Root Canal Therapy and Extractions

Root Canal Therapy

Simple Extraction

Surgical Extraction

Teeth are made up mostly of hard mineralized tissue; Enamel and Dentin. But teeth are hollow, there is a small internal space called the pulp chamber, with thin tunnels or root canals that run out the end of the roots.  Therein lives a tooth's nerve, blood vessels, and other soft tissue, collectively called the pulp. The pulp is the nerve and blood supply to the tooth. If the pulp is injured badly enough it may die, often painfully, and become non-vital or necrotic, literally gangrene inside the tooth, and abscess. Without a healthy pulp there is no blood supply up inside the tooth. Your immune system or an antibiotic can only go where the blood supply takes it, with no blood supply there's no way to bring it to the source of the infection.

Why do pulps die? Trauma is one way,  perhaps a crack in the tooth, and bacterial infection from a deep cavity are common reasons. Sometimes it's just accumulated injuries over a long time. To bring relief from pain and eliminate the source of infection the diseased pulp tissue has to come out.

The tooth could be extracted, taking the diseased pulp out with the rest of the tooth, but you lose the tooth. Or you could  remove just the diseased pulp tissue, and keep the rest of the tooth. This is called Root Canal Therapy, or Root Canal for short. an access opening is made into the pulp chamber and the root canal system is meticulously cleaned out, and filled with an inert material that seals up the pulp space. In a front tooth the access opening is typically repaired with a filling. A back tooth that has had Root Canal Therapy is usually so weakened by loss of tooth structure that restoring it with a crown is recommended to protect it from fracture.

Extractions are dental treatment of last resort, the surgical removal of teeth. The distinction between Simple and Surgical Extraction is technical and has to do with procedure codes for Dental Benefit Plans. When necessary we take teeth out in our office, or refer you to a specialist with whom we have an excellent working relationship, depending on the case.

The loss of teeth has biological consequences that we will discuss with you so that you are aware of them.  This could naturally lead to a discussion on how you could replace your missing teeth to avoid or mitigate a negative outcome.

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Dr. Wiener & Dr. Bihary


200 East Main Street, Suite 4 E Smithtown, New York, 11787


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