Root canal treatment, often simply called a "root
canal," is a dental procedure used to treat and save a tooth that has a
damaged or infected pulp, which is the innermost part of the tooth. This
treatment involves removing the damaged or infected pulp and then cleaning,
disinfecting, and sealing the tooth to prevent further infection and pain.
Here's an overview of the root canal procedure:
Diagnosis: The dentist or endodontist (a specialist in
dental pulp and root canal treatments) will start by examining the tooth and
may use X-rays to assess the extent of the damage or infection.
Anesthesia: To ensure you are comfortable during the
procedure, the dentist will administer a local anesthetic to numb the tooth and
the surrounding area.
Isolation: A rubber dam is placed around the tooth to keep
it dry and free of saliva during the procedure.
Access Opening: The dentist drills a small access hole into
the tooth's crown to reach the pulp chamber and root canals.
Cleaning and Shaping: The infected or damaged pulp is
removed using special instruments. The dentist then cleans and shapes the inner
canals of the tooth to remove any remaining bacteria or debris.
Disinfection: The cleaned canals are irrigated with an
antibacterial solution to further disinfect the area.
Filling: Once the canals are cleaned and disinfected, they
are filled with a biocompatible material, typically a rubbery substance called
gutta-percha, to seal the space and prevent future infection.
Restoration: After the root canal is completed, the access
hole is sealed with a temporary or permanent filling. In some cases, a crown
may be necessary to strengthen and protect the tooth, especially if it's a back
tooth or if it has been extensively weakened by decay or damage.
The procedure aims to remove the source of infection,
alleviate pain, and save the natural tooth. Root canals are highly successful
and can allow a tooth to function normally for many years, often for the rest
of a person's life.
While the term "root canal" may be
associated with pain and discomfort, the procedure is actually performed to
relieve severe toothache caused by an infected or damaged tooth. With the use
of modern techniques and anesthesia, patients typically experience little to no
pain during the procedure. It is important to follow post-treatment care
instructions and maintain good oral hygiene to ensure the long-term success of
the treated tooth.
A "root canal" is not a treatment, but part of a tooth. It is the hollow section of a tooth that contains the nerve tissue, blood vessels, and other cells, also known as the pulp.
A tooth consists of a crown and roots. The crown is mainly above the gum, while the roots are below it. The roots attach the tooth to the jawbone.
Inside the crown and the root, or the root canal, is the pulp. The pulp nourishes the tooth and provides moisture to the surrounding material. The nerves in the pulp sense hot and cold temperatures as pain.
The name of the dental procedure commonly referred to as a "root canal" is actually endodontic therapy, which means "inside the tooth." However, the term "root canal" has come to be commonly used to talk about the procedure.
Root canal therapy is done in three steps, and it takes between one and three sessions to complete.
1. Cleaning the root canal
First, the dentist removes everything that is inside the root canal.
With the patient under local Anesthesia, the dentist makes a small access hole on the surface of the tooth and removes the diseased and dead pulp tissue with very small files.
2. Filling the root canal
Next, the dentist cleans, shapes and decontaminates the hollow area, using tiny files and irrigation solutions. Then, the tooth is filled with a rubber-like material, using an adhesive cement to seal the canals completely.
After root canal therapy, the tooth is dead. The patient will no longer feel any pain in that tooth because the nerve tissue has been removed, and the infection has been eliminated.
3. Adding a crown or filling
However, the tooth will be now more fragile than it was before. A tooth with no pulp must receive its nourishment from the ligament that attaches the tooth to the bone. This supply is adequate, but in time, the tooth will become more brittle, so a crown or filling offers protection.
Until the crown or filling is complete, the patient should not chew or bite on the tooth. Once there is a crown or filling is done, the person can use the tooth as before.
Treatment often takes only one appointment, but if there are curved canals, multi-canals, or large infections, this could take one or two additional appointments.
One of the great fears about this kind of treatment is that it will be painful, but the treatment that is carried out by a trained dental surgeon should be relatively painless.
The pain that is felt comes from the infection and not from the treatment. The treatment does not cause pain; it helps to alleviate it.
The dental surgeon will relieve the pain of the procedure by numbing the tooth and surrounding area with local anesthesia.
After the treatment, some tenderness is normal. It is temporary, and over-the-counter (OTC) pain medication may be enough to relieve it. If needed, prescription drugs, such as codeine, are available.
The dentist may prescribe an antibiotic to treat or prevent infection.
If the pulp becomes injured or diseased, it cannot repair itself, and the tissue dies.
If there is a deep cavity, a cracked tooth, or a loose filling, bacteria can enter the pulp.
The bacteria will eventually destroy the pulp. If the bacteria penetrate through the root openings, it can cause an infection in the bone.
An infection will weaken the bone and break it down. The ligaments around the tooth will swell, and the tooth will become loose.
A pulp injury will make the tooth sensitive to high and low temperatures. There may be pain when chewing, and some people have a continuous, throbbing pain.
Without treatment, the infection will spread. Eventually, the tooth will become loose and need extracting.
Some patients opt for extraction, especially if it hurts a lot or if the tooth cannot be restored, for example, if there is large decay, trauma, or loss of bone due to periodontal, or gum, disease.
However, removing a tooth may mean that the surrounding teeth start to move and become crooked. This can look unsightly, and it can make it hard to have a good bite.
Root canal therapy will usually save the tooth and eliminate the pain.
If the tooth cannot be saved, the next best option is an implant.
However, saving the natural tooth is best, if possible, because nothing functions as well as a natural tooth.
The cost of dental treatment varies widely, but saving the tooth with a root canal is relatively cost-efficient.
The other option is extraction, and the cost of an implant or bridge to replace the tooth afterward is usually more expensive. Extraction can also lead to malocclusion, or misaligned teeth, and difficulty chewing.
To avoid complications, patients should always follow the dentist's instructions. If an antibiotic is needed, it is important to finish the entire prescription.
It is essential to have a permanent restoration placed, such as a crown, once the root canal therapy is complete.
To prevent infections, tooth decay, and gum disease, dentists recommend:
Dental sealants can also prevent decay.