Root Canal Therapy: (Endodontic Therapy)
When the nerve of your tooth becomes infected or inflamed, a successful root canal treatment lets you keep the tooth rather than having to pull it out. Keeping your tooth helps to prevent your other teeth from drifting out of line and causing jaw problems. Saving a natural tooth avoids having to replace it with an artificial tooth.
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anaesthetics, most 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 dentist’s instructions carefully.
Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure, or pain that lasts more than a few days, call your dentist.
Endodontic treatment can often be performed in one or two visits and involves the following steps:The dentist examines and x-rays the tooth, then administers local anaesthetic. After the tooth is numb, the dentist 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.
The dentist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
After the space is cleaned and shaped, the dentist 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 dentist before the tooth is restored.
After the final visit with your dentist, you must return to have a crown or other restoration placed on the tooth to protect and restore it to full function. If the tooth lacks sufficient structure to hold the restoration in place, your dentist may place a post inside the tooth. Ask your dentist t for more details about the specific restoration planned for your tooth.
The dentist gives you a local anesthetic (freezing).To protect your tooth from bacteria in your saliva during the treatment, the dentist places a rubber dam around the tooth being treated.
The dentist makes an opening in the tooth to reach the root canal system and the damaged pulp.
Using very fine dental instruments, the dentist removes the pulp by cleaning and enlarging the root canal system.
After the canal has been cleaned, the dentist fills and seals the canal.
The opening of the tooth is then sealed with either a temporary or permanent filling.
The cost varies depending on how severe the problem is and which tooth is affected. Molars are more difficult to treat and usually cost more. Most dental insurance policies provide coverage for endodontic treatment.Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration.
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment fails to heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this happens, another endodontic procedure can save the tooth.
Most teeth can be treated. Occasionally, a tooth can’t 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. And, when endodontic treatment is not effective, endodontic surgery may be able to save the tooth.
After a root canal treatment, your tooth has to be restored (fixed) to look, feel and work as much like a natural tooth as possible. If an endodontist performed your root canal treatment, he or she will fill the opening of the tooth with a temporary filling and send you back to your dentist for tooth restoration.Your dentist may use a permanent filling or a crown to restore your tooth. The choice of restoration will depend on the strength of the part of the tooth that’s left. A back tooth will likely need a crown because chewing puts a great deal of force on back teeth. If there is not enough of the tooth left, posts may be used to help support the crown.
Root canal treatment may be done in 1 or 2 appointments. After root canal treatment, your tooth may be tender for the first week or two. Intense pain or swelling is NOT common. If this happens, call your dentist or endodontist.You can still get a cavity or gum disease after a root canal treatment. Root canal treatment does not protect your tooth from other types of damage. With proper care and regular dental visits, the tooth could last as long as your other teeth. Most of the time, a tooth that has had a root canal treatment can be saved. However, there are cases where everything possible has been done to save a tooth and still the tooth must be extracted (pulled).
Most root canal treatments are successful. However, in some rare cases, a second root canal treatment is needed. Sometimes this is caused by new trauma, deep decay, or a loose, cracked or broken filling which can cause a new infection in your tooth. In other cases, your dentist or endodontist may discover very narrow or curved canals that could not be treated during the initial visit. This is called retreatment. When retreating a tooth, the root canal filling material is taken out, and the canal is recleaned, reshaped and refilled.
Sometimes root canal surgery is needed when a regular root canal treatment cannot be done or when it has not worked. Surgery is done to:
Check the end of the root for fractures (cracks).
Remove parts of the root that could not be cleaned during regular root canal treatment.
Clear up an infection that did not heal after regular treatment.