First lets look at what a healthy tooth looks like and how it works:

The tooth is made up of 2 hard tissues the Dentin and the Enamel. The enamel is a rock hard outer shell of the tooth.  It is a transparent-whitish tissue that is 95% crystal and 5% collagen. Enamel is the hardest tissue in our bodies and is designed to withstand the abrasive nature of chewing.  Dentin makes up the inner core of the tooth as well as the roots.  Dentin is 50% crystal / 50% collagen and is a firm, flexible tissue similar to bone, but much denser.  It is made up of millions of microscopic tunnels where tiny extensions of the nerve reside. That is why exposed dentin is “sensitive”.  Inside the dentin core and the roots is the Pulp.  It is composed of blood vessels, which nourish the tooth, and the nerve that gives sensation to the tooth.  Blood vessels and the nerve enter an exit the tooth trough a pin-sized hole at the tip of the root.  The nerves in our teeth have only one “feeling” PAIN!

Why do teeth “die”?

The pulp lives inside the tooth, which can be thought of as a “hollow rock”.  Its only entry and exist is a pin-sized hole at the tip of the root.  Anything that cause pulp inflammation caused the nerve to hurt.  Inflammation causes swelling and as the tissue inside the tooth expands it has no-where to go.  Given enough time or enough swelling the nerves and blood vessels inside the tooth become crushed or asphyxiated, eventually leading to nerve death.  The nerve can deal with a little inflammation as when eating something very cold or hot, or a minor tap on the tooth.  However, trauma, deep decay, improperly placed fillings or crowns and cracks in teeth can all lead to irreversible pulp inflammation and eventual nerve death.  This is a very painful process!

How do teeth die?

When the pulp is inflamed and the inflammation is constant the nerve begins to die.  This is often a very painful process. The pain is described as bad as the worst earache and worse that childbirth! Eventually after several days or weeks the nerve dies and the pain goes away.  If you have been taking pain medicine to mask the pain and wait it out until the pain goes away, you may think everything is OK!  Unfortunately, the tissue inside the tooth is silently decomposing. This is called Tissue Necrosis or Putrification.  The tissue first liquefies, and then gas is released. This gas eventually begins to put pressure on the one exit: the pin–sized hole at the tip of the root.  At this point pain to HOT foods or drinks is felt because the heat expands the gas, putting more pressure on the bone surrounding the tooth.  The gas pressure causes the bone surrounding the root to liquefy or necrose, causing an abscess.  If there is bacteria present in the tooth form a cavity, a tooth crack or poorly fitted filling or crown an infection follows.  This infection can spread to the face and in rare instances to the brain.  People have actually died form untreated tooth infection!

What is Root Canal Therapy?

Root Canal Therapy is the careful removal of the sick pulp from the center of the tooth and the roots, followed by disinfection and sealing of the empty space that once housed the pulp.  Sounds simple? Well its not. Root canal treatment is one of the most complicated dental procedures. In fact, a Dental Specialty has been developed so that some dentists can focus their full attention and careers at performing Root Canal Treatment.  These dentist as called Endodontists. 

Why an Endodontist?

Endodontists have advanced training in Root Canal Therapy as well as root canal surgery, called Apicoectomy.  They undergo 2 additional years of post-doctorate education and training. Root Canal Specialists spend their entire careers performing root canal treatment.  Today, with modern technology such as the dental microscope, ultrasonics, advanced disinfection procedures, improved sealing techniques and new cements, root canal therapy can be 95-97% successful. Although some general dentists perform root canal treatment, we recommend that all root canal treatment is performed by a modern-trained Endodontist.   After all, do you really want to have your root canal treatment done more than once?

Treatment Challenges:  Root Canal Treatment success in the hands of a well trained Root Canal Specialist can be in the high ninety percentile.  Nevertheless, here are some challanges or complications that some teeth may present:

Dr. Jeffrey Etess

Dr. Etess is an Micro Neuro-Vascular Endodontic Surgeon, commmonly known as a Root Canal Specialist.  Our office is very fortunate to have Dr. Etess as part of our staff.  He is trained in advanced root canal treatment techniques and uses the Dental Surgical Microscope and Lasers to help him achieve optimal treatment outcomes. Dr Etess shares our office philosophy and is dedicated to patient comfort and exceptional dental care.

Dr. Shvartsman is so confident in Dr. Etess that he had his own root canal treatment done by him!

For a consultation or a second opinion please call (631)361-3577