Endontists (Root Canals) Information
Root canal therapy is a treatment used to repair and save a tooth that is badly decayed or infected.
A root canal procedure is performed when the nerve of the toothbecomes infected or the pulp becomes damaged. During a root canal procedure, the nerve and pulp are removed, and the inside of thetooth is cleaned and sealed.
Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed. The discomfort experienced in the period leading up to seeking dental care is truly painful, not the root canal procedure itself.
Signs you may need root canal therapy include:
- Severe toothache pain upon chewing or application of pressure
- Prolonged sensitivity (pain) to hot or cold temperatures (after the heat or cold has been removed)
- Discoloration (darkening) of the tooth
- Swelling and tenderness in nearby gums
- A persistent or recurring pimple on the gums
Sometimes no symptoms are present.
The Root Canal Procedure
The root canal procedure requires one or more office visits and can be performed by a dentist or endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice of which type of dentist to use depends to some degree on the difficulty of the root canal procedure needed in your particular tooth and the general dentist's comfort level in working on your tooth. Your dentist will discuss who might be best suited to perform the work in your particular case.
The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. Your dentist or endodontist will then use local anesthesia to numb the area near the tooth. Actually, anesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetize the area to make the patient more relaxed and at ease.
Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth.
An access hole will then be drilled into the tooth. The pulp, along with bacteria, the decayed nerve tissue, and related debris, is removed from the tooth. The cleaning-out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it needs to be sealed. Some dentists like to wait a week before sealing the tooth. For instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep contaminants out between appointments.
At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta-percha are placed into the tooth's root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.
The final step may involve further restoration of the tooth. Because a tooth that needs root canal therapy often is one that has a large filling or extensive decay or other weakness, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your dentist will discuss the need for any additional dental work with you.
The root canal procedure should relieve the pain you feel. Until your root canal procedure is completely finished -- that is, the permanent filling is in place and a crown, if needed, is in place -- it's wise to minimize chewing on the tooth under repair. This step will help avoid recontaminating the tooth’s interior and also may prevent a fragile tooth from breaking before the tooth can be fully restored.
For the first few days following the completion of treatment, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Most patients can return to their normal activities the next day.