The end of root canal torture?

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Treatment involves extracting the tooth or removing bacteria from the root canal system to prevent further decay and, in severe cases, the loss of the tooth. Picture: Kristen van Schie

London - Dentists have developed an unusual strategy for avoiding the need for root canal treatment — making tiny cuts in the teeth.

Studies suggest that making tiny areas of damage in the nerve root of damaged and infected teeth triggers bleeding, which then forms bloodclots.

These clots appear to stimulate blood supply to the tooth nerve, helping it re-grow and avoiding the need for painful and lengthy treatment.

The treatment is being trialled at the University of Liverpool.

In the centre of each tooth is a network of nerves and blood vessels that run from the top, or crown, down to the root, which is embedded in the jaw.

This network is called the root canal system, and the nerves and blood vessels are collectively referred to as the pulp.

Root canal treatment is necessary when the pulp becomes infected, often as a result of injury, tooth decay or a faulty filling.

Treatment involves extracting the tooth or removing bacteria from the root canal system to prevent further decay and, in severe cases, the loss of the tooth.

Removing bacteria involves a dentist drilling into the tooth, removing the infected pulp, then filling the entire system with a type of sealant.

The tooth is then topped with a filling or a crown.

However, because the procedure is so long that it requires multiple visits to the dentist, usually over the course of around 18 months.

Often this treatment is needed on the large teeth at the back of the mouth, which contain multiple root canal systems.

The new treatment, called revascularisation, can be performed in just two visits.

In the procedure, dentists drill into the tooth and then apply an antibiotic paste to disinfect thecanal. At a second visit two weeks later, the dentist uses a tool to make tiny cuts to the root canal system, until the tissue starts to bleed.

This bleeding quickly triggers a blood clot, which encourages the growth of new blood vessels.

This boosts oxygen and nutrient supply, and helps the pulp repair itself. Exactly how it does this is not clear, but one suggestion is that the blood clot contains a high concentration of growth factors — compounds that help repair damaged tissue.

Early studies have shown that the technique is successful, and scientists at the University of Liverpool are using it on 30patients.

Half will have the new treatment and half will have conventional root canal treatment.

Commenting on the new treatment, Hugh Devlin, professor of restorative dentistry at the University of Manchester, said: “It’s an excellent technique and is getting a lot of interest in the academic journals.

“Traditional treatment eliminates bacteria, but prevents growth of a new blood supply to the root.”

* Meanwhile, scientists say that a substance based on the sticky glue mussels use to cling onto rocks may be a new treatment for sensitive teeth.

Researchers from Hong Kong have developed a similar material to mussel glue that is sticky enough to hold minerals such as calcium against teeth.

Early stage laboratory tests show this helps repair enamel — the tough outer layer that can wear down and trigger sensitivity.

If further trials are successful, the researchers hope to start human trials in the next five years. - Daily Mail

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