Root Canals:
A Detailed Guide
Root canal treatment is the dental procedure that is often recommended for patients with tooth decay and other similar oral health issues.
From this new guide, you’ll learn the details of root canal treatment including:
• What root canal treatment is
• When root canal treatment is recommended
• The common causes of root canal
• The root canal procedure
• Essential tips to take better care of your oral health after root canal
• Lots more
If you want to learn more, this guide is for you! Continue reading to discover more.
Contents
What Is A Root Canal?
Introduction
In the real sense, ‘root canal’ is part of a tooth. It is the inside of the tooth, which is why tooth canal treatment is also referred to as ‘endodontic’ treatment (‘endo’ and ‘odont’ being Greek words for ‘inside’ and ‘tooth’). It is important to note that root canal treatment is just one type of endodontic treatment.
Root Canal, as a term, also refers to the treatment of root canal. Depending on who you are discussing with, it can also be called root canal treatment, endodontic therapy, or root canal therapy. For the purpose of this guide, we will use root canal and root canal treatment interchangeably.
Root canal treatment is a dental procedure that is used to repair and save a badly damaged or infected tooth instead of removing it. It involves the removal of the pulp, which is the soft center of the tooth that contains nerves, blood vessels, and connective tissue. The pulp is contained in the root canals, and when they are removed, the canals are cleaned and treated.
Root canal is an effective remedy for serious tooth decay and infection that has affected the canal. The treatment can save the tooth and surrounding teeth, which may be at risk of being infected too. The alternative treatment to root canal is extraction of the damaged tooth and replacing it with an implant, bridge, or removable partial denture.
How Painful Can A Root Canal Be?
Decades ago, when local anesthetics weren’t as common, root canals caused more discomfort for patients. There have been several advances over the years, and now root canal can be almost painless procedures.
Local anesthetic will be administered to numb the tooth and the surrounding area. You will be awake when the dentist makes an incision on the teeth. You may feel a little sensation, but the procedure is relatively painless when it is performed by a trained dental surgeon.
After the root canal procedure, you may feel some tenderness on the treated teeth. You may also feel a little pain or sensitivity as the anesthesia starts to wear off. At this point, over-the-counter medication can help. The pain will disappear in a few days.
In most instances, the pain caused by inflammation or infection of the root canal is more troubling than the mild pain associated with the procedure. In the long run, root canal treatment is not painful; rather, it helps to alleviate pain caused by a seriously decayed or damaged tooth.
When Are Root Canals Recommended?
Root canal treatment is recommended when a tooth has been badly damaged because of decay or infection. Tooth decay and most types of oral infections are normally detected early and treated. If they are not treated, there is a chance that the inside of the tooth can be affected.
The root canal is the innermost part of the tooth. It is covered by a hard layer called ‘dentin’, which is under the part we see ‘enamel’. When an infection gets into the root canal or it begins to decay, there is no way to treat it with regular medications or minor dental procedures. The damaged pulp, which is the major constituent of the canal, will be removed.
The Common Reasons for Needing Root Canal Treatment
There are different factors that can contribute to root canal decay or infection. When a tooth is cracked, for instance, it becomes easier for bacteria to enter the pulp and cause extensive damage. A deep cavity also can expose the pulp to infection.
Serious tooth decay or gum infection that is left untreated can also affect the root canal. When it is not treated on time, problems like tooth abscess, pulp death, bone loss, and loss of the tooth can be the outcome. Damage to the pulp can generally result from:
- A chipped or cracked tooth that is not treated promptly
- Deep decay due to untreated cavity
- Multiple dental procedures on a tooth
- An injury to the tooth that affects the pulp, even when the tooth is not cracked or chipped.
