Good News The majority of root canal procedures can be now performed in a painless single visit. With the application of modern techniques in dentistry, root canal is now easy and fast.
However, some cases with severe infection or difficult anatomy still need more time and extra visits, in order to obtain the best quality treatment.
Root Canals
Has your dentist told you that you need root canal treatment? If so, you're not alone. Millions of teeth are treated and saved each year with root canal, or endodontic, treatment.
To understand a root canal procedure, it helps to know about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.
Root canal treatment treats the inside of the tooth, and it is necessary when the pulp becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, faulty crowns, or a crack or chip in the tooth. In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
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How does Root Canal Treatment save the tooth?
During root canal treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. Afterwards, the tooth is restored with a crown or filling for protection. After restoration, the tooth continues to function like any other tooth.
Contrary to jokes about the matter, modern root canal treatment is very similar to having a routine filling and usually can be completed in one or two appointments, depending on the condition of your tooth and your personal circumstances. You can expect a comfortable experience during and after your appointment.
Saving the natural tooth with root canal treatment has many advantages:
• Efficient chewing
• Normal biting force and sensation
• Natural appearance
• Protects other teeth from excessive wear or strain
Root canal treatment helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last as long as other natural teeth and often for a lifetime.
What are the signs of needing root canal treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gum tissues. Sometimes, however, there are no symptoms.
Will I feel pain during or after the procedure?
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.
Step-by-Step Root Canal Procedure
Root canal treatment can often be performed in one or two visits and involves the following steps:
1. The endodontist (root canal specialist) examines the x-ray of the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “rubber dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called gutta-percha. The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
How much will the procedure cost?
The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat; the fee is usually more. Generally, root canal treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with an implant or bridge to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than root canal treatment and appropriate restoration.
Will the tooth need any special care or additional treatment after root canal treatment?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings. Most root canal treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.
What causes a treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure.
Can all teeth be treated endodontically?
Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When root canal treatment is not effective, surgery may be able to save the tooth.
Your Office Visit
A typical visit to an endodontist begins with completing paperwork, which includes your medical history and consent forms. It is advisable to bring a list of all the medications (over-the-counter and prescription) that you regularly/have taken within the past month. Once all forms are complete, an assistant will review and chart your chief complaint, referring dentist’s information and history of the tooth pain before taking x-rays of your teeth.
Once your first set of X-rays are complete, your endodontist will review your paperwork and evaluate your symptoms prior to testing the tooth in question along with adjacent teeth. After the tests are complete, a diagnosis will be given to determine the best treatment care and prognosis. The endodontist will make you aware of the benefits, options and risks involved in order for you to understand how root canal treatment can relieve your pain and save your tooth. Possible post-treatment decisions such as a crown on the treated tooth also will be addressed.
If you decide to receive treatment, the procedure may start immediately. Before treatment begins, you will receive local anesthesia to numb any sensations you may feel during the procedure. If the procedure is unable to be completed within one visit, medicine may be placed inside the tooth between appointments.
Once your procedure is complete, more X-rays are taken to track the success of the treatment. You will be provided with review sheets that include your post-operation instructions and what to expect over the next few days.
Be sure to contact your endodontist if you have any questions or concerns regarding your treatment.