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Endodontic (Root Canal) Therapy
Many patients are concerned when they are told they need a root canal. All of our dentists are highly skilled in providing endodontic therapy and in fact, most root canals can be performed from the comfort of our practice.
If you need a root canal and have questions, you can learn more about the procedure below.
WHAT IS THE DENTAL "PULP"?
Inside the tooth is a hollow chamber filled with soft tissue. This soft tissue is the "pulp". It consists of a nerve, vein, arteriole, and lymphatic tissue. The pulp is living tissue whose job it is to maintain the tooth in a healthy state.
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ENAMEL |
DENTIN |
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PULP CHAMBER |
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ROOT CANAL
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WHY DOES THE PULP DIE? WHAT IS AN ABSCESS?
If infected by bacteria the pulp can get abscessed. When this occurs, the infected pulp swells like an infected finger would. The problem is, since the pulp is encased in hard tooth structure, there is no place to swell. The swelling creates pressure on the nerves against the inner walls of the pulp chamber. Thus you will experience moderate to intense pain, and then the pulp dies. The entire tooth fills with bacteria and it must be either extracted or root canalled.
HOW IS A ROOT CANAL DONE?
First the tooth is opened, giving the doctor access to the pulp chamber. The dead tissue and bacteria are cleaned out with very small files that go down to the end of the root. The pulp chamber and the canals are enlarged and flushed with a germicide until they are clean. If the infection is large, many times root canals are completed in two visits. On the first visit, the infected tissue is removed from inside the pulp chamber and canals. This is called an “open and drain". Antibiotics are then given between appointments to help minimize the infection. At the second visit the canals are filled to block them from harboring bacteria again. In the rare case a canal cannot be navigated and cleaned thoroughly, the procedure will be referred to a specialist, endodontist, to complete the procedure.
WHY MUST ALL ROOT CANALLED TEETH BE CROWNED?
Once a tooth has been root canalled, it is non-living and very brittle. If a root canalled tooth is not crowned it will break from chewing pressure and often require extraction. Front teeth will darken over time as the tooth dries out. It is standard dental procedure to crown all teeth needing root canals.
WILL I HAVE PAIN AFTER MY ROOT CANAL?
This is certainly possible. A root canal is a form of surgery and post-operative discomfort is very common. Anything other than discomfort, however, should be brought to our attention. Most discomfort goes away in a few days. In most cases, pain relieving medication is prescribed to help reduce any post-operative pain.
WHY DO I HAVE TO TAKE MY ANTIBIOTIC?
An abscessed tooth is an infection. We can remove infection causing bacteria inside the tooth, but not from the bone around it. The antibiotic will do that. It is very important to take the antibiotic until all is gone. If all of the antibiotic is not taken, then only the weak bacteria are killed and the stronger more virulent bacteria are left to reproduce. A larger infection could occur, known as a super infection. Taking all medication as prescribed is critical to successful root canal treatment.
DO ANY ROOT CANALS FAIL?
Yes! Current endodontic techniques are around 90% successful. If yours is not a success we will refer you to a specialist for further treatment. About 5% of all teeth respond to no therapy and require extraction.
WHY ARE SO MANY X-RAYS TAKEN?
Root canal procedures are "blind". The doctor performs the procedure by feel. An x-ray is the only way he can tell where he is relative to the end of the root. Remember, dental x-rays are very minimal compared to medical x-rays in terms of radiation.
ARE ROOT CANALS EVER DONE ON CHILDREN?
Usually children under the age of 14-16 will require a different procedure. A pulpotomy, removal of pulpal tissue only, is performed on children. The root formation must be complete before a successful root canal can be done.