Signs That You May Need Root Canal Treatment
You may not know when your root canal becomes inflamed or infected. However, there are signs and symptoms associated with the problem. Your dentist or endodontist will confirm if you need a root canal therapy or not, but here are some signs that may suggest that you need it:
- Severe tooth pain while biting or chewing, or upon application of pressure
- Prolonged pain or sensitivity to hot or cold food or drink even after the source of the heat or cold has been removed
- Persistent or recurrent pimples on the gum
- Deep decay that may be indicated by darkening of the gum
- Swelling and tenderness in the nearby gum
Getting Started With Root Canal Treatment
A root canal can be done by a general dentist or an endodontist, who is a specialist in treating the inside of teeth. The procedure normally takes two visits, but it is not uncommon for dentists to schedule additional visits until the tooth is completely repaired.
Before your dentist schedules a root canal procedure, you will have a dental x-ray to determine the extent of the damage. The actual procedure may be scheduled that same day you had an x-ray or a future date.
About the Procedure
As stated earlier, root canal treatment usually takes two visits, at least. Here, we will discuss the different steps involved to intimate you with what to expect.
X-Ray
Even after your dentist or an endodontist has confirmed that you need tooth canal, a radiography of the tooth with x-ray will still be taken. This follows a physical examination of the tooth and surrounding area. The dentist needs to be sure of the extent of damage and how to proceed in order to achieve the best result.
Anesthetic
This is normally recognized as the first major procedure in root canal treatment. After the x-ray, the dentist will administer a little amount of medication to the gum near the affected tooth. This is followed by the injection of a local anesthetic into the gum near the affected tooth to control pain. Pain is more severe when the tooth is abscessed.
In some instances, local anesthetic can be injected without prior numbing medication. You may feel a sharp pinch or burning sensation when it is being injected, but it will pass quickly. A rubber-like sheet, called a dental dam, will be put in your mouth to keep the tooth clean, protected and free from saliva. You will remain awake throughout the procedure, but the anesthetic keeps it painless.
Removing the Pulp
Removing the pulp is the major purpose of root canal and needs to be done carefully. The dentist or endodontist will start by removing any decay and tartar on the teeth. When that is done, an incision will be made through the crown of the tooth to gain access to the pulp chamber (root canal). The incision is made with small dental instruments.
Once the infected pulp has been reached, the dentist or endodontist will begin to remove it, using a special small dental tool called files. Being the most important part of the procedure, the dentist takes time to ensure that the entire pulp is evacuated. The canals will be thoroughly cleaned to get rid of the decay or infection. Irrigation solutions may be used at this point to flush and clean the pulp chamber/root canals.
Antibiotics
After evacuating the infected pulp and cleaning the canal thoroughly, the dentist may administer coat the area with a topical antibiotic. This is done to properly take care of the infection and eliminate or reasonably minimize the risks of reinfection.
When the dentist is certain that the canals have been properly cleaned, he/she will fill and seal the tooth with a sealer paste and gutta-percha, which is a rubber-like material. Depending on the severity of the infection and how the dentist feels about the procedure, antibiotics may be prescribed to keep fighting the infection before the second visit.
Temporary Filling
Ideally, the first stage of the procedure ends with a temporary filling of the tooth. Unless the procedure is scheduled for a single visit (which is rare), a temporary filling will be placed on the small opening in the top of the tooth. The sealant is usually a soft, temporary material.
The temporary sealant performs a number of protective functions. For a start, it keeps out debris and saliva. This, in turn, plays a significant role in minimizing the chances of reinfection. It will protect the canal from any chance of damage. It is important that you avoid biting and chewing on a tooth that is undergoing canal therapy until it has been fully treated and restored.
Risks of a Root Canal
Just like other dental procedures, there are risks associated with root canals. While the procedure is aimed at saving a damaged tooth, it may fail for some reasons. When the damage to a tooth is too deep, root canal may not save the tooth. Again, when the tooth enamel is too frail (most probably as a result of decay or infection), the tooth may not withstand root canal treatment. In any of these two instances, root canal treatment will likely lead to loss of the tooth.
