Root canal therapy is used to treat disorders of the pulp of the tooth (the tooth’s soft core). In the past, teeth with damage to the pulp or disease in the nerve had to be extracted. Today, root canal therapy provides a way to save a tooth and eliminate pain with a five step process that removes infection and stabilizes the remaining tooth.
The outer shell of your tooth is made of enamel. Below the enamel lies a layer of dentin. The inner part of your tooth is made up of a soft core full of pulp, which contains nerves, arteries, veins and lymph vessels, providing nourishment for the cells within the tooth. Each tooth has only one pulp chamber, but teeth with more than one root will have one canal for each root.
If a tooth’s pulp is exposed to saliva, whether because of trauma causing a break or crack, an untreated cavity, or a lost filling, bacteria can enter and cause an infection. Infected pulp then becomes unable to repair itself, and dies. The nerve endings become exposed, and pus can build up inside the tooth at the root tip, forming an abscess. Untreated infections will result in the surrounding tissues also becoming infected.
Indications you need a root canal may include:
Even in the absence of pain, certain byproducts of a diseased pulp can injure the bone that anchors your tooth in the jaw. Without root canal therapy, your tooth will eventually have to be removed.
After the tooth is anesthetized, a small opening is made through the top surface of the tooth into the pulp chamber.
The depth of the root canal is determined.
Unhealthy pulp is carefully removed from both the pulp chamber and the root canal(s), prior to cleaning, enlarging, and shaping the canal(s) to a form that can be properly filled.
The pulp chamber and root canal(s) are then filled and permanently sealed with a material that prevents bacteria from re-entering.
In the final step, a gold or porcelain crown is usually placed over the tooth to restore structure, function and appearance.
A root canal and the placement of a crown can often restore a tooth’s functionality, eliminate pain, and prevent the loss of the tooth.
It is not uncommon for a tooth to be uncomfortable or even exhibit a dull ache immediately after receiving root canal therapy. This pain should subside within one week. Your tooth will be sensitive to biting pressure, and may even appear to feel loose. This is temporary; it is due to sensitivity of nerve endings in the tissue just outside the end of the root where we cleaned, irrigated, and placed filler and sealer material.
We recommend that you take an approved medication for pain relief within one hour of leaving our office, to get the medication into your blood system before the anesthesia we administered begins to subside.
We recommend ibuprofen (Nuprin, Advil, Motrin) – 800 mg (four tablets). If you have a medical condition or gastrointestinal disorder which precludes ibuprofen, acetaminophen (Tylenol, Excedrin) is a substitute, although it does not contain anti-inflammatory properties. Aspirin and aspirin-containing products are not advisable, as they tend to increase bleeding from the area that was treated.
Whenever possible, try to chew on the opposite side of the tooth we have just treated, until you have a crown or onlay placed, or until the access area is restored. Until that time, your tooth still is weakened and could fracture.
While the course of treatment must be your decision, there are many disadvantages to losing a tooth. When a tooth is removed and not replaced, the teeth next to the empty space begin to shift from their normal position. This may cause teeth to become crooked or crowded which decreases chewing and biting efficiency. Crowded or crooked teeth may be more prone to dental disease because they are harder to keep clean than properly aligned teeth.
In addition, the bone beneath the site of the extracted tooth will start to disappear, causing adjacent teeth to become loose and eventually more teeth will be lost. Root canal treatment can safely and comfortably save a tooth that otherwise would have to removed. Root canal therapy is successful approximately 95% of the time, and leaves you with a healthy restored tooth.