Endodontics / Root Canal Therapy
Dental Health and Root Canals
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.
"Root canal" is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth's nerve lies within the root canal.
A tooth's nerve is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory -- to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.
Why Does A Tooth Pulp Need to Be Removed?
When a tooth's nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the tooth. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:
- Swelling that may spread to other areas of the face, neck, or head
- Bone loss around the tip of the root
- Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.
What Damages a Tooth's Nerve and Pulp in the First Place?
A tooth's nerve and pulp can become irritated, inflamed, and infected due to deep decay, repeated dental procedures on a tooth, and/or large fillings, a crack or chip in the tooth, or trauma to the face.
What Are the Signs That a Root Canal Is Needed?
Sometimes no symptoms are present; however, signs you may need a root canal include:
- Severe toothache pain upon chewing or application of pressure
- Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
- Discoloration (a darkening) of the tooth
- Swelling and tenderness in the nearby gums
- A persistent or recurring pimple on the gums
What Happens During a Root Canal?
The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. After this the dentist will then use local anesthesia to numb the area near the tooth.
An access hole will then be drilled into the tooth. The pulp along with bacteria and the decayed nerve tissue is then removed from the inside of the tooth. Once this is removed, the inside of the tooth is cleaned and irrigated with an antiseptic solution. The root canal is then filled and sealed to prevent future infection. Usually, a crown restoration is need to accomplish adequate sealing and to prevent fracture of the tooth.
How Painful Is a Root Canal?
Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed. This is because of newer, more profound anesthetics and anesthetic techniques.
What Should One Expect After the Root Canal?
For the first few days following the completion of a root canal, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Most patients can return to their normal activities the next day.
Until your root canal procedure is completely finished -- that is to say, the permanent filling is in place and/or the crown, it's wise to minimize chewing on the tooth under repair. This step will help avoid recontamination of the interior of the tooth and also may prevent a fragile tooth from breaking before the tooth can be fully restored.
As far as oral health care is concerned, brush and floss as you regularly would and see your dentist at normally scheduled intervals.