Another major risk factor associated with root canal is the development of abscess at the root of the tooth that is being treated. This normally happens when some of the infected materials are unintentionally left behind or when the antibiotic administered during the procedure is not effective against the infection.
While these risks are real, it is important to state that most root canal procedures are successful. Also, dentists and endodontists examine a situation properly before recommending root canal. Working with a certified and experienced dentist also reduces risks. If you are apprehensive about the procedure, express your concerns to your dentist.
Possible Complications
Every medical procedure has possible complications, and root canal is not an exception. Though they rarely occur, here are some complications associated with root canal treatment:
- If a dentist finds fewer root canals than a tooth actually has (maybe three in a tooth that has four), the untreated canal will continue to cause problems, and the infection may spread into the bone.
- If the filling does not properly seal the incision on the tooth, reinfection can occur and damage the tooth beyond repair. Most dentists spend enough time to ensure that the filling material goes far enough into the canal and fill it up.
- In some unfortunate cases, the root of the tooth may crack during the root canal procedure. There are rare cases of the small dental instrument perforating the canal or even breaking in the canal. This makes it harder to fill the tooth effectively, meaning that extracting the tooth may be the only possible solution.
Depending on the complication that arises during your procedure, the dentist or endodontist may try to correct it. In many instances, complications can be handled without resorting to tooth extraction. If it comes to that, trust your dentists’ professional opinion.
Patients also have roles to play to minimize the chances of complications. It is all about listening carefully to the dentist’s instructions and following them religiously before and after the procedure. Take every prescription seriously and speak up when you are confused about anything.
Post-Op Care & Alternatives to Root Canals
Follow Up Appointment
The next important appointment with your dentist will be to restore the tooth. However, a tooth that has undergone root canal treatment will be more fragile than it was before. It will have to be nourished from the ligament that attaches it to the bone. This may be enough, but the tooth will likely become more brittle with time. This is why a crown or filling is normally recommended.
A crown or another type of restoration will be placed on the tooth to protect it and also restore it to full function. In an instance that the tooth lacks sufficient structure to hold the restoration in place, the dentist may place a post inside the tooth. While the crown or filling is still in place, patients are expected to use the tooth carefully.
After the Procedure
After a root canal procedure, it is expected that you will up your dental hygiene routine to prevent the chances of reinfection or any other dental issue. Some dentists will place a permanent restoration, like a crown, on the tooth that has been treated.
It is important to state here that you may experience mild pain after the procedure. This happens as the anesthesia administered before the procedure begins to wear out. You shouldn’t be overly concerned about the pain or sensation unless it is too much. The mild pain and sensation normally stop after a few days. You may take some over-the-counter painkiller to help with the pain. Make sure that your dentist and doctor know and approve of any mediation you use this period.
Tips To Take Better Care Of Your Oral Health after Root Canal
As mentioned earlier, you will need to up your oral hygiene game after a root canal treatment. This is not just to protect the treated tooth but all your teeth and entire mouth. Here are some tips that can help in this regard:
- Brush teeth at least twice a day (the last thing at bedtime and one other time or more during the day)
- Use toothpaste that contains fluoride or anyone recommended by your dentist.
- Use a suitable toothbrush and replace it regularly. Your dentist can recommend a particular type of toothbrush and tell you how often you should change it.
- Floss daily to clean between the teeth and prevent the buildup of plaque and tartar.
- Avoid overly hard foods, especially right after the root canal procedure.
- Cut down on the number of sugary foods and drinks you consume.
- Schedule and attend regular teeth cleaning and dental checkups.
- Follow a healthy diet.
Alternatives to Root Canal Therapy
Root canal is a restorative treatment. This means it is a treatment that will save your natural teeth, which is something you should aim for whenever possible. As long as there is a chance of saving your natural teeth, root canal therapy is the treatment of choice.
