DENTAL PRACTICE: ENDODONTICS

Enciodontics is the branch of Dentistry that involves the.pulp of the tooth.

Treatmentcan range from placing a temporary filling (to reduce symp toms of cold /heat sensitivity) to re moving the pulp (when the pain is strong and intermittent /constant or when the tooth is svmptomless but the pulp is infected sometimes causing gum/facial swell ing) to operating on the apex ofthe tooth depending on the clinical problem that presents.

Advances in this field are almost an annual event with new rotary files thai supersede the pre vious year's file as an example. Re moving the pulpand later filling the root canal with a special rubberbased material is complex as the root canal system differs in every tooth ranging from a fairly straight canal to a twisted S-shaped canal that is extremely difficult to root treat.

is greater the pain is constant and unbearable) come from either the bacterial population within dental caries (tooth decay) or from bacte ria present in the mouth reaching the pulp through a fracture line in the tooth which com municates with the dental pulp.

Advances in this field are almost an annual event

Sometimes, when the discom fort is mild and in flammation is only just starting, a spe cial temporal^' fill ing is used to at tempt to reverse the discomfort and inflammation. The success rates are variable for this procedure, either a permanent filling is later placed on the tooth if the symptoms disappear or if the discomfort continues/gets worse then the pulp of the tooth has to be removed.

Samuel lhaiii HPS

DENTAL .SliRGEON

Bruce Hung Hl)S iHmt.ii

DENTAL SURGEON visiting OnhotloiiiiM & Oral Surgeon 62 Main Street. Suite 6. PO Box 909, Gibraltar Tel: 76817

Now jvallabio, health products in sloop in ,it night and lri wear by day, from a long established japanosc company operating in over 20 countries. Those products are totally natural, and both provide more effective sleep and increase energy by day. They also •Mse distomtori in the joints and back.

For more details contact; Xillion, 24 College Lane, Gibraltar. Tel: 72011

For all your Pharmaceutical needs

Added to the difficulty are factors such as patient compliance (each stage can take up to an hour and not everyonecan keep their mouth open for prolonged periods of time) and access (easier at the front of the mouth and extremely difficult for the last molar where it is sometimes difficult to reach to instrument the root canals).

There are broadly three stages. The first to alleviate the pain and control infection by thorough clean ing of the root canal system. The bacteria responsible for infecting and causing inflammation of the pulp with correspondingdegreesof discomfort and pain (from sensitiv ity to cold/hot drinks lasting a few seconds, then to a few minutes and eventually when the inflammation

A rubber dam is placed around the tooth once anaesthetised (which can be difficult in cases of severe pulpal inflammation necessitating anaesthetising around the bone of the tooth or anaesthetising the pulp directly) an access cavity is cut and the pulp removed with hand or ro tary files. Sometimes the root canal can be filled at the same visit when there is no infection pre.sent and the whole pulp can be removed. Oth erwise a dressing is placed for later fillingatanotherappointment when a period oftime is required to see if the pain and/or infection starts to diminish. In cases where facial swelling is present then antibiotics are prescribed (as well as draining as much pus as possible through the root canal to reduce the number of bacteria at the apex of the tooth).^