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 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 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 fallout. 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.
Though an extraction
is cheaper, the
space left behind
will require an
implant or a
bridge, which can
be more expensive
than root canal
therapy. If you
have the choice,
it's always best to
keep your original
teeth.
If you're given a temporary
filling, usually on the next visit it's
removed and the pulp chamber and
canal(s) are filled with rubber like
gutta percha or another material to
prevent recontamination. If the
tooth is still weak, a metal post
may be inserted above the canal
filling to reinforce the tooth. 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.
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 is involved in root canal
therapy?
Once your general dentist performs
tests on the tooth and recommends
therapy, he or she can perform the
treatment or refer you to an endo-
dontist (a pulp specialist).
Treatment usually involves one to
three appointments.
First, you will probably be
given a local anesthetic to numb
the area. A rubber 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 fill the canals.
What happens after treatment?
Natural tissue inflammation may
cause discomfort for a few days,
which can be controlled by an
over-the counter analgesic. A
follow up exam can monitor
tissue healing. From this point
on, brush and floss regularly,
avoid chewing hard foods on the
treated tooth, and see your dentist
regularly.
Sources: A Consumer's Guide to Oentistry,
by Gordon I. Christensen, DDS, MSD,
PhD, Mosby- Year Book, Inc., 1994;
Practical Endodontics: A Clinical Atlas, by
Edward Besner, BS, OOS, et al., Mosby
Year Book, Inc., 7994; Your Teeth Can Be
Saved by Endodontic Treatment, American
Dental Association, 7992; Pathways of the
Pulp, by Stephen Cohen, MA, OOS, FICO,
FACO, et al., Mosby Year Book, Inc.,
1997.
Endodontic Practice, 77th ed., by Louis I.
Grossman, et. al., Lea and Febiger,
1988.
This information was compiled for General Dentistry. Your dentist cares about long-term dental health for you and your family and demonstrates that concern by
belonging to the Academy of General Dentistry. As one of the 35,000 general dentists in the United Sates and Canada who are member of the Academy, your dentists
participates in an ongoing program of professional development and continuing education to remain current with advances in the profession and to provide quality patient
treatment. Visit the AGD’s website at www.agd.org. You have permission to photocopy this page and distribute it to your patients.