The only viable alternative to root canal treatment is tooth extraction. Root extraction, as the name clearly shows, involves the removal of a tooth. The tooth is then replaced with either a dental implant, a bridge, or even a removable partial denture. While these artificial tooth options can restore complete smile and biting and chewing functions, they are never equal to natural teeth in terms of functionality.
Another reason root canal is better than tooth extraction and replacement is the fact that it is more affordable. Extracting a tooth and replacing it with a reliable artificial tooth costs a lot of money. Again, it will require many procedures and more treatment time. The chances of affecting adjacent teeth and supporting tissues are also high if you choose tooth extraction and replacement.
FAQs
Q: Can all teeth be restored through root canal?
Most teeth can be treated endodontically. On rare occasions, a tooth may not be saved through root canal treatment because the root canals are not accessible. Other instances include when the root has been severely fractured, when the tooth doesn’t have enough bone support, and when the infection or decay has completely damaged the teeth beyond repair. Recently, teeth that were considered unrepairable have been saved, thanks to advances in endodontics. We believe things will continue to improve.
Q: Are root canals a painful procedure?
In the past, root canals were considered a painful procedure. All that is changing. Many dentists have perfected the procedure to make it as painless as possible. Local anesthetic is normally administered to numb the tooth and surrounding area. This means the procedure will be painless. There may be mild pain and sensitivity after the procedure when the anesthetic begins to wear out. The discomfort will only last a few days, and OTC painkillers can help to take care of it.
Q: Do I need a crown after a root canal?
You may need a crown after a root canal procedure: your dentist will make the call. Ideally, this will depend on the location of the treated tooth. Since the teeth at the back of the back, like premolars and molars, are needed for chewing, they require crowns after root canal treatment. Incisors and canines, on the other hand, don’t always require crowns. Your dentist will determine whether you need a crown or not.
Q: What kind of dentist performs root canals?
A general dentist can perform root canal treatment; every dentist has the necessary training to perform the procedure. However, more complicated root canal treatment falls within the specialty of endodontists. More often than not, these procedure are often performed by endodontists.
Q: Can a tooth canal fail?
Yes, a tooth canal can fail, but it is not really common. There are many reasons that can cause this. The common cause is when the canal is not properly cleaned during the procedure, leaving room for reinfection. The procedure can also fail as a result of a breakdown of the crown or its inner sealant.
Q: Does a root canal kill the tooth?
No, a root canal doesn’t kill a tooth. Some people assume that since the nerves and blood vessels inside the tooth are removed, the tooth is dead. This is not true; the pulp (nerves and blood vessels) are not really needed in a fully formed tooth. The teeth will function as it normally does after the procedure, being nourished by the ligament that attaches it to the bone.
Q: How many visits does it take to complete a tool canal?
Ideally, it takes two appointments to treat a root canal. The first visit is the actual procedure when the infected pulp is removed, and the canals cleaned. In some cases, a single visit can be enough for the treatment. The second visit will also involve cleaning the canals and filling them with crowns or other types of filling. In some instances, dentists schedule root canal for one visit. It is also not uncommon to have two or more follow-up appointments.
Q: Can I eat before a root canal procedure?
Yes, you can eat on the day of root canal treatment. Actually, most endodontists and general dentists will allow you to eat just one hour before the procedure. You will just have to brush your teeth before the procedure commences.
Q: Can I smoke after a root canal?
Smoking is a bad habit, but no one will stop you from smoking after a root canal. However, you should know that smoking increases the risk of needing another procedure. It also increases the risk of root canal failure. For your dental and overall health, it is better to avoid smoking.
Q: Is it better to have a root canal or tooth extraction?
Yes, it is better to have root canal therapy to extract a tooth. If there is any chance of saving any damaged tooth, dentists will always advise that you save your natural teeth. A treated tooth is always more functional than artificial teeth. Again, root canal treatment is more affordable than extraction and replacement with artificial teeth or dentures.
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