Surgical cure for tooth root infections
Tooth root infections are caused when the nerve inside the tooth pulp chamber and deep pockets get infected. Radiographs (dental x-rays) will determine the extent of the infection and also the amount of remaining bone around the roots of the teeth. If the there is enough bone around the roots then the first line of therapy in this case is always to carry out gum treatment. This involves cleaning above and below the gum line with both specialised hand scalers called gracey currettes and ultrasonic scaler. After this, the tooth is checked to see whether the nerve is still alive. If not, then root canal therapy is carried out by an endodontist (dentist who specialises in root canal therapy). This involves the removal of the infected nerve by drilling into the tooth after it has been anaesthetised. After the removal of the infected nerve the root canal is thoroughly cleaned and a root filling placed. There is usually very little post operative pain or discomfort after this procedure. By carrying out both the root canal and the gum treatment the longevity of the tooth is increased considerably.
Upper molar teeth have usually 3 roots and the lower molar teeth have normally 2 roots. If the deep pockets and bone loss is such that the back molar may be in danger of being lost then the option of removing the infected portion of the tooth root becomes available. This is called root resection in the upper teeth and usually the one of the three roots is removed if the other two are saveable. Around the lower molar teeth this is called hemisection. Here infected root is removed and the tooth is literally cut in half. The remaining portion is then crowned afterwards to protect it from biting/chewing forces. The tooth can survive for long time (10yrs +) with this technique as long as the patient attends for regular check ups and dental hygienist maintenance visits. In fact we have a upper molar that has survived almost 16 years after having root canal therapy and then a root resection procedure to remove the infected portion and finally being crowned with a porcelain crown.