What is a root canal?
A root canal, or endodontic therapy, is a treatment done for a tooth that the pulp or the center of the tooth has become infected from bacteria entering the tooth or by trauma to the tooth.
Local anesthetic, numbing, is achieved around the problem tooth, then the tissue in the center of the tooth (pulp) is removed. The canal or center of the tooth is cleaned and filed until all debris is removed and then filled with a material that is compatible with the body and tooth, called gutta percha. Often this treatment is done in one visit unless much infection exists then two or more appointments might be necessary.
In years past there have been other treatments for root canal filling: silver points and sargenti paste and others. These proved to be not as effective. Occasionally a tooth that has had these treatments will flare up and need to have retreatment of the root canal. Retreatment is typically done by a specialist, Endodontist, with advanced training in treating teeth needing root canals.
Common Symptoms of a Root Canal
Some possible symptoms of an infected or damaged tooth can be:
- Lingering sensitivity to hot or cold
- Sensitivity to touch or pressure
When this occurs, the nerve inside the tooth is dying or necrotic or inflamed. Other causes can be many large fillings over time causing trauma to the tooth.
What happens to an untreated infected tooth?
A tooth that needs endodontic therapy (root canal) will eventually develop an abscess, which is an infection at the base of the tooth. This can lead to swelling, pain and if left untreated, the swelling can progress to the facial tissues and can be life threatening. Sometimes a tooth that is abscessed will have no symptoms, no pain or swelling, but it still could cause damage to the jawbone. The infection will often spread and destroy bone in its path.
Can antibiotics stop the infection?
Antibiotics can slow down the infection for a short time but once the infection really progresses, even antibiotics aren’t enough. Antibiotics are just a Band-Aid in that they may get you comfortable for a while but they do not eliminate the infection.
What to expect at Root Canal Consultation
The patients overall health, cavities on other teeth, infection and bone support need to be evaluated. If the patient has cavities on many teeth, a decision needs to be made on what are the priorities, what can the patient afford and if we treat only one tooth, when there are many that need treatment, what are we accomplishing overall?
If the decision is made, yes, to do the root canal treatment, who will you have do the treatment? At Deer Park Dental, we believe it is important to look at the whole mouth, not just one tooth. Once it is determined that you need a root canal, you will be referred to a specialist that only treats teeth that need root canals.
Why might you be referred to a specialist?
Technology today allows us to do many more thorough treatments of dental conditions. One of these advances is the use of the microscope in treatment of teeth needing root canals. We at Deer Park Dental want you to have the very best of care. We work with specialists that use the dental microscope to treat your tooth, especially for complex cases, to achieve the best possible care available.
Will I need a crown after Root Canal Treatment?
Teeth in the back of the mouth have stronger forces on them than the front teeth. Generally we recommend having a cap or crown placed on the endodontically treated tooth so that the forces of biting and chewing do not split or fracture the tooth resulting in the tooth having to be extracted. If a tooth splits in half, down the middle, it will not be able to be saved or restored. If the root canal is in a front tooth, the tooth often does not need a cap or crown but may just need a filling where the specialist accessed the center of the tooth from the back of the tooth.
Alternatives to Root Canal Treatment
The alternative to root canal treatment in an infected tooth is extraction, removal of the tooth. This will leave a gap or space which might later be restored with an implant, bridge or removable partial denture. If the space is left too long then the other teeth might drift and cause a malocclusion (bad bite). Also, if the extraction site is left too long without further treatment, the bone will shrink and an implant may not be a possibility in the future.
Root Canal vs Tooth Extraction
Although implants in the last 10+ years have been very successful, implants can also fail. One needs to look at the bone support available to do a root canal and save the tooth. Before implants many teeth were saved for a very long time with root canal treatment. If the cavity is deep below the bone, it might be better to do an implant. If the bone support is good, a root canal can be very predictable.
Talk to your dentist or specialist about what is right for you.
How long does it take to complete a root canal?
Sometimes root canals are done in one visit. Other times, when there is more infection or if the patient’s time is limited, the patient will return for a second visit where the tooth center will be cleaned out again and the tooth will be filled with a material called gutta percha and then sealed. On rare occasions, when the tooth is very infected, the tooth will be cleaned out (re-instrumented) multiple times to allow the tooth to settle down before the final fill and seal is completed.
How long does a root canal treatment last?
This is like asking, how long will my car last. Root canals can last 30+ years and some can fail in a short time. Limiting factors can be: how calcified the canals in the tooth are, was the treating dentist able to find all the canals (some teeth have one, two, three or even four canals in a tooth, especially molars), what are the forces on the tooth (grinding or bruxing), how well do you clean around your teeth (avoiding re-infecting the root canal), and how soon the tooth receives the final restoration after the root canal is completed. If the root canal treatment is not sealed, it can become reinfected.
Root Canal Aftercare
If you have just had a root canal and perhaps a core buildup to seal the center, the next step is to evaluate if it needs a crown. The crown or cap will help protect the tooth from breaking. The most important fact to realize at this point is that the tooth, even with a crown or cap on it, is more brittle. If you were to chew on a piece of ice, a bone, a hard candy or other hard food item, the tooth could still crack. A tooth with a root canal is more brittle than the natural tooth. So, getting the tooth restored after the root canal is important as well as being careful to not put excessive force on the tooth. With good homecare, brushing and flossing and a little extra care, this tooth could last a lifetime.