Treatments

Dr. Ettrich can provide several treatment options to save your natural teeth. The procedures available range from non-surgical root canal treatment to surgical methods. He also treats teeth that have had trauma and have not properly formed. Utilizing modern techniques and materials, Dr. Ettrich strives to provide his patients with the highest quality of endodontic care.

Consultation

Your initial appointment will consist of an exam and diagnostic radiographic images to determine the cause of your discomfort. Afterwards, Dr. Ettrich will discuss your diagnosis and treatment options. Routine root canal therapy can typically be performed on the same day as the consultation. It is common in our practice to see emergency patients who present with discomfort or infection. We will attempt to accommodate emergency patients as soon as possible, usually on the same day.

Please provide the following information at the time of your consultation:

  • Your referral slip and X-rays if applicable
  • A list of the medications and dosage you are currently taking
  • If you have dental insurance, please bring the necessary information for us to file your claim. For your co-payment convenience, we accept cash, Visa, MasterCard and Discover.

Non Surgical Root Canal

Why do I need a root canal? At the center of your tooth is pulp. Pulp is a collection of blood vessels and nerve tissue that helps to form the surrounding tooth. A root canal is indicated when bacteria infects the pulp tissue. Infection of the pulp can occur by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury and/or swelling of the tooth, sensitivity to temperature, or pain in the tooth and gums. Root canal treatment can be performed to save your natural tooth.

How is a root canal performed? If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. The injured pulp is removed and the root canal system is thoroughly cleaned and sealed. A filling will be placed in the root canal system to create a seal. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 95% of cases.

What happens after treatment? When your root canal therapy has been completed, a temporary restoration will be placed in the tooth. We will contact your dentist and send a record of your treatment to their office. We recommend that you contact your dentist to schedule an appointment within thirty days for permanent restoration placement.

Non Surgical Root Canal Retreatment

With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.

Improper healing may be caused by:

  • Untreated or complicated canals that were not detected during the initial treatment.
  • A permanent crown or restoration was not placed within the appropriate amount of time following the procedure, allowing for reinfection of the root canal system.
  • A poorly fitted crown or restoration that did not prevent bacteria from contaminating the inside of the tooth.

In some cases, new problems can influence a tooth that was successfully treated:

  • New decay can expose the root canal filling material, causing loss of the endodontic seal.
  • A cracked or loose filling or crown can expose the tooth to new infection.

How is a root canal retreated? Non-surgical retreatment of a root canal is performed in a similar manner as initial treatment. The existing material will be removed, and the canals will be cleaned, shaped and disinfected. Once cleaned, your endodontist will fill and seal the canals and place a temporary filling in the tooth.

What happens after retreatment? When your root canal therapy has been completed, a temporary restoration will be placed in the tooth. We will contact your dentist and send a record of your treatment to their office. We recommend that you contact your dentist to schedule an appointment within thirty days for permanent restoration placement.

Endodontic Surgery/Apicoectomy

Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicoectomy.

Surgery can help save your tooth in a variety of situations.

  • Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
  • Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
  • Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
  • Surgery may also be performed to treat damaged root surfaces or surrounding bone.

What is an apicoectomy? In this procedure, the endodontist opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.

Removal of inflamed or infected tissue

A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gums to help the tissue heal properly.

Root-end filled and gum sutured

Over a period of months, the bone heals around the end of the root.

Healed apicoectomy

What are the alternatives to endodontic surgery? Often, the only alternative to surgery is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most biologic and cost-effective option for maintaining your oral health.

No matter how effective modern artificial tooth replacements are—and they can be very effective—nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for the rest of your life.