfortable (about 2-4 weeks). It is very important to see your regular dentist at that time to have a permanent restoration (typically a crown) placed in order to protect the remaining tooth structure. Until the permanent restoration is in place, do not chew on the treated tooth.

What Happens if I Wait Longer Than Recommended to Get the Crown of the Tooth Permanently Repaired?

If the remaining tooth structure is not properly and permanently covered and protected, your tooth could fracture and not be salvageable at all. The bacteria in saliva, as well as food debris, can go between the temporary filling and the tooth surface and contaminate the root canal treatment. This may cause treatment failure. If a re-infection occurs, often, another root canal treatment will need to be done (endodontic retreatment). If the damage is very extensive, extraction should be considered.

What are the Benefits of Root Canal Therapy Versus Extraction?

The single most important benefit of root canal therapy is that you keep your tooth. Extraction may lead to other dental problems. For instance, drifting of teeth, bite problems, TMJ pain, and the need to treat adjacent teeth that do not otherwise need dental treatment in order to restore the missing tooth.

How successful are Root Canals?

Root canal treatment has a high degree of success if done properly by a trained skilled professional. The success of root canal therapy is equally dependent upon the technical skill of the doctor, as well as the follow through of the patient, to have the tooth immediately restored.

What Should I Do if a Medicated Dressing was Placed Under My Filling and it is Still Sensitive to Heat and/or Cold?

Sensitivity to hot and/or cold, which persists, usually indicates that the nerve of the tooth is irreversibly inflamed. The indicated treatment is Root Canal Therapy. Immediate attention by your dentist or endodontist is necessary to prevent severe pain and abscess.

What is Resorption?

Resorption is a physiologic or pathologic condition associated with loss of bone, cementum and/or dentin. There are different types of resorption such as external, internal, inflammatory, replacement and surface. Its etiology is unknown, even though it commonly is associated with trauma.

  • EXTERNAL: a pathologic process that initiates from the periodontium affecting the external surface of the tooth. Can be further classified by location: cervical, lateral or apical. Or type: surface, inflammatory or replacement.
  • INTERNAL: a pathologic condition that initiates within the pulp causing loss of dentin and sometimes, cementum. It may or may not perforate the external root surface.
  • INFLAMMATORY: a pathologic loss of bone, cementum and dentin in the root.
  • REPLACEMENT: Also known as ankylosis, it is a pathologic loss of cementum, dentin and periodontal ligament with simultaneous ingrowth and fusion of bone to the tooth surface. A loss of the physiologic mobility is common.
  • SURFACE: a physiologic condition causing small surface defects in the cementum and dentin that are usually self-repaired by deposition of new cementum in the defect.

What is an Apicoectomy?

This is an endodontic micro-surgical procedure for a tooth that has had a root canal. The purpose is to remove persistent infection at the end of a root and seal the root end to prevent re-entry of bacteria. This procedure also provides the opportunity to detect possible root fractures.

Why is a Rubber Dam Used During Root Canal Treatment?

The purpose of a rubber dam is to protect the patient from swallowing the small instruments used during root canal treatment and to keep the tooth clean and dry during the procedure. It is for medical/legal reasons that a rubber dam is used for patient safety.

What is Endodontic Retreatment?

Retreatment is a term used to describe a procedure when a root canal has to be redone. The reason for retreatment is because germs or bacteria in the mouth have re-entered the tooth, usually due to decay. A patient may experience pain to biting or swelling. Sometimes, a patient may have no symptoms and your dentist sees something on the x-ray that shows a root canal has not healed and advises a patient to see a root canal specialist for an evaluation.

What is Bleaching?

This procedure is used to lighten a darkly discolored tooth. There are two very different types of bleaching, internal and external:

  • INTERNAL: Non-vital (Internal) bleaching is performed in teeth that have had root canal therapy. A chemical oxidizing agent is placed within the coronal portion of a tooth to remove tooth discoloration. It may be performed at the dentist’s office in one or more appointments, depending upon the discoloration of the tooth. When bleach crystals are place inside the tooth and after then removed after a period of time, the procedure is known as “chair side bleach.” Another method is when bleach crystals are placed inside the tooth and are left for several days inside the tooth. This is called “walking bleach.” An endodontist commonly performs these procedures.
  • EXTERNAL: Vital (External) bleaching is a similar procedure performed by a general dentist on the outside of a tooth or teeth with vital pulps; teeth that have not had root canal therapy. There are different methods for this procedure, such as lasers, or chemical agents (30% hydrogen peroxide and urea peroxide). The procedure often involves taking an impression of your teeth and the fabrication of a tray that will hold the bleaching agent. The patient wears this tray several hours each day or at night while sleeping. Other methods do not involve trays, but rather bleaching strips.

How Long Will I Be Numb After Root Canal Treatment?

The numbness will last for several hours after your treatment. It is best to avoid chewing until the local anesthesia has completely disappeared to prevent accidentally biting your lip, cheek, or tongue. It is okay to drink or to use a straw to have liquids after treatment.

Will I Be Able to Return to Work After Root Canal Treatment?

Yes. Most patients return to work after root canal treatment. They may keep a light schedule and plan to get rest during the days that follow treatment.

Why Do I Still Feel My Tooth if I Had Root Canal Therapy? I Thought My Tooth Was Dead.

A tooth that has had a root canal is not “dead”. It is still considered a “live” or vital part of your body. There are nerve endings that are present in the jawbone underneath the tooth, as well as nerves that attach from the jawbone to the tooth. This is why there is still feeling in a tooth that has had root canal therapy.