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Root Canal Therapy

What is a root canal?

Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp, which carries the tooth's nerves, veins, arteries, and lymph vessels. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but normally no more than four root canals.

Why do I feel pain?

When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and/or applying hot or cold foods and drinks.

Why do I need root canal therapy?

Because the tooth will not heal by itself, without treatment, the infection will spread. Bone around the tooth will begin to degenerate, and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite and possible loss of other teeth. Though an extraction is cheaper, the space left behind will require and implant or a bridge, which can be more expensive than root canal therapy. If you have a choice, it's always best to keep your original teeth.

What is involved in root canal therapy?

Once your dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an Endodontist, or pulp specialist. Treatment usually involves one to two appointments. First, you will probably be given a local anesthetic to numb the area. A rubber latex sheet is then placed around the tooth to isolate it. Next, a gap is drilled from the crown into the pulp chamber, which, along with any infected root canal, is cleaned of all diseased pulp and reshaped. Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, or the tooth may be left open to drain, or the dentist may go right ahead and permanently fill the canals with rubber-like gutta percha or another material to prevent recontamination. If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled. Depending on the amount of remaining tooth structure, a metal post may be inserted above the canal filling to retain the core for the crown. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance. Following RCT, most teeth will need crowning for support.

Root Canal Treatment

If your tooth's nerve chamber becomes infected by decay, root canal treatment is often the only way to save your tooth.

 

Cosmetic Dentistry - Root Canal

 

Inside your tooth's hard outer shell is a nourishing pulp of blood vessels, lymph vessels, and nerves. The root canals, which contain the pulp, extend to the bone. Deep tooth decay, or an injury, can cause serious damage and infection to the pulp's nerves and vessels. Root canal, or endodontic, treatment cleans out the infected pulp chamber ad repairs the damage.

Some indications of the need for root canal treatment may be:

  • Spontaneous pain or throbbing while biting.
  • Sensitivity to hot and cold foods.
  • Severe decay or an injury that creates an abscess (infection) in the bone.

 

The Procedure

 

Root Canal Opening - Crown

Canal Length

Canal Cleaning

Step 1

Step 2

Step 3

After the tooth is anesthetized, an opening
is made through the crown into the pulp chamber.

The length of the root canals is determined

Unhealthy pulp is removed. Canals are cleaned, enlarged and shaped.

 

Canal Sealed

Temporary Filling

Step 4

Step 5

Canals are filled and sealed. A post may be
added for structural support or to retain restorative materials.

The tooth is sealed with a filling. We usually recommend
a crown to protect the tooth.

 

More than 95% of root canal treatments are successful; however, sometimes a case may need retreating. This can be due to diseased canal offshoots that were undetectable or the fracturing of a canal filing instrument used, both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain.

What happens after treatment?

Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic or prescription pain medicine. A follow-up exam can monitor tissue healing. If indicated, the crown needs to be placed as soon as possible. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth, and see Dr. Cheng every 6 months.

 

What are the risks and complications?

More than 95 percent of root canal treatments are successful. However, sometimes a case needs to be redone due to diseased canal offshoots that went unnoticed or the fracturing of a canal filing instrument used both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain.

What happens after treatment?

Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic or prescription pain medicine. A follow-up exam can monitor tissue healing. If indicated, the crown needs to be placed as soon as possible. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth, and see your dentist regularly.

 

Copyright 2017. Thomas Cheng, DMD, PA All Rights Reserved
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