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Q. Are dental x-rays safe?


What does an x-ray do here?

The basic function of a dental x-ray is to provide your doctor important information about your health, so that an accurate diagnosis can be made.

How does it help your doctor?

For a dentist, an x-ray makes it easier to know whether they are:

  • dealing with a cavity,
  • periodontal disease,
  • an infection or something else.

An x-ray makes it possible to see inside your teeth and behind your gums, thus helping the dentist find out the disease before it gets too advanced. Since it helps in early detection of such diseases, it helps prevent more pain and discomfort for you.

Does it cause any damage?

As for any damage, exposure to radiation from sources like the sun, the appliances in your home and dental X-rays are capable of damaging the body’s tissues and cells, leading to the development of cancer.

Should you be worried?

The dose of radiation you are subjected to during a dental x-ray is small enough to be harmless. Lead-lined and full-bodied aprons are used to make it even safer.

Q. How is an endodontist different from a general dentist?


Who is an endodontist?

An endodontist is a dentist, but with a specialization in certain areas like root canal treatment, finding out the cause of oral and/or facial pain and relieving it and preserving natural teeth.

How do they work?

  • Endodontists generally employ a microscope to be able to see clearly the area between the teeth.
  • Such levels of magnification allow them to find and clean nerve canals and cracks that would have been harder to locate otherwise.
  • Microscopes are much more advanced than the binocular-like magnifiers used by other dentists, which are known as dental loupes.

Q. What exactly is root canal therapy?

Root canal therapy involves three steps

  • removing the nerve that may be inflamed or infected,
  • cleaning and shaping the nerve canals of the root of the teeth
  • going ahead and sealing the space which has been prepared while doing this.

How long does it take?

It depends on the number of canals, but most treatments are completed within two sessions ranging from thirty to ninety minutes each. After the treatment, a follow-up may be advised for a permanent restoration. The restoration is essential because the cleaned canal needs to be sealed to protect it.

Q. In what conditions would I need to get a root canal?

A. Root canal therapy is recommended when the nerve becomes infected.

When can this happen?

This may be caused by some reasons, such as dental cavities, crack or chips in the enamel, or multiple dental procedures. Another reason could be trauma, which is indicated by the tooth being discoloured. If such an inflammation or infection is not treated timely, it can lead to pain. It can also lead to a pus-filled abscess.

Q. What symptoms should I look out for to know if I need a root canal?

Important symptoms

  • If you have been feeling sensitivity to hot and cold for a prolonged period,
  • have experienced pain without any reason,
  • noticed any of your teeth being discoloured
  • tenderness in the tooth or the surrounding gums, you might be a candidate for root canal therapy.

Transient sensitivity can be caused by root surfaces that are exposed. They can also be caused by grinding, but if the sensation stays and leads to a headache, it normally means that there is severe damage to your nerve that can be irreversible as well.

What if there are no symptoms?

Remember, no symptoms does not mean that you do not need the treatment. Sometimes the need for the procedure is indicated only through x-rays. If bacteria from decay reach the pulp of the tooth, root canal therapy is recommended.

Q. What is meant by the ‘pulp’?

The pulp includes the blood vessels, connective tissue and nerves that form the adjacent dentin for the tooth when it is in the development stage.

How does it get its food?

The pulp gets its nourishment from vessels in the root. Even after removal of the pulp, nourishment is provided to the tooth by the tissues that are adjacent to it.

Q.Why do people say root canals are a very difficult procedure to go through?

How painful is it?

Most of the root canals are virtually painless. Anaesthesia and twenty-first-century medicine have made the process so unremarkable that some people say it is almost like getting a normal cavity filled.

Are all cases the same?

But there are some people who have a special case. This kind of tooth is a tooth where the damaged nerve is inflamed in a severe way, but is still alive. The tooth is already quite sensitive and causes a lot of pain when exposed to anything hot or cold. Such a tooth requires multiple anaesthetic injections for the patient to feel numbness. It is sometimes referred to as a hot tooth.

Q. If I feel sore after the procedure, should I be worried?

A. No, it is perfectly regular to feel a slight soreness after the treatment. The reasons may be the anaesthesia, keeping the mouth continuously open for an extended period or the procedure itself.

The temporary filling you get will become firm in approximately thirty minutes, but it would be good if you could avoid biting the affected tooth and chewing with it if you feel pain, particularly if there were pain or inflammation or infection before the therapy.

