What is endodontic (Root Canal) treatment?
“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic (root canal) treatment treats the inside of the tooth.
To understand endodontic (root canal) treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.
Why would I need a root canal procedure?
Root canal treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
What are the signs of needing root canal treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival (Gum) tissues. Sometimes, however, there are no symptoms.
How does root canal treatment save the tooth?
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, a channel inside the root, then fills and seals the space. Shortly afterwards, you will need to return to your general dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Root Canal Procedure
Root canal treatment will usually be performed in one or two visits and involves the following steps:
1. The endodontist examines, performs diagnostic tests, and takes a digital radiograph of the tooth, and then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
2. The endodontist makes an opening in the crown of the tooth. Very specialized small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. After the root canal space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your general dentist before the tooth is restored.
4. Once root canal treatment is completed with your endodontist, you must return to your general dentist to have a crown or other permanent restoration placed on the tooth to protect and restore it to full function.
If your tooth lacks sufficient structure to hold the restoration in place, your general dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
What will I feel during and after the procedure?
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, patients report that they are comfortable during the procedure.
For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully, and contact our office if you have any questions or concerns.
Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.
What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, your endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure. Also periodontal (gum) disease can be a cause of failure.
Can all teeth be treated endodontically?
Most teeth can be treated endodontically. Occasionally, a tooth cannot be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When root canal REtreatment is not indicated, endodontic surgery may be able to save the tooth.