Root Canal Therapy

Has a dentist told you that you need root canal treatment?

If so, you are not alone. Millions of teeth are treated and saved each year with root canal Therapy. It is important to remember that root canal treatment does not cause pain, but relieves it.

Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.

Contrary to jokes about the matter, modern endodontic treatment is very similar to having a routine filling and usually can be completed in one or two appointments, depending on the condition of your tooth and your personal circumstances. You can expect a comfortable experience during and after your appointment.

Saving the natural tooth with root canal treatment has many advantages:

• Efficient chewing
• Normal biting force and feeling
• Natural appearance
• Protects other teeth from excessive wear and tear.

• With proper care, even teeth that have had root canal treatment can last a lifetime. But sometimes, a tooth that has been treated does not heal properly and can become painful or diseased months or even years after treatment.If your tooth failed to heal or develops new problems, you have a second chance. An additional procedure may be able to support healing and save your tooth.If you are experiencing dental pain or discomfort in a previously treated tooth, talk to your dentist about retreatment.As in any dental or medical procedures, a tooth may not heal as expected after the initial treatment for a variety of reasons:
  • Hard to find or narrow canals were not treated during the initial procedure.
  • Complicated canal anatomy went undetected in the first procedure.
  • The placement of the crown or other restoration was delayed following the endodontic treatment.
  • The restoration did not prevent salivary contamination to the inside of the tooth.

  In other cases, a new problem can jeopardise a tooth that was successfully treated.

  For example:

  • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
  • A loose, cracked or broken crown or filling can expose the tooth to new infection.
  • A tooth sustains a fracture.

  During retreatment, your dentist will reopen your tooth and remove the filling materials that were placed in the root canals during the first procedure. He will then carefully examine the tooth, looking for additional canals or new infection. The Dentist then removes any infection, cleans and shapes the canals, and places new medicated materials. The opening is then sealed with a temporary filling. Once the tooth heals, a new crown or other restoration is placed on the tooth to protect it.

Occasionally, a nonsurgical root canal procedure alone cannot save your tooth and your Dentist will recommend surgery. Endodontic surgery can be used to locate small fractures or hidden canals that were not detected on x-rays or during previous treatment. Surgery may also be needed to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth.

There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which is occasionally needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure. In this microsurgical procedure, the dentist opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. A small filling may be placed to seal the end of the root canal and few stitches or sutures are placed to help the tissue heal. Over a period of months, the bone heals around the end of the root. Local anaesthetics make the procedure comfortable, and most patients return to their normal activities the next day. Postsurgical discomfort is generally mild.

Traumatic dental injuries often occur in accidents or sports-related injuries. Chipped teeth account for the majority of all dental injuries. Dislodged or knocked-out teeth are examples of less frequent, but more severe injuries. Treatment depends on the type, location and severity of each injury. Any dental injury, even if apparently mild, requires examination by a dentist or an endodontist immediately. Sometimes, neighbouring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and creates the surrounding hard tissues of the tooth during development.

The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

All dentists, including your general dentist, received training in endodontic treatment in dental school. General dentists can perform endodontic procedures along with other dental procedures, but often they refer patients needing endodontic treatment to endodontists.

Endodontists are dentists with special training in endodontic procedures. They provide only endodontic services in their practices because they are specialists. To become specialists, they complete dental school and additional two or more years of advanced training in endodontics. They perform routine as well as difficult and very complex endodontic procedures, including endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

It is normal to feel some tenderness in the area for a few days after your root canal treatment as your body undergoes the natural healing process. You may also feel some tenderness in your jaw from keeping it open for an extended period of time. These symptoms are temporary and usually respond very well to over-the-counter pain medications. It is important for you to follow the instructions on how to take these medications. Remember that narcotic medications, if prescribed, may make you drowsy, and caution should be exercised in operating dangerous machinery or driving a car after taking them.

Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed. However, if you have severe pain or pressure that lasts more than a few days, contact your dentist.

• Do not eat anything until the numbness in your mouth wears off. This will prevent you from biting your cheek or tongue.
• Do not chew or bite on the treated tooth until you have had it restored by your dentist.
• Be sure to brush and floss your teeth as you normally would.
• If the opening in your tooth was restored with a temporary filling material, it is not unusual for a thin layer to wear off in-between appointments. However, if you think the entire filling has come out, contact your dentist.
• Contact your dentist right away if you develop any of the following:
  • a visible swelling inside or outside of your mouth;
  • an allergic reaction to medication, including rash, hives or itching (nausea is not an allergic reaction);
  • a return of original symptoms; or
  • Your bite feels uneven.

Root canal treatment is only one step in returning your tooth to full function. A proper final restoration of the tooth is extremely important in ensuring long-term success.

Contact your dentist as soon as possible to arrange your next appointment. If your tooth is being treated in more than one visit by a dentist, do not return to your dentist for the final restoration until the root canal treatment is completed.

The tooth that has had appropriate endodontic treatment followed by a proper restoration can last as long as your other natural teeth. After the tooth has been restored, you need only practice good oral hygiene, including brushing, flossing, regular check-ups and cleanings.

Your dentist or endodontist may periodically x-ray the tooth to ensure that healing has occurred. Occasionally, a tooth that has undergone endodontic treatment does not heal or pain continues. At times, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, repeating the endodontic procedure can save the tooth.

Patients today have more options than ever before to treat their teeth. Understanding your choices and their impact on your future dental health and lifestyle is important. Read on to learn why nothing is as good as your natural tooth and get simple tips for saving your teeth!

Saving a natural tooth through endodontic treatment should always be the first choice for the best health and cosmetic results. There are many advantages to saving your natural tooth:

• Efficient chewing
• Normal biting force, so you can continue to eat your favourite foods
• Maintains a natural appearance
• Limits the need for more costly, ongoing dental work

1. If you are given a choice between root canal treatment or tooth extraction, always choose root canal treatment. Dentistry has yet to produce a denture, bridge or implant that looks and feels or functions as well as a natural tooth.
2. If your dentist recommends tooth extraction, ask whether root canal treatment is an option.
3. If your dentist says that an endodontic procedure is not an option, ask why, and request a referral to an endodontist. Endodontists are dentists who specialize in saving teeth, and have at least two years of advanced training in root canal procedures. They are experts at diagnosing and relieving tooth pain, and use advanced equipment to treat patients quickly and comfortably. Your dentist probably has partnerships with endodontists in your area already.

• Never choose extraction because you think it will be cheaper! When a natural tooth is extracted, it must be replaced with an artificial tooth to prevent other teeth from shifting, and to prevent future dental problems. The cost of a denture, bridge or implant, plus the extraction, often is higher than the cost of an endodontic procedure that would save the tooth for years to come. Most dental insurance plans cover endodontic treatment.
• Never choose extraction because you think root canal treatment will be painful! Modern techniques and effective anaesthesia make root canal treatment virtually painless .In fact, discomfort after the procedure is generally greater with a tooth extraction. Patients who have experienced root canal treatment are six times more likely to describe it as “painless” than patients who have not had a root canal.
• Never choose extraction because you think it will be quicker! Endodontic treatments generally require one to two visits lasting less than an hour each. An extraction requires one visit, but the denture, bridge or implant will require several additional visits with your dentist.