Dr. Richard Gangwisch performs a root canal on an actual patient. Dr. Gangwisch performs root canal treatment in Lilburn, Snellville, Lawrenceville and surrounding communities of Gwinnett County.
Narrator - Actually, the two words Root Canal can strike up the fear in any of us. But with today’s advanced technology, a root canal is relatively pain free and it doesn’t take as long as it used to. So if you are about to have a root canal or if you are just interested in knowing about the procedure, this video can hopefully inform and put you at ease. But I do have to warn you. If you are at all squeamish about pointy dental instruments at work, or a little bit of blood, maybe this video isn’t for you. But if it is, then let’s get started with Dr. Richard Gangwisch.
Dr. Gangwisch – I chose this tooth because the patient had fractured the tooth below the gum line which provides a very remarkable opportunity to see how a root canal is done. What we have now is we are opening up the tooth. We have to be able to expose the nerve so that we can go and clean everything out. When we clean those out, that is basically the root canal itself which we will be seeing here shortly. Here we go. We have got to identify the canals. There is a little probe there to see where we are at. And we take an instrument that is a rotary instrument and go into the canals and open them up a little bit so we can have the ability to get down them. Now this canal goes all of the way through the root and into the bone. Now we have an instrument that’s called a file. And we attach a probe there. It’s an electronic device that is actually used to determine the length of the tooth. So we clean it up; check again. Still can’t get down that darn canal, so we have to continue on that. We’ll open it up a bit. There we go again, opening it up a bit more. We need to have plenty of access to do that. Now normally we have to drill through tiny openings in the tooth, so this is a great opportunity to see exactly what goes on. Here we go. We take the file down again. We clamp what is called an apex locator. We still have to get down a little further, so we are going to work that file. That file is so tiny. That’s the problem that we have with those type of canals; trying to get down that last little bit. So now, we take an irrigating solution. That’s a material that is basically sodium hypochlorite. That’s able to clean out all of that debris, dead tissue, live tissue; anything that is in the way. We have to clean that out real good. So now we’ve got some files there and we are going to take an x-ray. And that is how we determine our final length. So now we know our length, so we are going to go ahead and clean it out real good. What we do is take a series of these files. These are nickel-titanium, a space age metal. We periodically change, stop and clean everything out. We go back in. It’s kind of a slow process, but it’s not that bad. But the good news is that you notice that the patient doesn’t feel a thing. So that works great. Everyone is always concerned about having a root canal done, but as you can tell, the patient isn’t even flinching at all; doesn’t feel a thing. So, as you notice, the canal is getting bigger and bigger. And we are able to get further down and further down. Now what we are doing now is that we are cleaning and shaping all of that area so that we will be able to go ahead and get every single bit of debris out of there. So we are getting close at this point. Modern technology is much better than the old days. We used to have to have to go in with hand files and clean everything out that way. Alright, now we’ve got the agitator. It takes that irrigating solution and mixes it up real good. And helps dissolve more and more tissue that is hiding in the little nooks and crannies. Now these little white things are called paper points. That’s exactly what they are, little points of paper. And what we are doing now is taking that irrigating solution and drying that up. We have to have a perfectly dry canal. We want to make sure that there is no moisture and blood at the end. Now it looks like it’s coming around real good on that. Now the pink things are called gutta percha. And what that is is a resin substance that is found in a tree in Peru. It’s very biocompatible. What we do is we put that in. We have a little white sealer. You saw that ooze out there. What we are doing there is we are taking heat and pushing that down to the bottom of the apex which is the end of the root. And we will go ahead and pack that in and that gets that in to all of those little spaces there right at the end of the root. And we will seal that up real good. And now we are going to go into the other canal. This particular tooth has two canals. You can see the white sealer. That’s going to seal up all of those areas that are little off shoots to the canal. Here we go with the same thing. We have the heat. We’ll pack it down there real good. We’ll get a good seal on that. That’s what’s going to make for a long lasting root canal. And we’ll go ahead and pack that in real good too. Alright, now we are going to do the backfill. We have already gotten the ends of the roots taken care of. Now, we are going to go ahead and fill everything up and make sure that we have a good, solid fill. Sealing the end of the canals is the important thing. If you go ahead and clean out all of that debris and seal it, then the body doesn’t realize that there is no nerve inside, so it retains the tooth. So that gives us the ability to save teeth. And you can see all of that extra gutta percha. And I’ll go ahead and pack that in real good. Same thing; you notice that the patient isn’t even flinching at all. He doesn’t feel a thing. And, we’ll go ahead and apply a little bit of temporary material over the top. This tooth will be ready to put a crown on at the next appointment. And there we go. That’s what a finished root canal looks like; totally pain free.