Inflamed Teeth

A damaged tooth that has inflammation of the pulp or pulp ligament can be acutely painful for the patient and can only improve with professional treatment.

How can we help?
Often, the patient can be distressed and in considerable pain. By ensuring a prompt response from one of our expert pain management specialists, we can relieve the stress for both the patient and the referrer.

What we do?
Treatment is geared towards removal of the inflamed tissue, full preparation of the canal systems and full obturation, ensuring that, allied with a good crown or filling, bacteria can be prevented from multiplying in the canal spaces. Prognosis in this instance is usually very good and success rates of 95% are not unusual.

Infected Teeth

The situation can be worse if the nerve or blood vessel has disintegrated and bacteria have colonised the root canal system. This can lead to abscess formation, with the bacteria sending toxins right into the bone.

How can we help?
With the use of the most modern equipment, microscopes, nickel titanium files and ultrasonic activated irrigant systems, we can make sure the canals are as clean as possible. We then seal them with thermo-plasticised gutta-percha to ensure a three-dimensional seal.

What we do?
Treatment is more demanding where infection is present, as it then involves cleaning the contaminated root canal system of all bacteria. Canals are complex, three-dimensional spaces where absolute sterility will not occur, so the aim of sealing the canals is to trap any remaining bacteria and prevent any nutrients getting to them so that they will no longer be viable. Even with the most advanced and efficient mechanical equipment, it is impossible to get rid of all the bacteria, so we employ various irrigants, such as Sodium Hypochlorite and EDTA, to further cleanse the canals and increase the chances of a successful first-time treatment. As long as there are no fresh sources of leakage and the tooth is well sealed, a very high success rate of about 90% can be expected.

If previous treatment has not achieved satisfactory results, or the canals have got re-infected, a further attempt can often be made to cleanse the canals and re-treat the tooth. Teeth involved in re-treatments are more complicated to disinfect and often require the removal of any obstructions to the canal.

How can we help?
Often, the patient can be distressed and in considerable pain. By ensuring a prompt response from one of our expert pain management specialists, we can relieve the stress for both the patient and the referrer.

What we do?
Re-treatment may require post removal and removal of the original root filling. This in itself can be quite time-consuming and different irrigants need to be used to counter specific bacteria known to contribute to failure. The success rates for re-treatment tend to be not quite as good, but a rate of around 80% can still be achieved – certainly a viable alternative to extraction.

Occasionally surgery has to be undertaken to rectify any errors or to clean an inaccessible portion of a tooth, bone taken away and the offending portion of root removed a week later.

How can we help?
We will thoroughly assess the causes of failure and only perform surgery if it the best option. Using microsurgery techniques, ultrasonics and biocompatible materials such as MTA, we will try and make surgery as predictable as possible.

What we do?
With the modern techniques we employ we often can avoid all surgical treatment by first re-treating the tooth and this is usually our first option. However there are specific indications for surgery such as to avoid damage to a new post crown or if there is an untreated portion of root not amenable to routine cleansing. In these cases we perform surgery if it has a good prognosis.