Every time I hear the magic sound of grinding my teeth and filing my teeth, Uncle Zhang is afraid and says that he can't continue root canal treatment. I recently wore false teeth and suddenly felt a toothache. The doctor said it was inflammation of the tooth nerve and needed root canal treatment. "It was 10 years ago! Uncle Zhang said that root canal therapy was only once before. Why do doctors now say to do well? Is it because the doctors' skills are poor now?
The doctor explained, "Because the nerve was previously' poisoned' by arsenic compounds, it is now necessary to completely remove the inflamed tooth nerve from the pulp cavity and then seal it to prevent bacteria from damaging the tooth again. Because the root nerve malocclusion is complicated, it is necessary to make sure that all the infected sites are removed before it can be cured. So it has to be divided into many times, and some may even have to be treated for 4 to 8 times. 」
In the past, arsenic was used to kill tooth nerves and lead to bone necrosis.
Hong, a part-time physician and dentist at National Taiwan University Hospital, said that the danger of using poisons to kill tooth nerves in the past was that these poisons were very penetrating. If you are not careful, poison may penetrate into the bone, leading to bone necrosis. So the doctor will tell the patient: "You must change the medicine tomorrow. 」
Because if the dressing is not changed in time, the bone may be necrotic. Although the drugs used later are less toxic, the toxic drugs will still cause damage to teeth, jaws and other bones because the pulp nerve is connected with bones. Now orthodox root canal therapy no longer uses poison, but really "pumps" nerves.
After many root canal treatments, the bacteria in the pulp cavity were completely eliminated.
As for why root canal therapy should be divided into multiple times? Dentist Lin Zhengyi said, because root canal therapy is not only to remove the nerves, blood vessels and lymphatic vessels of teeth, but also to enlarge the pulp cavity, remove the pulp tissue, and enlarge and flush the root canal. The part of the pulp infected by bacteria should be completely removed, then the root canal should be shaped, and then some drugs such as sodium hypochlorite should be filled for sterilization. After the root canal is dredged, the root canal can be closed without pus leakage. Now it is mainly filled with Malay glue, so that there is no bacterial damage in the pulp cavity, and then the patient's own immune ability is used to cure it.
As for many times, it is because many people's pulp nerves are more complicated, and some people have many nerve branches. If you want to completely remove it, you must repeatedly determine whether the depth of treatment under X-ray is enough. Can you take it out completely, can you put the medicine in, can you melt the nerves and bacteria, and then you can seal it. When it is completely taken out in the next course of treatment, it can be sealed and filled, and treated with patches.
Under what circumstances should root canal therapy be done?
In addition to toothache caused by inflammation of pulp, Lin Zhengyi said that even if there is no tooth decay, there are many situations that require root canal treatment:
◆ Tooth trauma
According to statistics, about 20% of people under 0/4 years old in Taiwan Province Province/KLOC have had tooth trauma. If the pulp tissue is damaged, root canal therapy must be performed to save the teeth.
◆ Periodontal disease
Statistics show that 90% of adults over 40 suffer from periodontal disease, which not only affects periodontal health, but also damages dental pulp and teeth.
◆ Love to bite hard objects leads to tooth wear.
Many people like to eat hard things such as melon seeds, sugar cane and bones. In the long run, it will cause enamel wear on the outside of teeth, and in severe cases, it will cause dentin exposure and cause pain. Sometimes root canal therapy is needed to relieve the pain.
◆ Brushing your teeth too hard leads to root exposure.
Many people brush their teeth too hard, which may cause damage to teeth, neck and gums, leading to pain in root exposure. If necessary, root canal therapy is needed.
◆ Abnormal tooth development
Some people have abnormal tooth types, such as the common "central dental mound" of maxillary and mandibular premolars, that is, the enamel structure protruding in the middle of the occlusal surface of teeth. When the upper and lower teeth rub together for a long time or accidentally, the structure of the central dental mound is destroyed, which leads to nerve exposure and pain. Root canal treatment is also necessary.
◆ Too short root causes gingival atrophy.
Some people's teeth are worn out or their roots are too short to use, but after tooth extraction, their gums will shrink quickly and even their bones will degenerate. Therefore, doctors sometimes deliberately do root canal therapy, keep the root, and forcibly pull it out in the oral direction in a corrective way to increase the thickness of gums and bones (forcibly eruption of roots), which can improve the aesthetics and durability of dentures or dental implants.
Root canal therapy cannot guarantee 100% complete success.
Many people's teeth after root canal treatment actually hurt again, and they suspect improper medical treatment. Lin Zhengyi said that root canal therapy can't guarantee the complete success of 100% because our root canal system is as complicated as an underground waterway. Some root canals may be calcified, blocked, bent and mutated, some root tips are deformed and difficult to be completely removed, and some bacteria will coexist with people. When people get old, their immunity drops, and bacteria will go wrong again.
It is possible that after years of treatment, the inflammation of apical abscess will occur again. Therefore, root canal therapy, debridement, disinfection and complete sealing are needed again. Most of them can be well remedied, but if some conditions cannot be removed, apical surgery may be needed for treatment.
After root canal treatment, put on false teeth. Don't think that false teeth are not afraid of tooth decay, so don't worry. In fact, after root canal treatment, teeth tend to become brittle because they lose more dentin and lose the nutrition and water supply of pulp. Therefore, you should not chew hard or tough food in the future, so as not to break your teeth or roots.
Medical technology is changing with each passing day, so don't be afraid of root canal therapy.
Many people get scared as soon as they hear the sound of drilling teeth, and even the root canal treatment is half done. When the tooth doesn't hurt, it won't be treated. In fact, there are new sharp tools for root canal therapy, which can be detected by computerized tomography and ultrasound. Manual file has also evolved into a new nickel-titanium root canal therapy instrument, and advanced clinics are also equipped with ultrasonic osteotome and microscope surgery.
Apical surgery combined with regenerative medical technology such as bone powder regenerative membrane has a higher success rate. Although these new technologies, new materials and new instruments need to be paid at their own expense, if toothache can be found as soon as possible or tooth damage is less, and only a few treatments or fillings are needed, you don't have to worry about the level of root canal treatment or spending a lot of money on dentures.
Must braces be made after root canal treatment?
Most patients who have undergone root canal therapy will be advised to have a crown, that is, a false tooth (braces). This is because many people in China are afraid of dental care. Therefore, the teeth that need root canal treatment usually have a large range of caries or cracks in the pulp cavity. Therefore, they will be advised to make false teeth, which will not only restore the occlusal function, but also further prevent bacteria from invading and destroying the pulp cavity. If the damage to the teeth during root canal therapy is not great, or occurs in the front teeth, dentures may not be made.
Content source: Changchun Monthly 4 19.