Root Canal Therapy

Root canals have gotten a bad reputation, but we dentists don’t know why! This type of treatment actually makes you feel better!  

The term "root canal" is used to describe the natural chamber in the center of the tooth and its root.  “Root canal treatment” involves removing the pulp and its nerve from within the chamber of a badly decayed or infected tooth to save it from being extracted.  Without this treatment, the tissue surrounding the tooth often becomes infected and may form an abscess.

The main function of the pulp is sensory, providing the sensation of hot and cold. After a tooth has emerged through the gums, the pulp is not vitally important to its health or function and its absence will not affect the day-to-day functioning of the tooth. 

A root canal procedure requires one or more office visits and can be performed by a dentist or endodontist. Your dentist will discuss who might be best suited to perform the work in your particular case.

Root canal treatment has a success rate of about 95% allowing many teeth to last a lifetime after treatment!

There are a variety of conditions under which the pulp and nerve tissue of a tooth become irritated, inflamed, and infected. When these occur, the tooth often becomes sensitive to cold or biting and eventually requires a root canal procedure to save the tooth or an extraction to eliminate the pain.  Some causes include pulp irritation include:



• Deep dental decay
• Cracks or fractures in the tooth
• Trauma to the tooth
• Repeated dental procedures on a tooth
• Large fillings
  

When the pulp is damaged due to a large cavity, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth.

If you are having dental pain, your dentist will do a careful diagnosis of your tooth to determine whether or not it needs a root canal.  Some signs and symptoms that you need a root canal include:

• Pain that occurs even when you’re not eating or drinking
• Pain that wakes you up in the middle of the night
• Extreme sensitivity to cold or heat
• Pain when pressure is applied to the tooth or when eating
• Darkening or discolouration of a tooth
• Tenderness in the gums
• Swelling of the gums


Ignoring these signs or symptoms can be detrimental to your oral health and in severe cases can be life-threatening!

If you are unsure about any of the symptoms you’re experiencing, please call us!

Before starting the root canal procedure, an X-ray is taken to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone.  Your dentist will then do a careful diagnosis to ensure that the tooth requires a root canal procedure.  Diagnosis may include tapping on the tooth, placing ice quickly on the tooth, or using a pulp vitality tester.  Even with careful diagnosis, it can be difficult to determine which tooth is causing the pain.  If the diagnosis is unclear and the symptoms aren't severe, root canal therapy may be delayed until an accurate diagnosis can be made.

Once the diagnosis is made, the tooth is thoroughly anesthetized and a rubber dam (a sheet of rubber) is placed to keep the area dry and free of bacteria-containing saliva.

During the procedure, an access hole is drilled into the tooth and the pulp along with bacteria, the infected nerve tissue is removed from the tooth. The cleaning process is accomplished using a series of files of increasing diameter until the full length of the root canal chamber is cleaned.  Sodium hypochlorite is used periodically to flush away the debris and sterilize the inside of the tooth.

Once the tooth is thoroughly cleaned, it is sealed either temporarily or permanently depending on the situation.  In the case of a badly infected tooth, a medication is placed, the tooth is sealed with a temporary filling and you must return for another appointment to complete the procedure.  In other cases the tooth is sealed permanently at the first appointment and the root canal procedure is completed.

To complete the root canal procedure, the sterilized canals are filled using a sealer paste and a rubber compound called gutta percha.  The exterior access hole created at the beginning of treatment is then closed with a white filling material.

Teeth that need a root canal often have a large filling, cracks or extensive decay. For this reason, a crown is usually recommended to prevent the tooth from breaking and to restore it to full function. Without a crown, teeth with root canals will often fracture and need to be extracted.

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 and usually the pain they were experiencing before the treatment is diminished.

For the first few days following the completion of a root canal, 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 or Motrin) or acetaminophen (Tylenol).  Most patients can return to their normal activities the next day.