Root Canal Therapy
What is a root canal?
Underneath your tooth's outer enamel and within
the dentin is an area of soft tissue called the
pulp, which carries the tooth's nerves, veins,
arteries and lymph vessels. Root canals are
very small, thin divisions that branch off from
the top pulp chamber down to the tip of the root.
A tooth has at least one but no more than four
root canals.
Why do I feel pain?
When the pulp becomes infected due to a deep
cavity or fracture that allows bacteria to seep
in, or injury due to trauma, it can die.
Damaged or dead pulp causes increased blood flow
and cellular activity, and pressure cannot be
relieved from inside the tooth. Pain in the
tooth is commonly felt when biting down, chewing
on it and applying hot or cold foods and drinks.
Why do I need root canal therapy?
Because the tooth will not heal by itself.
Without treatment, the infection will spread, bone
around the tooth will begin to degenerate, and the
tooth may fall out. Pain usually worsens
until one is forced to seek emergency dental
attention. The only alternative is usually
extraction of the tooth, which can cause
surrounding teeth to shift crookedly, resulting in
a bad bite. Though an extraction is cheaper,
the space left behind will require an implant or a
bridge, which can be more expensive than root
canal therapy. If you have the choice, it's
always best to keep your original teeth.
What is involved in root canal therapy?
Once your general dentist performs tests on the
tooth and recommends therapy, he or she can
perform the treatment or refer you to an
endodontist (a pulp specialist). Treatment
usually involves one to three appointments.
First, you will probably be given a local
anesthetic to numb the area. A rubber sheet
is then placed around the tooth to isolate it.
Next, a gap is drilled from the crown into the
pulp chamber, which, along with any infected root
canal, is cleaned of all diseased pulp and
reshaped. Medication may be inserted into
the area to fight bacteria. Depending on the
condition of the tooth, the crown may then be
sealed temporarily to guard against
recontamination, or the tooth may be left open to
drain, or the dentist may go right ahead and fill
the canals.
If you're given a temporary filling, usually on
the next visit it's removed and the pulp chamber
and canal(s) are filled with rubber-like gutta
percha or another material to prevent
recontamination. If the tooth is still weak,
a metal post may be inserted above the canal
filling to reinforce the tooth. Once filled,
the area is permanently sealed. Finally, a
gold or porcelain crown is normally placed over
the tooth to strengthen its structure and improve
appearance.
What are the risks and complications?
More than 95 percent of root canal treatments
are successful. However, sometimes a case
needs to be redone due to diseased canal
off-shoots that went unnoticed or the fracturing
of a canal filing instrument used both of which
rarely occur. Occasionally, a root canal
therapy will fail altogether, marked by a return
of pain.
What happens after treatment?
Natural tissue inflammation may cause
discomfort for a few days, which can be controlled
by an over-the-counter analgesic. A
follow-up exam can monitor tissue healing.
From this point on, brush and floss regularly,
avoid chewing hard foods on the treated tooth, and
see your dentist regularly.
This information was compiled for you by the
Academy of General Dentistry.
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