Harlamb Endodontics Blog

The Source of Your Tooth Pain


Most people, at some point in their life, will experience tooth pain or another discomfort in the mouth. If you are experiencing pain right now, you are probably wondering “Why does my tooth hurt?” and, more importantly, “How do I make it stop?”

As endodontists, we are specialists in stopping tooth pain in its tracks. That’s right! Root canal therapy is one of the most dependable and permanent ways to make tooth pain stop. It also happens to be the healthier choice when compared to extraction.

As experts in pain-relief, we offer you this quick guide to the top three sources of tooth pain (can you guess what number one is?) The good news is that each of these conditions is both preventable and treatable.

  1. Cavities – Yep! You guessed it! Dental caries are the number one cause of tooth pain. While a general dentist can take care of early-stage caries with a filling, more serious decay that has gone past the crown and entered the roots requires a visit to the endodontist for root canal treatment. Prevent cavities in just 6 minutes a day by brushing twice and flossing once!
  2. Broken Fillings – If you have an old silver filling in your mouth, there is a good chance it will crack at some point during your life. The important thing to do if you suspect you have a broken or cracked filling is to visit your dentist ASAP for a replacement. Otherwise, bacteria will find its way into the crack and infect the root, which will then require more aggressive treatment such as root canal therapy.
  3. Cracked Teeth – If you feel a sharp pain when biting down on food, you probably have a cracked or chipped tooth. Tooth fractures are usually the result of biting down on something hard such as ice, nuts or hard candy, so those items should be avoided when possible.

Now that you know the source of your pain, we want you to know that we are here to help you determine the best remedy. We aim to get you in and out quickly, safely and comfortably. Don’t wait any longer to resolve your pain, give us a call at Harlamb Endodontics Phone Number 02 9715 2344.

Study Reveals Tooth Enamel Structure Composition


Exciting news in the world of dentistry and endodontics!

A University of Sydney research team has produced detailed 3D maps of the composition of tooth enamel. While we have known for some time that enamel is the hardest substance in the human body and that its strength comes from a complex hierarchical structure that includes magnesium, carbonate and fluoride ions, this is the first in-depth and detailed look at what the composition of that structure is.

Findings of this Study

Two major findings are exciting the dental community. First, there is now direct evidence that an amorphous magnesium-rich calcium phosphate phase may determine (to some degree) how teeth are formed. Second, organic material was also found in the structure, suggesting that proteins occur in patterns throughout the enamel, not just in the interfaces as we used to think.

What does this mean for endodontists?

Tooth enamel is the first line of defense when it comes to teeth and their roots. Once the enamel is compromised, decay starts to take place and, if left untreated (as you know), the infection may spread to the tooth’s roots, landing you in one of our chairs for root canal therapy. That is why we, as endodontists, want your enamel to stay healthy and strong for as long as possible!

What does this mean for patients?

The impact of this could be great down the road. This type of detailed information will allow dentists and other scientists and researchers to better determine what is going on inside the enamel of your teeth before, during and after decay.

New Treatments?

Potentially…yes! New treatments and prevention strategies for dental health are always on being made, thanks to ground-breaking research and studies such as this.

If you are experiencing tooth pain, it may be that you are in need of root canal therapy. We can help! Call Harlamb Endodontics Phone Number 02 9715 2344 for more information.

Getting the Basics Right in Endodontics

Dr Stephen Harlamb


As an Endodontist with over 20 years of experience as well as a degree in Health Law, I have noticed general dentists commonly ask questions with a recurring theme.

These newsletters will address many of your clinical endodontic and trauma questions, provide tips and other simple ‘dento-legal’ concerns that you may have. Being the inaugural edition, I have selected seven of the most common clinical questions I am asked.

  1. What to irrigate with and for how long?Irrigating is an essential part of endodontic treatment and to this day I continue to use EDTA and 1% Sodium Hypochlorite (Na OCl) – I use a 5 ml syringe for EDTA and 10 ml for the Na OCl and in that way I can make a mental note to alternate their use – each time I put a file down I irrigate, alternating the two.
  2. What to medicate canals with, when, and for how long?Calcium hydroxide (CH) remains the medicament of choice in infected cases – I spiral it in with a lentulo spiral, no nearer than 4 mm from the apex.
    I recommend leaving CH in the canal for no less than 14 days. Odontopaste® (which has replaced Ledermix®) is more often used in inflamed cases (pulpitis) and applied in the same way.
  3. When to use antibiotics?
    Antibiotics are commonly misprescribed when it comes to endodontics – postoperative pain is often inflammatory in nature and as such NSAIDs such as Nurofen are most effective. Patients often will receive no relief with antibiotics, especially with an inter-appointment flare-up.
  4. What instrument size to finish with and why?There are no hard and fast rules with the final sizing of canals. The final size is dictated by the initial file size which binds. See below:

    The initial size to bind here was a 70H. Hence the final prep size was a 100H.

  5. What to obturate with and why?
    I still use the lateral condensation technique taught as an undergraduate all those years ago!! GP and AH+ with finger spreaders do the job just fine! I am not a fan of thermoplasticised GP with carriers – they make re-treatment quite challenging.
  6. What to do if you don’t find the MB2 canal?
    Fourth canals (aka MB2, MBA), especially in upper 6s and 7s are more common than many think (over 90%)…so, therefore, assume one is there, and if you don’t find one, a specialist referral is recommended.
  7. When to re-treat prior to crown placement?
    A contentious issue commonly debated as it can come down to a subjective rather than objective discussion. I tend to recommend re-treating (even if apically all appears fine) prior to crown placement especially if the endodontic history is vague or if there are radiographic deficiencies in the RCF. Nothing worse than cementing a crown and then followed by a flare-up!