Saturday, April 13, 2024

Dental care for seniors

On 29 Oct, 2022 Seniors Today hosted their weekly Health Live with Dr P D Joshi, a Senior Dental Surgeon who spoke on and answered questions about Endodontic Care for Seniors. 


Dr P D Joshi is an eminent Consultant Endodontist practising in Mumbai since 1980. He has graduated from Nair Hospital Dental College, Mumbai: BDS in 1980 and has done an MDS (Conservative Dentistry) in 1983.


He is Head of the Dept of Dentistry and Hon Consultant Endodontist at Lilavati Hospital & Medical Research Centre, Mumbai. He is on the panel of Bhabha Atomic Research Centre as Consultant Endodontist and is a Consultant Lecturer at Zeiss – MUHS Microdentistry department at Government Dental College, Mumbai. He runs his own training centre CARE in MicroDentistry Pvt.Ltd.


He is recognised and well-known as a trainer for various companies like DentsplySirona, Carl Zeiss, De-trey, Maillefer, VDW from Germany and Switzerland.


He conducts training programmess on Endodontics for practising Dental Surgeons, under the aegis of various Dental Associations all over the country, Abroad & at his own Endodontic Centre in Mumbai.



He has taught at the University of Kebangsaan at Kuala Lumpur, Malaysia. He is invited at Various Dental Conferences all over India, Sri Lanka, Thailand, Nepal , Malaysia and Endodontic Forums  at China, Singapore and Thailand and Malaysia and also at Hong Kong University, Bangladesh.


He has published original research articles, and writes in many national and international Journals He has been on the Advisory Board of Famdent,Cipla and Quintessence Publications. 


15 million root canal treatments are done in the US, annually; of which about 50% would be senior citizens. And after examining and reviewing patients who had received root canal treatment after 8 years of receiving the treatment, the survival rate of 96% was observed. 

A well conducted Endodontic treatment has a success rate of 99.4% 


The need for a root canal treatment typically starts with the formation of a deep cavity which on further cleaning will show us some soft tissue and there also might be nerve exposure. If the nerve is exposed, a root canal treatment is required. If the nerve is not exposed; you dentist at that point in time can take an educated decision 

Another cause for nerve exposure can also be excessive tartar collection. This means that it is collected over time and you should get it cleaned on the regular, every 6 months, if you want to retain your teeth. 


Wear and tear of the teeth because of bad chewing habits, for example chewing tobacco, pan, supari or guttka can lead to this. Some individuals also have a condition called bruxism where the individual grinds his teeth involuntarily which can also lead to their wear and tear. 


A successful treatment depends on a few factors, some of which are in the hands of the patient, a few in the hands and skill of the treating physician and others depend on the condition that has led to the need for the root canal treatment. 

The factors are: 


  • General factors: Coexisting medical conditions and comorbidities, mouth opening of the patient, salivation, approach to the tooth.  
  • Pre- operative factors: Your diagnosis, faulty treatment at the end of the dentist, lack of knowledge and training of the dentist. 
  • Pre operative status of the tooth: whether or not your tooth is vital or viable, if the tooth has been previously treated or if incomplete treatment was given, if there is any a fire of chronic disease or infection in the tooth that might have led to a cyst or lesion, and if so, the size of it. 
  • During treatment factors: Access to the tooth, cleaning and shaping of the tooth, obturation, post endo-  restoration. 


Steps of Root Canal Treatment: 

  • Diagnosis 
  • Treatment planning, by the dentist, where in he will decide how many sitting will he require, his approach, etc 
  • Pain management and relief 
  • Isolation of the tooth 
  • Access preparation 
  • Magnification and canal isolation 
  • Glide path formation 
  • Cleaning and shaping 
  • O Tu ration 
  • Post Endodontic restoration 

Some of the above are technical terms and steps that you should not worry about. 


For you, as a patient, steps would be:

  • Getting an early appointment 
  • Diagnosis 
  • Control of pain 
  • Going through the procedure of root canal 
  • Completing the procedure 


You might experience pain and the kind of pain can vary, these can be 

  • Pain on it’s own 
  • Pain during intake of hot and cold food items 
  • Disturbance in sleep due to pain 
  • Inability to chew food due to pain on chewing or biting 
  • Visible swelling externally or internally 
  • Pus discharge 


Dr Noor Gill
Dr Noor Gill, MBBS, deciphers the space between heartbeats, figuratively and literally. Powered by frequent long naps and caffeine, she believes that “knowledge without giving back to society is meaningless” and works to make caring cool again.

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