Q. If my pain persists after the procedure, what should I do?

A. There are many analgesics that help relieve the discomfort, like acetaminophen, aspirin or ibuprofen, which can be obtained over the counter. In rare cases, other medication may be recommended as well.

What should you do if the pain does no subside?

If the pain lasts beyond a few days, or there is swelling or severe pain, schedule an appointment with the endodontist. It is important to remember that if you experienced pain or hurt in your tooth before the therapy, it may be a while before it feels normal again.

Q. What should I do in case of a swelling?

A. Contact your dentist immediately so that s/he can find out the why the swelling happened and prescribe antibiotics, if necessary.

Q. Why does it occur?

A. A minor swelling may be caused by irritation of the gum due to everyday actions, and hot salt water rinses are often enough for them. Abscesses are generally caused by cavities that were not treated on time, cracked enamel, a failed root canal treatment or extensive gum disease. There are three kinds of abscesses:

  • One is the gingival (gum) abscess. This involves only the tissues of the gum. It is a swelling, filled with pus; that may have been initiated from an inflamed periodontal pocket. Your dentist will clean out the affected gum pocket and drain it. A Hot rinse should follow this treatment, and antibiotics may be required too.
  • A traumatic gum abscess originates from a trauma like irritating the area while brushing your teeth, or mistakenly poking your gums with something sharp like a crust of bread, a chip, a breadstick or a bone. Such traumatic abscesses mostly heal without the need for a dentist, with the help of warm salt water rinses.

What is tooth abscess?

A tooth or root abscess, on the other hand, involves the tissues of the jaw bone that are located at the tip of the tooth that has been infected, and pus has been enclosed within this tissue. A bacterial infection that has amassed within the nerve area of the tooth is the usual cause of this kind of abscess.

Q. What can happen?

A. In extreme cases, a tooth abscess may even go through bone and start draining into the adjacent tissue, causing facial swelling. Lymph glands that are located in the neck may become swollen and tender in reaction to this. The treatment would include root canal; and antibiotics for severe cases. If you have any swelling, tenderness, fever or pain, immediately contact your dentist.

Q. What happens if I don’t treat a dental abscess?

A. A dental abscess should be treated timely, as it can be dangerous. If ignored or not treated completely, it can have severe consequences, even death. Some of them are:

  • Tooth loss. This may happen because the infection may cause the loss of the adjacent bone area.
  • Sinus Infection. If there is an infection in the upper back teeth, there is a big chance that it may infect the surrounding sinuses too.
  • Bacterial Endocarditis. This is a disease where the abscess can be dangerous to the heart. Bacteria can travel to the heart using the blood vessels as a pathway.
  • Brain Abscess. This is when the brain gets infected because of the abscess, again with the blood vessels as a pathway
  • Osteomyelitis. The bacteria can be dangerous to the bone or the bone marrow. An infection is caused. This infection can be either local or generalized
  • Cellulitis. Cellulitis is a result of not getting timely treatment. Symptoms are swelling in the facial area, and the tissues and there might also be a fever. The infection can also extend to the mouth, affecting the bone and soft tissues that are present on the mouth floor.
  • Ludwig’s angina. This is the most severe infection of all. It can spread to the lower jaw, resulting in death due to suffocation because of blockage of airways.

Q. If I want to get my tooth removed instead of getting a root canal done, is that safe?

A. You could have that done, but there is the possibility that surrounding teeth may move and hamper with the chewing if you don’t get the tooth replaced.

Q. What are the options?

A. You have the option of placing an implant as part of a bridge (that may be fixed or removable) or getting another tooth. It is sometimes called a dummy tooth.

A fixed bridge is a good option but knows that it is expensive, may require further dental treatment and involves removing the surrounding healthy tooth structure. The best option is saving your own tooth, if there is any chance of its long-term survival.

