What’s a Root Canal?
A root canal is a procedure to treat diseased or damaged teeth. This procedure saves millions of teeth a year and can relieve pain from a tooth and make it healthy again. The root canal is a quick and comfortable treatment your dentist can use to save your natural tooth.
A soft tissue called pulp is inside your teeth beneath the enamel and dentin (hard layer of the tooth). The tissue has connective tissue, nerves, and blood running through it to help the root of your tooth grow during its development. When the tooth is fully developed, it can survive without the pulp as your tooth continues its nourishment from the tissues surrounding it. Its function once the tooth is mature is to provide the sensation of cold or heat. The absence of this nerve will not impact the day-to-day functioning of the tooth.
The canal where the pulp resides can become diseased, infected, or damaged. The root canal treatment will clean out this canal, so you do not have to lose the tooth. These treatments were once extremely painful, but with new technology and dental advances, you will experience little pain from having a root canal. Today, it is much more painful to live with the infected tooth; then it is to have a root canal treatment.
Why Does The Pulp Have to be Removed?
If the pulp inside the tooth becomes damaged or infected, it breaks down and allows bacteria to grow. The bacteria, along with other dying pulp remnants, can create an infection or abscessed tooth. Besides creating an abscessed tooth, the infection in your root canal can also cause:
- Swelling in your head, neck, face
- Loss of bone material around the tooth’s root tip
- Problems with drainage from the root. A hole can open up through the side of your tooth and cause drainage into your gums or through your cheek into the skin
The pulp inside of a tooth can become inflamed, irritated, or infected from tooth decay, numerous dental procedures performed on a tooth, large fillings, a chip or crack in the tooth, or from trauma to your face.
What is Root Canal Treatment?
The softcore or pulp in your tooth extends from the crown ( the part of the tooth you can see) to the top of the tooth’s root in your jaw. This pulp contains blood vessels, connective tissue, and nerves which can become infected when bacteria enter it through a crack in the tooth. If the infection is not treated, decaying material and bacteria will cause a severe infection or tooth abscess which can cause the pulp in the tooth to die, loss of bone in your jaw, and the possible loss of your complete tooth.
Symptoms of this infection include a hole in your tooth, toothache, swelling of the gums, swelling around your neck and face, and sensitivity to temperatures. These signs alert you and your dentist that a root canal treatment is necessary.
A general dentist or an endodontist can perform a root canal. The root canal procedure usually needs two visits to your dentist's office, unless more serious issues are uncovered during the treatment. An x-ray is taken of your teeth to determine the extent of the damage, and if there are any infections in the surrounding bone. If the tooth is abscessed, it will be more painful, so the dentist will use local anesthesia to numb around the tooth. Many dentists will numb this area even though the nerve is dead to ensure the patient is at ease and comfortable.
- An abscessed tooth is a when a pocket of pus becomes infected from bacteria inside your tooth. The abscess can occur in different areas of your tooth for different reasons. A periapical abscess happens at the top of the tooth’s root, and the periodontal abscess happens in the gums alongside the tooth’s root.
When your tooth becomes abscessed, you experience persistent throbbing from a toothache radiating from your jaw to your neck and ear. You will begin to have a sensitivity to hot and cold temperatures along with a sensitivity to biting or chewing. There may be a fever present, and you will notice signs of swelling in your cheek or face. Other symptoms could include a hard time swallowing or breathing, foul-tasting, salty fluids released in your mouth, and tender swollen lymph nodes under your jaw.
- An endodontist is a dentist who specializes in saving teeth. They are dental specialists who have received additional, advance training after completing dental school, which includes treating dental pain and making a diagnosis, along with the treatment and prevention of diseases and injuries to a tooth’s dental pulp. All dentists receive training in endodontic treatments while in dental school. A general dentist can perform a root canal along with many other dental procedures, but will often refer patients to specialized dentists who perform more endodontic treatments.
A dental darn, rubber-like sheet, is placed in your mouth to protect your tooth and keep it clean and free of saliva. The decay will be removed from an opening made in the crown of your tooth. The opening is necessary to gain access to the pulp canal and with the use of root canal files enable removal of the infected tissue.
A series of root canal files are used in increasing diameter measurements into the access hole and worked downward along both sides of the tooth. The files are used to scrub and scrape the sides of the root canals. Sodium hypochlorite or water is then applied to clean out the debris periodically.
- Sodium hypochlorite is used to prevent and treat skin and tissue infections. These injuries could be the result of pressure sores, scrapes, or cuts. The solution is also used before and after surgery to prevent infections. Eliminating any remaining infection inside the tooth increases the chance of success, and by irrigating with sodium hypochlorite, your chances of eliminating all bacteria are increased.
