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1) What causes tooth decay or dental caries ?
The main factor that causes dental decay is the dental plaque, which is a thick sticky substance that collects on the teeth surface. Dental plaque is made up of large amount of bacteria, food particles and salivary products, If food, especially rich in sugar / starch is left in the mouth, bacteria acts on it, breaking it down into acids. The acids produced then soften and dissolve the minerals of the tooth producing microscopic cavities in the tooth. Over time, with repeated acid attacks, a chalky white spot develops (first visible sign of decay). Then the spot turns into a cavity later. This cavity will collect more food and leads to further destruction and larger cavity.

2) Does a decayed tooth / cavity need treatment ?
If left untreated the cavity would continue to enlarge in size (both width and depth). Finally bacteria will reach the tooth pulp causing a toothache and infection. A cavity is to be filled in the initial stages to preserve the remaining healthy tooth and prevent complications. If left untreated, a root canal treatment may become mandatory to save the tooth, or in rare cases the tooth may have to be extracted.

3) Why Root Canal treatment will be needed for me ?
The blood supply and nerve supply to the teeth are contained within a small chamber called the dental pulp. Dental decay, fracture of tooth or loss of filling could lead to contamination of the dental pulp by bacteria. This bacterial invasion will affect the blood flow to the teeth. In such situations you will need a root canal treatment to clean the pulp of the bacteria, and fill the pulpal space by specialized material. The aim of root canal therapy is to save the teeth in which the pulp has been damaged. The other alternative is removal (extraction 0 and to replace the tooth with an artificial one.

4) How do I know if I require a Root Canal treatment ? (Symptoms that indicate the need for root canal treatment)
1) Moderate to severe; lingering tooth ache when having hot or cold.
2) Tooth ache which becomes severe in the night or lying down.
3) Pain in the tooth or in the gums when chewing or biting (sometimes pain spreading to other areas of the jaws or face).
4) Swelling in the gums and tenderness of the tooth on chewing.
5) In extreme cases the face will be swollen, red and extremely painful and may run temperature.
6) In some cases there will not be any symptom

5) How is a Root Canal treatment done ?
Firstly the pulp chamber is entered by making a hole in the tooth. In case of painful teeth, the area is anaesthetized before the procedure.
Then very fine delicate and sterilized instruments called files are used to clean, shape the root canals. .
Finally the shaped canals, which are sterile, are filled by a biocompatible. inert material and the hole on the tooth surface is sealed. Most of the cases the treatment protocol is completed in a single visit.
Then a root canal treated teeth is crowned for protection and to avoid further damage.
In some cases when the root canals are much infected a medicated dressing is placed in the pulp canals to disinfect the same. In such situations 2 or 3 visits may be required.
6) Is root canal treatment painful ?
The actual treatment by itself is not necessarily painful. In cases with hypersensitivity/ symptoms the procedure is done under local anesthesia. wherein an injection of local anesthetic is given to numb the area of the teeth which is being treated. This makes the patient do not feel anything. In cases with severe infection, antibiotics are prescribed to control the infection and hence the pain. Usually pain if any is felt only before treatment because of the infection rather than by the procedure. For the first few days after treatment, the tooth may feel sensitive, especially if there was a lot of pain or infection before treatment. If so, you may be advised a painkiller or even antibiotics to control the same.

7) What is root canal retreatment and why is it done ?
When a root filling has been completed and there is still infected material within the root canal system. Then removal of the existing root filling is carried out and if possible a new better root filling is placed to eliminate any spaces.
In very few cases already root canal treated teeth may get re-infected due to the following reasons:
• Filled root canal is exposed to bacteria and saliva due to new decay or a loose / broken filling causing.
• Root canals are complex and often there is more than one canal in each root. Some canals are extremely difficult to see and may be missed even with sophisticated instruments leading to reinfection.
• In teeth with curved roots or with very narrow root canals, there will be extreme difficulty in cleaning the canal and sealing it rendering it susceptible to re-infection.
• Root canal treatment may fail if the earlier treatment has pitfalls in cleaning and sealing procedure.
For re-treatment of a root canal the tooth is re-opened by removing the old filling and the canals are re-cleaned and re-filled. Some cases could require surgical intervention in case of non-possibility of sealing the canal adequately.

8) What are crowns / bridge ?
Teeth, which are extensively damaged by decay, excessive wear or fractured, need to be brought back to their shape to facilitate function. This is achieved by remaking the outer portion of the teeth with an artificial material. This totally covering of the teeth by artificial material is termed as crown. A crown can be fabricated with different material depending on the patient’s need, area in question and the function. The common materials are full ceramic, porcelain fused to metal, full metal.
A root canal treated molar teeth, which aids in chewing is crowned so that to avoid further damage by fracture.
When one or more teeth are missing because of any reasons, a bridge is fabricated to replace and rehabilitate the missing teeth. A bridge is therefore a fixed artificial teeth prosthesis (which cannot be removed by the patient), which is supported on either side by strong teeth. Basically a bridge has two or more crowns, getting attached to the adjacent teeth and artificial teeth called as pontic.

9) What are the symptoms of gum disease ?
1. Gums which bleed either spontaneously or when brushed and/or flossed (Healthy gums DO NOT bleed).
2. Swollen, red or puffy gums (Healthy gums are firm, pink and adhere tightly to the teeth and bones).
3. Bad breath or a constant bad taste in your mouth (Diseased gum tissues release volatile sulfur compounds which contribute greatly to halitosis).
4. Tartar build-up on your teeth.
5. The gumline going down towards the root surface.
6. Loose or shifting teeth and a change in the way the teeth fit together.
7. Mild disturbing pain in the gum with occasional swelling in the gums.