Consider These Root Canal Alternatives
The mere mention of a root canal is enough to strike fear in hearts of even the bravest of dental patients. The procedure is often perceived as difficult and painful, and even though this reputation might be undeserved, the truth is some would do almost anything to avoid a root canal.
Root canals are done to save a tooth that is badly decayed or infected. The pulp and the nerve of the affected tooth are removed, and the canal is cleaned and sealed. But in some cases, a root canal alternative is a viable option for patients hoping to avoid the trauma of a root canal procedure.
Resin Direct Pulp Cap
“It’s a common assumption that once infection gets all the way down to the nerve, there is probably infection of the nerve, and the tooth will probably die,” says Michael Teitelbaum, DMD, a cosmetic dentist at Briarcliff Center for Esthetic Dentistry in Briarcliff, NY. But if the cavity has just barely reached the nerve, and the nerve is still alive and not infected, Dr. Teitelbaum says a direct pulp cap is a procedure that often works very well.
Direct pulp capping is a root canal alternative technique Teitelbaum has been using since 1991 with a better than 90 percent success rate. The procedure involves cleaning out the bacteria from the cavity and covering it tightly with a resin seal. The nerve and pulp are left in place, but prior to sealing, the nerve is tested to ensure it’s still viable.
The procedure works for all sizes of cavities, even very large ones, as long as the nerve is still alive and has not been infected. It’s typically no worse than a regular filling and is appropriate for patients of all ages. “I have done it on patients as young as 2 years old and the oldest patient I’ve performed the procedure on was in her mid-eighties,” says Teitelbaum.
Opting for direct pulp capping instead of a root canal is not only less traumatic for patients, but it can save both time and money. “It’s much faster than a root canal because many times that procedure requires two, three, even four visits, and can end up costing as much as seven to 10 times more,” Teitelbaum says.
For a direct pulp capping procedure to be successful, it requires the use of modern bonding material and a proper seal. Teitelbaum, a direct pulp-capping expert who presents lectures on the topic around the country, says there’s no room for error. “You have to have a hermetic seal, and it really has to be perfect.” When done correctly, pulp caps can last for years.
Patients interested in direct pulp capping, should talk to their dentist before they actually need the procedure. Only a few dentists offer it and waiting until pain, swelling or other symptoms begin may mean it’s too late.
Laser Nerve Treatment
The use of lasers is becoming more common in the field of dentistry. The Academy of Laser Dentistry says the use of lasers can reduce the need for anesthesia and minimize bleeding. But for patients who experience dental anxiety, the biggest advantage may be the absence of the high-pitched squeal made by dental drills.
Some dentists are performing laser root canal procedures as a traditional root canal alternative. A statement by the American Association of Endodontists acknowledges there are both advantages and disadvantages to using laser energy for root canals. Laser sterilization of the canal and removal of dead or infected tissue is effective as long as the root canal space is straight, but in most cases there are curved shoots and branches off the main nerve root. Since laser probes are glass and cannot be bent to follow the curves, disinfection of those areas difficult.
There is also concern that high temperatures associated with laser energy and tissue interactions can lead to soft tissue or bone damage. But advocates of laser root canal say it provides superior disinfection and is less harmful to patients than chemical cleaning of the tooth root canal.
The goal of dental treatment is to save the natural teeth whenever possible, but if a tooth becomes infected and a root canal or root canal alternative is not done, the only solution is removal of the affected tooth.
A missing tooth can lead to problems with the bite and affect your ability to chew or speak. It can also cause surrounding teeth to drift and move. Any tooth extraction should be followed by placement of a bridge, dental implant or partial dentures to prevent complication.
Tooth roots are softer and more prone to decay than teeth, which are protected by the harder enamel. Most people over 50 have tooth-root decay, according to the American Dental Association. Regular brushing and flossing, eating a healthy diet and scheduling periodic dental checkups and cleanings are the best way to prevent tooth decay and abscess.