Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.
Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy:
An abscess (or pimple) on the gums.
Sensitivity to hot and cold.
Severe toothache pain.
Sometimes no symptoms are present.
Swelling and/or tenderness.
What does root canal therapy involve?
The first step in the root canal treatment is making an examination of the tooth so that the dentist understands the nature of the problem and is able to treat it effectively. This typically involves a physical examination of the inside of the mouth, in addition to X-ray imaging of the tooth to visualize the pulp chamber.
Next, a local anesthetic is administered to numb the tooth and increase the comfort of the patient during the procedure. A “dental dam” – a small protective sheet – is then put in place over the affected area to isolate the tooth and keep saliva and other substances away from it while the work is completed.
The dentist is then able to drill into the crown of the tooth to open it. This allows specialized dental instruments to be inserted into the pulp chamber and root canals to clean the inflamed or infected pulp from the area. The remaining space is then cleaned completely and shaped to make space for a filling, which will replace the pulp in the tooth.
The root canal can then be filled with a suitable biocompatible material, such as gutta-percha. Adhesive dental cement is also usually used to ensure that the root canal is properly sealed and to prevent future infections in the area.
Once the root canal has been filled, a temporary filling is usually put in place over the opening to seal it. Eventually, a crown is usually placed over the tooth to protect it over the long-term, but there is usually a waiting period between dental appointments while the crown is constructed. A temporary filling is useful during this time. At the subsequent dental appointment, the temporary filling can be removed and the tooth restored with a crown or other restoration.
Pain During the Procedure
The techniques used to perform a root canal have progressed significantly over recent decades. As a result, most patients now find that they are relatively comfortable while the procedure is being carried out and do not experience significant pain.
This is in large part due to the local anesthesia used during the procedure to numb the area. It may, in fact, bring relief to the patient, particularly if the pulp inflammation caused significant pain and thus brought about the need for a root canal treatment.