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Pain therapy – endodontics and/or extractions

Have you ever had a toothache that has kept you up all night? Not to worry- you can be pain free by the end of the day so you can have a good night’s sleep. Call us right away and you can have a same day emergency visit.

The first step is coming into the office so we can determine the cause of the pain. Our team at Pacifica Dental will gather information about your medical and dental history, as well as an accurate description of the pain. A certified dental assistant will take care of the required diagnostic aids and tests, such as radiographs, photographs, study models, and digital scanning. The dentist will perform a dental examination including an extra-oral evaluation as well as an intra-oral evaluation of soft tissue and dentition. You can expect questions such as “when did the pain start?”, “is it spontaneous?”, “is it lingering?” “did it wake you up?, “how would you score the pain, on a 1-10 scale?”, “are there any factors that make the pain worse or reduce it?”, and “is it triggered by temperature changes?”. In most cases, additional specific examinations are required in order to come up with an accurate diagnosis.  Ice and heat will be applied to your teeth and you will be required to grade the level of the pain/sensitivity. Percussion and palpation will also play a role in diagnosis. A bite test might be performed, if a cracked tooth is suspected. If necessary, referrals will be made to specialists at the dentist’s recommendation.

A diagnosis is made from the review of the data that was collected and recorded during the clinical examination, supplemented by the necessary radiographs and/or study models and/or the results of any tests or consultation. The dentist will provide you with a treatment plan consisting of urgency and order of treatment, the options for materials and methods,  alternatives (including no treatment), all recommendations, instructions and advice, risks and complications associated with each treatment, financial implications, and arrangement for payment options.

Once you have made a decision with respect to the choice of treatment and informed consent has been obtained, we will proceed with treatment.

Dental pain is most often due to tooth decay, or an inflammation or infection of the pulpal tissue. Performing endodontic treatment can significantly reduce the pain.

Studies have shown that pulpotomy and pulpectomy treatments alleviate pain and can restore the health of the tooth.

During a pulpotomy, a dentist/endodontist removes the coronal pulp (the pulp above the gum line, within the main part of the tooth). A pulpotomy can only be completed on a tooth that is still alive, meaning that it responds to temperature and has sensation and vascular flow. For this procedure to be successful, it is important there is no abscess in the area. In approximately 90% of cases, pulpotomy treatment reduces pain symptoms within a day.

A pulpectomy is a procedure that entirely removes the pulp from all parts of a tooth, including the root system. The main goal of the procedure is to clean the entire root canal, protecting it from further infection and to prevent it from spreading the infection into the surrounding apical bone. Root canal treatment can sometimes be combined with an incision for drainage and occlusal reduction. All these procedures are performed under local anesthesia.

Once root canal therapy is completed, your tooth should be examined periodically (the time between appointments will be recommended by your dentist). This allows us to ensure that the tooth has healed and/or is healing properly. Since an abscess may take 2 or more years to heal, the tooth should be re-evaluated once a year for at least a few years after treatment.

In many cases, patients come to us only when the tooth is too damaged to be saved. Then we   need to perform an extraction. The extraction can be non-surgical or surgical, depending on the tooth’s roots, surrounding bone and how badly damaged the tooth is.

One of the various tooth extraction techniques is called alveolotomy. An alveolotomy involves removing part of the alveolar and cortical bone in some complicated cases. It is performed whenever there are elements of difficulty and involves a minimal, controlled loss of supporting bone, avoiding uncontrolled fractures and accidents during extraction.

At Pacifica Dental, we believe in providing our patients with access to the best dental technology available. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been clinically proven to help patients heal faster with fewer complications after dental surgery and other procedures.

Did You Know?

PRP and PRF can help you:

  • Heal faster and get back to work and other activities quickly after a surgical dental procedure.
  • Reduce your need for strong pain-medication and anti-inflammatories following dental surgery.
  • Greatly lower the risk of infection after oral surgery.

Best of all, PRP and PRF are 100% natural.

In general, after a simple extraction, the recovery period is 5-10 days, until the resorbable sutures are dissolved. After a surgical (more complicated) extraction, the recovery is within 2 weeks,  however, the nonresorbable sutures and membranes will be removed after a month during a follow up appointment. We highly recommend that patients do not smoke, drink alcohol, swish, suck, or rinse the mouth on the day of the extraction. Icing is recommended for 2 days in order to avoid swelling and decrease bruising.

If you are in any kind of dental pain, don’t waste any time and schedule an emergency appointment with Pacifica Dental. We will take care of you as soon as possible and we will make sure you have a quick and successful recovery.