Root Canal Therapy

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection.  In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed.  Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:

  • An abscess (or pimple) on the gums.
  • Sensitivity to hot and cold.
  • Severe toothache pain.
  • Sometimes no symptoms are present.
  • Swelling and/or tenderness.

Reasons for root canal therapy:

  • Decay has reached the tooth pulp (the living tissue inside the tooth).
  • Infection or abscess have developed inside the tooth or at the root tip.
  • Injury or trauma to the tooth.

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.  An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria.  If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials.  A filling will be placed to cover the opening on top of the tooth.  In addition, all teeth that have root canal treatment should have a crown (cap) placed.  This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.

You will be given care instructions after each appointment.  Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

Does a root canal hurt? 

The patient is first numbed using a local anesthetic. Access to the pulp is achieved by creating a small hole in the crown of the tooth, and the infected tissue is then cleared out using a series of drills and files. Afterwards, the hollows of the tooth are cleaned and decontaminated. A series of files, gradually increasing in size, are used to widen and shape these canals to prepare them for restoration. This part of the process can take multiple appointments, as the dentist needs time to ensure that the infection doesn’t return after removal.

Once the area is officially clean and infection-free, the hollows are filled with inert material, most commonly gutta percha, a natural polymer made from latex from the Percha tree. This helps to prevent future infections. Depending on the condition of the tooth, a final restoration of either a filling or a crown will then be placed.

After successful completion of endodontic therapy, the tooth is considered officially “dead,” as all the nerve tissue has been removed. Given this, teeth with root canals are more brittle than natural teeth. Care should be taken to avoid fracture or further damage to the tooth. Saving the outer structure and roots of the tooth, however, is usually preferable to losing the tooth altogether, and a root canal will do just that in many cases.

What should I expect after a Root Canal?

  • You can expect to be numb for a few hours following your procedure. Due to this numbness, drinking and eating may be difficult in the affected area. Avoid drinking anything very hot or chewing as you might hurt yourself without realizing it.
  • Since the nerve was removed, sensation for that particular tooth will be diminished or absent. However, sensitivity or soreness is normal following the procedure due to the manipulation of the surrounding tissues and probable infection in the bone from the diseased nerve. This usually abates in a couple of weeks but could last as long as six. If your sensitivity worsens, does not subside or you are in pain, call your dentist to schedule a follow up so they can make sure the infection is gone.
  • Swelling can happen following root canal therapy.  Swelling can be a symptom of a more serious issue or remaining infection. To be safe, call your dentist immediately if swelling is present.
  • Teeth that have undergone root canal therapy are more brittle due to the lack of blood supply and must be protected accordingly. For posterior teeth, or teeth missing a lot of their original structure, our office recommends placing a crown to strengthen the tooth and prevent further trauma. Think of this a your way of protecting your investment!
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