ROOT CANAL THERAPY pediatric dentistry staten island ny dr flagiello dr ray flagiellodr ray flagiello dds Staten Island cosmetic dentistry family dentistry pediatric invisalign implants

Why have root canal therapy?

Your teeth have a core of blood vessels and nerves at their centre. This living tissue is called
the pulp and is in a space called the root canal. The number of root canals in each tooth varies
depending on how far back it is in your mouth. Front teeth often have one root canal, while
back teeth may have three or more.

If your tooth is injured or has deep decay, the pulp can be damaged and the blood vessels
may die. A "dead" tooth is likely to get infected. Without treatment, a dental abscess
(collection of pus) can form as the bacteria multiply and are forced beyond the end of the root.
As the collection of pus is trying to expand within the bone, the tooth may rise slightly out of its
socket and feel tender when you bite down. If left untreated, the infection may spread to the
nerves and surrounding tissues and cause nausea, fever and difficulty swallowing.

Dr. Flagiello will usually recommend root canal therapy to:

Open up the pulp chamber
Clean out the infected remains of the pulp
Fill the pulp chamber to prevent the infection returning
Restoring teeth
Tooth Whitening

Sometimes a live tooth may have insufficient tooth substance to retain a crown so the tooth
may have to have root canal therapy and be restored with a post-retained crown. Teeth that
have been treated with root canal therapy sometimes discolour but you may be able to have
treatment to correct this. For more information please see the separate

How does the pulp get damaged?

There are a number of ways that a tooth's pulp can be damaged.

Decay

If tooth decay is left untreated, bacteria can spread into your tooth and infect the pulp. Once
this happens, your tooth will need to be treated with root canal therapy to remove the bacteria
and damaged pulp.

Gum disease

If you have severe gum disease then your gums tend to pull away from the teeth creating a gap
called a periodontal pocket. This pocket traps bacteria, further damaging the supporting
tissues of your teeth. Bacteria in deep periodontal pockets may theoretically infect the pulp.

What are the alternatives to root canal therapy?

If your tooth is seriously damaged by decay or injury, or the support of the tooth is
compromised by gum disease, then your dentist will discuss whether root canal therapy will be
able to repair your tooth. He or she may recommend that you have the tooth taken out instead.

What to expect

Dr. Flagiello will take an X-ray of your tooth to check whether or not you need root canal
therapy. This X-ray can help to show how far any decay has spread, and will show if there is an
abscess, and how many root canals the tooth has. If you do need root canal therapy, he or she
may give you a local anaesthetic injection. This will make the tooth numb so that you will not be
able to feel any pain. If your tooth is already "dead", a local anaesthetic may not be necessary.
Your dentist will discuss this with you.

The treatment

Dr. Flagiello will remove any decay or old filling from the tooth with a drill. He or she will then
drill into the pulp to reach the root canals.A sheet of thin plastic called a rubber dam (which is
held on with a metal clamp) is placed over your tooth to separate it from the rest of your mouth.
This helps your dentist to keep the tooth that he or she is working on dry, to stop bacteria from
your saliva getting into the root being treated. The rubber dam also protects your throat during
the treatment. The dam may feel a little uncomfortable.

Cleaning the root canal(s)

Our office may take an X-ray before he or she cleans your root canal to check how long your
root canal is and what instruments to use. He or she will then use thin instruments and
disinfectant to remove infected tissue and bacteria from the canals. You may feel some
vibration in the area being treated but you should not feel any pain.

Dr. Flagiello may take another X-ray to make sure that he or she has cleaned right to the end
of the canals. This cleaning stage is very important for the overall success of root canal
therapy as it aims to prevent another infection.

Filling the root canal(s)

Dr. Flagiello needs to fill the space in your canal(s) that is created by cleaning out the pulp.
This may happen at the same visit. However, if there is not enough time or if there is a lot of
infection, your dentist may want you to make another appointment. He or she will place a
temporary filling on the tooth until you come back.On your return visit your dentist may give you
another local anaesthetic to make the area numb. He or she will put the rubber dam in place
again to protect the area, remove the temporary filling and make sure that the canals are
completely clean and dry.Your dentist will fill the canals with thin pieces of gutta percha (a
rubber-like substance). He or she will take an X-ray to make sure the canals are filled to the
ends.

Finally, Dr. Flagiello will place a permanent filling or crown on top of the tooth.