Root Canal Treatments

A tooth has outer enamel, the dentin (main body of the tooth) and the soft tooth pulp. Nerves and blood vessels enter the tooth through the end of the root (called the apex) and then pass through a canal inside the root to the pulp chamber. The pulp chamber is present inside the crown--the part of the tooth that is seen in the mouth.

In root canal treatment, the tooth pulp which may be inflamed or infected is removed. After removing the diseased pulp tissue, the space is cleaned, shaped and filled.  This treatment secures the root canal. Before root canal treatment was done teeth with diseased or injured pulps had to be extracted. This treatment has helped to save several teeth that would or else be extracted.

Pulp damage or death can be caused by

• Crack in the tooth
• Deep cavity in the tooth
• Injury to a tooth

If the pulp gets infected or dies, without treatment it can cause pus accumulation at the root tip in the jawbone, leading to an abscess. Untreated abscess can extend and destroy the bone around the tooth and cause pain.

How is a Root Canal Done?

The steps involved in root canal treatment are

• Initially an opening is made in the tooth----in the back of a front tooth or crown of back teeth (molar or pre-molar).
• The diseased or inflamed pulp is removed (a pulpectomy). After removing the diseased pulp tissue, the space is cleaned, shaped and filled.
• If the procedure is done in more than one visit, a temporary filling is placed on the opening to safeguard the tooth before the next dental visit. On the next visit temporary filling is taken out and the pulp chamber and root canal is permanently filled.
• After the treatment a crown is usually placed over the tooth. This helps to restore the natural shape and appearance of the teeth.

How Long Will the Restored Tooth Last?

Teeth after root canal treatment can last for the rest of your life with proper care. Your tooth can develop decay and cavities even after root canal treatment. To increase the longevity of your teeth maintain good oral hygiene. To maintain healthy teeth and gums brush with fluoride toothpaste (twice a day) and floss everyday. Go for regular dental checkups and professional cleanings.

Endodontists are specialist who diagnose and treat tooth pulp infection or disorders. They are specialists who do root canal treatment. A tooth has outer enamel, the dentin (main body of the tooth) and soft tooth pulp (in the center of the tooth and in canals also called root canals). Nerves and blood vessels enter the tooth through the end of the root (called the apex) and then pass through a canal inside the root to the pulp chamber. The pulp chamber is present inside the crown--the part of the tooth that is seen in the mouth.

Pulp nourishes the tooth while it erupts through the gum. But in a mature tooth the pulp can be removed from the pulp chamber and root canals. Removal of tooth pulp in a mature tooth from the pulp chamber and root canals causes no damage to the tooth. The procedure of removing the pulp is called root canal treatment or root canal therapy.

Why Would You Need Root Canal Treatment?

Root canal treatment is most often done for

• infection in the pulp or
• irreversible damage to the pulp.

 
The most common cause of pulp infection is tooth decay or cavity. Untreated caries can extend from the enamel to the dentin (main body of the tooth) up to the soft tooth pulp and the sensitive nerve fibers within it. Once the pulp is infected it cannot be treated by antibiotics. The inflammation due to infection restricts the tooth's blood supply and the penetration of antibiotics in the pulp of the tooth.

 

Tooth pulp can also become inflamed due to trauma, tooth fracture,  restorative work, such as repeated fillings over a period of time or even common dental procedures like preparing a tooth for a crown. As the inflamed pulp can heal and become normal your dentist may monitor the tooth for healing before doing a root canal treatment. If the pulp fails to heal it can cause pain and lead to infection.

 

If the pulp gets infected, without treatment it can cause accumulation of pus at the root tip in the jawbone, leading to an abscess. Untreated abscess can extend and destroy the bone around the tooth and cause pain. In root canal treatment, the tooth pulp which may be inflamed or infected is removed. After removing the diseased pulp tissue, the space is cleaned, shaped and filled.  This treatment secures the root canal. This treatment has helped to save several teeth that would or else need extraction.

 
Signs and Symptoms

 

Infection of the pulp of the tooth may not cause pain initially. But without treatment it can cause pain and swelling. In some cases untreated infection can cause pus accumulation at the root tip in the jawbone, forming an abscess. Untreated abscess can extend and destroy the bone around the tooth and cause pain.

 

Some symptoms that indicate your tooth may need root canal treatment are

•  Pain in tooth when you bite down on it, touch it or push on it
•  Sensitivity to heat or cold
•  Swelling in the jaw near the affected tooth
•  Discolored tooth that may or may mot be painful
•  Fractured or broken tooth

 
Your dentist will advise you for root canal treatment after examining the tooth and if required a dental X-ray.

 
Length of Treatment

 

Some dentist may do root canal treatment in one visit while some may do in more than one visit. Before doing a root canal treatment your dentist will ensure that the infection from the tooth is eliminated. Most uncomplicated root canal treatment can be done in one visit. But if there is a complication it may need two or more visits to do the root canal. After the treatment a crown is usually placed over the tooth. This helps to restore the natural shape and appearance of the teeth.

 

How is a Root Canal Done?

 

The steps involved in root canal treatment are

• Your dentist or endodontist will give a local anesthesia to numb the area around the tooth. If you are very apprehensive and tense you may need sedation, such as nitrous oxide.
• Initially an opening is made in the tooth - in the back of a front tooth or crown of back teeth (molar or pre-molar).
• The root canals are measured to determine the length so that your dentist can make sure all the diseased tissue is removed and the entire canal is cleaned. Length of the canal is determined using X-rays or an electric device called an apex locator.
• The diseased or inflamed pulp is then removed (a pulpectomy). After removing the diseased pulp tissue, the space is cleaned, shaped and filled.
• If the procedure is done in more than one visit, a temporary filling is placed on the opening to safeguard the tooth before the next dental visit. On the next visit temporary filling is taken out and the pulp chamber and root canal permanently filled.
• After the treatment a crown is usually placed over the tooth. This helps to restore the natural shape and appearance of the teeth.

 
After Root Canal Treatment

 

After the procedure you can have soreness in the concerned tooth for two to three days. You may be prescribed pain relievers such as acetaminophen or ibuprofen to ease the discomfort. You will be advised not to chew on the affected side. Even though the pulp of the tooth is removed the nerves that supply surrounding your tooth can feel pressure and touch.