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Root Canals

What is root canal treatment?

A root canal is necessary to treat a tooth that is suffering from severe tooth decay. At this point, the decay and inflammation has spread to the nerve of the tooth, causing it to die. This can lead to infection that can be extremely painful, and may cause swelling in the gums, causing a severe toothache. In the past, teeth whose nerves had become infected had to be removed. Today, dentistry has advanced to the point where all but the most severely diseased teeth can be saved. Root canal therapy is what makes this possible. The Academy of General Dentistry estimates that root canal therapy is successful for over 95 percent of cases.

What is the dental pulp?

The pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.

What happens if the pulp gets injured?

An abscessed (infected) tooth caused by tooth decay. When the pulp is diseased or injured and can’t repair itself, it dies. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tip, in the jawbone, forming a “pus-pocket” called an abscess. An abscess can cause damage to the bone around the teeth.

Why does the pulp need to be removed?

When the infected pulp is not removed, pain and swelling can result. Certain byproducts of the infection can injure your jaw bones. Without treatment, your tooth may have to be removed.

What happens during a root canal?

Before beginning your root canal, your dentist will carefully examine all of your teeth. Then, the infected tooth and the surrounding area will be numbed, using the same type of anesthetic that is used for filling a cavity. This helps to ensure that you remain comfortable throughout the root canal procedure. Your dentist will then remove the decayed tooth matter, inflamed and infected tooth pulp, and nerve tissue located within the tooth root. Your dentist will then use a special filling material different from ordinary fillings known as gutt-percha. This substance is rubbery, and will block the tooth root structure to prevent oral fluids from reaching the tooth.

In some cases where the infection or damage is extensive, removing the tooth pulp and other materials will leave the tooth much weaker than it ordinarily would have been. For this reason, your dentist will fill the core of the tooth and place a crown over the tooth in order to protect it from further damage. Your dentist may choose to place the crown during a separate visit if you appear distressed or uncomfortable during your root canal.

Root Canal 10 Step Process

Treatment often involves from one to three visits. During treatment, your general dentist or endodontist (a dentist who specializes in problems of the pulp) removes the diseased pulp. The pulp chamber and root canal(s) of the tooth are then cleaned and sealed.

Here’s how your tooth is saved through treatment:

  1. First, an opening is made through the crown of the tooth.
  2. An opening is made through the crown of the tooth into the pulp chamber.
  3. The pulp is then removed. The root canal(s) is cleaned and shaped to a form that can be filled.
  4. The pulp is removed, and the root canals are cleaned, enlarged and shaped.
  5. Medications may be put in the pulp chamber and root canal(s) to help get rid of germs and prevent infection.
  6. A temporary filling will be placed in the crown opening to protect the tooth between dental visits. Your dentist may leave the tooth open for a few days to drain. You might also be given medicine to help control infection that may have spread beyond the tooth.
  7. The pulp chamber and root canals are filled and sealed.
  8. The temporary filling is removed and the pulp chamber and root canal(s) are cleaned and filled.
  9. In the final step, a gold or porcelain crown is usually placed over the tooth. If an endodontist performs the treatment, he or she will recommend that you return to your family dentist for this final step.
  10. The crown of the tooth is then restored.

Following up after a root canal

Your dentist will likely schedule a follow-up appointment after a period of three to six months in order to check that the bone around the tooth has completely healed following the root canal. In the meantime, you should follow any after-care procedures recommended by your dentist and care for your teeth as usual. In some cases, your dentist may recommend additional procedures, or advise you on changes to your brushing and flossing technique in order to prevent any further damage to your teeth from tooth decay.

How long will the restored tooth last?

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums. However, regular checkups are necessary. As long as the root(s) of a treated tooth are nourished by the tissues around it, your tooth will remain healthy.