When the canal is thoroughly cleaned, the dentist needs to seal it. Some dentists prefer to give your tooth a week to heal before sealing. This waiting period allows them to check for any infection that may still be present and will enable them to treat it with medication. Other dentists feel it is acceptable to seal the tooth the same day as the root canal treatment. If the procedure is not finished at the time of the visit, a temporary filling will be placed inside the exterior hole to keep it free from contaminants until you return to the dental office.
On your second visit for the continued root canal treatment, a sealer paste will be used to fill the interior of the tooth. This paste is a mixture of rubber compound called gutta-percha and sealer paste. The mixture will fill the exterior access hole made to reach the tissue at the beginning of your treatment.
The last step of the root canal procedure is to restore the tooth. When a tooth has a root canal, it often means the tooth had a large filling, extensive decay or another form of weakness. This weakness means the tooth may need a crown or crown and post to restore its strength. The crown will prevent and protect the tooth from becoming broken and return it to its full function.
- A dental crown is a cap or covers put over an existing tooth. The dental crown will restore your tooth to its normal function, size, and shape. The crown will improve the looks of your tooth as well as make it stronger. People often receive a crown when they have a cavity that is too large for a filling. Others have a cracked, weakened, or worn down a tooth that will require a crown to repair. Other reasons for your dentist putting a crown on your tooth is after a root canal treatment or if you have a poorly shaped or discolored tooth.
A crown is made from several types of materials including ceramics, alloys, porcelain, porcelain fused to metal, or a composite resin. The crown is also colored to match the other teeth in your mouth. When placing a crown in your mouth, your dentist at Ganji Dental will want it to fit comfortably and blend with your other teeth. Factors they will look at include where the tooth is located and what its function is, along with the position of your gum tissue. They will also determine how much of the tooth should show when your smile.
What Happens After a Root Canal Treatment?
The first thing you will notice after a root canal treatment is that your pain has disappeared. If your root canal treatment is being completed in several steps, you should minimize your chewing on the tooth needing repair. This care should be taken until the whole procedure is completed and you have a permanent filling or crown in place. Watching how you chew will help eliminate the chance of recontaminating the tooth’s interior. It will also prevent a tooth that is fragile from breaking before your dentist can restore it.
After the complete treatment is finished, the tooth may feel sensitive for a few days. This sensitivity is due to the natural inflammation that occurs from the infection before the procedure was done. The sensitivity should dissipate within a couple of days, and while you are feeling some discomfort, you can treat it with over-the-counter medications. Medications suggested for pain relief include Aleve (naproxen), or Motrin or Advil, which are ibuprofens. Generally, patients return to their normal routines the following day after treatment.
Your daily oral hygiene should consist of brushing and flossing as you normally would. You should also schedule regular checkups with your dentist at Ganji Dental to check the status of the treatment area along with all your other teeth. Because the final step of the root canal treatment consisted of restoration to your tooth, there should be no obvious signs of it to onlookers. Having a root canal performed has a ninety-five percent success rate that your tooth’s been repaired. These procedures done on a tooth should last a lifetime.
Risks or Complications of Root Canal Treatments
Your dentist cleans and seals your tooth after the root canal treatment, but even using expert care to do this; infections can sometimes emerge. Some of the reasons behind these infections include:
- There was an undetected crack in the root of the tooth
- A breakdown of the inner sealing material occurred over time and allowed bacteria to reinfect the inner portions of the tooth
- There were more than the expected number of canals in your tooth, and one of them was left uncleaned
- The restoration process had a defect which allowed bacteria to get past it and into the interior portion of the tooth causing it to become reinfected
If any of the situations occur, you will require re-treatment of the canal. You may have this done in the dental office or be referred for endodontic surgery. The commonly used surgical procedure used is an apicoectomy, or what is known as root-end resection.
What is an Apicoectomy and When is it Required?
If you’ve had a root canal procedure, but the area becomes reinfected, you may have an issue near the apex of the tooth’s root. In most cases where this happens, a determination is made whether you need a second root canal or an apicoectomy. Technology now makes it possible for your dentist to detect other canals in your teeth that were not properly treated to determine if the second root canal will clear the infection before they perform the apicoectomy.
The apicoectomy is only done after a tooth has had at least one root canal treatment performed on it. If the tooth received re-treatment and that proved unsuccessful, an apicoectomy will be recommended, or if the infected tooth is part of a bridge or has a crown. To retreat a tooth that has a crown in place requires the crown to be cut through to reach the infection, which would significantly weaken the crown.
The apicoectomy is a surgical procedure performed with an operating microscope. This surgery is different from a root resection because, in the root resection treatment, the entire root is removed, not just the tip. Your general dentist can perform the apicoectomy if they have received advanced training and will want to consult with you before planning a procedure such as this. Your dentist may want to refer you to an endodontist or an oral or maxillofacial surgeon. There have been a lot of advances made in the field of endodontic microsurgery, and your dentist may feel more comfortable having a diagnosis from one of these specialists.
