Communicating with patients is a big part of being a dental assistant.
You must calm frightened patients, soothe angry patients, and explain complicated
procedures.
Your dentist just told a patient, Mrs. White, that she
has an abscessed molar tooth. The dentist can save the tooth by doing a root
canal and putting a crown on it afterwards. Mrs. White has never had a root
canal and she is afraid. She has heard a lot of horror stories from people
she knows. She is also in a lot of pain.
The infection from
an abscessed tooth can spread and harm other parts of the body. Some people
need to take antibiotics to cure the infection before the dentist can complete
the root canal.
Dental professionals call root canals endodontic
therapy. Endodontic therapy can lead to jaw bone infection but the dentist
can control the risks.
In most cases, root canal treatment is not
painful. The sooner it is done the better. If the tooth becomes severely infected,
the abscess may come to contain acids that will stop the local anesthetic
from working. In that case, the procedure will be painful.
Teeth
have a hollow area in the center that contains soft tissue or "pulp." The
hollow area contains a space called the "pulp chamber." Thin canals connect
this pulp chamber to the tip of the roots. They run through the roots like
lead runs through a pencil. Teeth have one to four canals, depending on where
they are in the mouth. The back molars have the most canals. Sometimes
a cavity on the outside of a tooth causes the pulp in the canals to become
infected. If this infection isn't treated, the infection can spread to the
jaw. This is very painful. To save the tooth, the dentist drills into the
pulp chamber and scrapes the infected pulp out of the root canals.
If
the infection is great, the dentist may prescribe antibiotics and leave the
tooth open for a week so the infection can drain out. Usually, they tell the
patient to rinse their mouth frequently with hot, salty water. This helps
the mouth heal.
In a week's time, when the infection is gone, the
patient returns for the second part of the procedure. The tooth should respond
to the anesthetic now, if it didn't before.
The dentist fills the root
canal passages with a polymer substance called Gutta-percha. He melts this
material and injects it into the canal passages. The dentist adds barium to
the material so the filling will show up in an x-ray. Then he will know that
the passages have sealed properly.
After the root canal is healed,
the tooth needs a crown to protect it. To do this, the dentist drills away
much of the remaining tooth. He puts a temporary crown on the tooth while
a dental laboratory makes the permanent crown. When the permanent crown is
ready, the patient returns. The dentist attaches the permanent crown. Sometimes
they may have to put small posts in the tooth to hold the crown in place.
Sometimes
root canals can fail. The canals can be tiny and difficult to see. Some canals
have odd shapes making it difficult to scrape out the pulp. And occasionally,
a bit of metal file breaks off in the tooth during the procedure. If this
happens, the dentist usually leaves it there.
You now must
explain the procedure to Mrs. Smith. Mrs. Smith's tooth will probably respond
to the anesthetic. The dentist is catching it early enough. She will require
antibiotics. Her dental insurance will cover 80 percent of the root canal
and 50 percent of the crown. She will have to pay for the rest herself. What
do you tell her?