Q. What does an endodontist do during a root canal procedure?

A. First of all, an x-ray is done. Anaesthesia may nor may not be used. A sheet of latex is positioned around the affected tooth. This keeps the tooth dry. There are these steps after this:

  • The diseased nerve pulp or tissue is accessed through an opening that is made.
  • Files, which are tiny instruments used to clean the root canals of the infected pulp and bring them to a shape that makes sure that it will be well sealed. It is probable that the root canal is not completed in one visit. In such a case, a temporary filling is placed to seal the opening that has been made, and to make sure that the tooth remains protected from any outside infections.
  • To prevent bacteria from infecting the site yet again, the root canals are filled and sealed with a special kind of material. A temporary filling is used to seal the crown of the tooth. Dental X-rays are made multiple times during the treatment, as often as required, generally before it, during the treatment and after it is complete.
  • Usually within a period of four weeks, the temporary filling that had been inserted is removed, and a permanent one takes its place. This is not it, however. Visit your dentist for a permanent restoration or a crown.
  • You will be recalled again, to check that recovery is going as planned, and that the root canal and the permanent filling are healing in a proper manner.

Q. How long can I expect my tooth to endure after a procedure?

A. The time you should wait depends on the state of your tooth before treatment. If there was a lot of healthy tooth structure to begin with, and if your tooth was permanently and properly restored, then your tooth has a great chance at longevity, provided you brush and floss, follow a healthy diet and keep your periodic dental appointments.

Q. For how long should I wait before getting a permanent restoration?

A. After your root canal treatment, you get a temporary filling for the time being. See your general dentist after that for a permanent solution. You have to get a permanent restoration, and may require a crown, depending on your case. The ideal period for permanent restoration is a few weeks. This time period is necessary to make sure that the tooth does not develop a fracture and to ensure that the temporary filling does not leak, which could make the root canal therapy a failed attempt.

Q. Is getting a crown mandatory after a root canal?

A. No, each and every root canal does not require a crown. But quite a lot of them do. This is because a crown provides support. After a large cavity or fracture, often there isn’t enough healthy tooth structure left for the tooth to endure without a crown. Also, teeth have a tendency of becoming brittle after the treatment, which increases the risk of a fracture.

What is an apicoectomy?

A. Ever wondered how your teeth stay in the position that they do? This happens because of the roots that lengthen into your bone. The ‘apex’ is the part that is the end of the root. The apex is essential because this is the pathway from which nerves and blood vessels reach the teeth. The root contains a canal through which they move to reach the pulp chamber. This chamber is inside the crown. These canals are cleaned during a root canal procedure. Any tissue that is inflamed or infected is removed.

When do you need it?

A. If even after a root canal treatment, an infection won’t go away or develops anew, an apicoectomy may be needed. Root canals are complicated, and even after treatment, sometimes contaminated debris can remain in these channels. This can come in the way of healing or even cause reinfection.

What does it involve?

A. In this process, not only is the infected tissue removed, but also the apex, and a filling is used to seal the root. This procedure is also named endodontic microsurgery because it is done with the help of an operating microscope. The procedure takes between thirty to ninety minutes, depending on where in your mouth the tooth is (position) and the complexity of the root structure. Front teeth take less time to heal, while the molars take the most.

What does an apicoectomy do?

A. In case a root canal has failed, it is because of an apex complication. Often, another root canal may be advised before an apicoectomy. With advanced technology, dentists can detect the canals that were not treated adequately. In such a case, a second root canal may do the trick. An apicoectomy may be done to avoid the need for a tooth extraction. Only in cases of failure of root canal is apicoectomy considered. For instance, in case of a tooth that has a crown, or a tooth that is part of a bridge, retreatment is not advised, because it would need the dentist to cut through it. Doing so may cause a weakening of the bridge or the crown, thus completely destroying the purpose. In such a case, an apicoectomy recommended.

An apicoectomy is not a root resection. In an apicoectomy, just the tip is removed, but in a root resection, the whole root is removed.

If I get a pimple-like bump on my gums after the procedure, should I be worried?

A. A pimple may develop in some cases after a root canal. It may seem to vanish and then recur. This fistula is a way for your body to drain out an infection. It is usually painless. If you experience hurt or a recurring fistula, contact your dentist. S/he will take x-rays and do an exam, and in some cases a root canal or apicoectomy may be required.

Should I be worried about the failure of the procedure?

A. Only 5% of all root canals fail, and this may be due to various reasons. One reason is that the cleaning of a particular canal(s) was not complete, and this trapped never tissue may lead to abscesses or severe pain, leading to failure. A fractured root can be another cause.

Teeth that have dead nerves are quite brittle. Fractured roots often mean that the tooth cannot be saved. In some very rare cases, there may be a reaction to the material used for filling, due to hypersensitivity to that particular material, but this hardly happens as the gutta percha, which is the used material, is usually very well tolerated.