- Oral and Maxillofacial surgeons are specialized dentists who work on your jaws, head, and mouth when a serious injury or infection occurs to your mouth or teeth. The oral and maxillofacial region of your body is the mouth and all its connecting areas. You chew with your jaw and teeth which are part of the network including your neck, head, and face.
A dental surgeon is a regular dentist or also known as a general dentist. The general dentist will perform various procedures throughout their day, including restorative dentistry, veneers, tooth whitening, bridge work, crowns, root canals, and some forms of oral surgery. While they can perform all these procedures, oral surgery is not their main focus of practice.
An oral or maxillofacial surgeon uses some of the same equipment and instruments as the general dentist, however; most of their tools are more extensive and specialized to allow them to work more quickly, delicately and precisely. The oral dentist will also have had extensive training in anesthesiology, so they can offer intravenous sedation to make their treatments more comfortable.
Before the apicoectomy, you may require additional x-rays of your tooth and its surrounding bone. Most times, an antimicrobial mouth rinse is provided to reduce your inflammation, or you may be given antibiotics. The dentist will need to review your medical history, and it is essential you inform them of all the medications you take, including vitamins and over-the-counter products.
A small incision is cut into your gum, and the gum is lifted away from the tooth’s surface and bone. The dentist will again need to gain access to your root just as when your root canal was done. The infected pulp is removed along the tip of the root. The endodontist might need to use a dye to highlight where the crack occurred in your tooth or to see any breaks in your tooth. If there are large breaks or cracks discovered, the tooth may have to be taken out. If your tooth requires extraction, the apicoectomy cannot continue.
If an extraction is not needed, the apicoectomy will continue with your endodontist cleaning and sealing the end of the tooth’s root canal. A special microscope with ultasonic instruments is used to clean out the root’s canal. The magnification and light will allow the endodontist to see the complete area more clearly. Seeing the area better will increase the chances of a successful procedure. Before the area is stiched closed, an additional x-ray will be taken.
The apicoectomy procedure will last from thirty to ninety minutes. How long it takes depends on the location of the tooth and how complex your root structure is, with front teeth taking the least amount of time. The lower molars take the longest to treat.
Are There Alternatives to Root Canal Treatments?
Your dentist will always want to perform the treatment that saves your natural tooth while meeting the needs of the tooth. With your natural teeth, you can eat various foods necessary for proper nutritional health. Root canals are the first choice for saving your tooth.
Alternatives to a root canal would be having the tooth taken out. Your dentist would then have to replace the tooth with other dental implants such as the partial denture which can be removed, a bridge, or a dental implant. One of these options would be necessary so you would be able to continue your chewing function and keep the adjacent teeth in their place.
- A dental bridge bridges the gap created when one or more of your teeth are lost or removed. It is made up of one or more crowns placed on either side of the gap. The two teeth used for anchoring are called abutment teeth, and a false tooth is placed in between them. The false teeth are sometimes referred to as pontics and are made of either porcelain, alloy, gold, or a combination of these materials. The dental bridge is supported by your natural teeth or implants.
- A dental implant is an artificial tooth with a root which is similar in shape to a screw. The dental implant is put into your jawbone and will bond with your natural bone. The implant becomes a sturdy base to support one or more artificial teeth. The artificial tooth is called a crown.
An abutment or connector is put on top of the dental implant to support and hold your crown. A crown will be custom-made to match the other teeth in your mouth.
- A removable partial denture or sometimes referred to as a bridge consists of replacement teeth that are connected to a gum-colored or plastic base colored pink to match your gums. Sometimes the base is connected by a metal framework to hold the denture in place in your mouth. A partial denture is used when one or more of your natural teeth remain in your jaw either in the bottom or the top.
The removable partial denture will fill in spaces created when a tooth is removed or lost and prevents your other teeth from moving positions. This dental piece is removable and has attachments inside instead of the clasps in other devices that would attach to the adjacent crowns. It gives you a more natural looking piece.
These alternatives are more expensive than a root canal and will require more treatment time along with additional procedures to protect the adjacent teeth and their tissue. You can help avoid the need for any procedure, including a root canal by following good oral hygiene practices. Some of the reasons a root canal becomes necessary are your tooth’s pulp becomes infected or inflamed. Other reasons include deep decay, repeated dental work on a tooth, or need of a large filling. When you brush at least twice a day followed by flossing and the use of mouthwash, you could reduce the need for a root canal procedure. If you are active in sports, you should wear a protective mouth guard to protect your teeth and prevent the need for a root canal treatment. You should also schedule regular checkup visits with your dentist at Ganji Dental.
Find a Hawthorne Dentist Near Me
If you are experiencing symptoms which indicate you may need a root canal, call Ganji Dental at 310-643-8045. You can schedule an appointment with one of our dentists to discuss your symptoms and decide on a dental plan to relieve your tooth pain. We care about oral and dental health and will dedicate ourselves to helping you relieve dental pain or restore your beautiful smile. We offer full dental services to families and individuals.