The space inside the hard layers of each of your teeth is called your root canal. This canal is filled with soft pulp made up of nerves and blood vessels that help the teeth to grow and develop. Normally the dental pulp is protected by hard layers of dentin and enamel, but deep decay or fractures due to biting or other trauma can injure the pulp and allow bacteria to enter the chamber.
Root canal therapy is a gentle and highly effective procedure in which the pulp is removed and the tooth is sealed. This treatment is the only way to save an infected tooth, but it does cause brittleness in the tooth structure. To maintain the treated tooth’s strength and stability it needs a dental crown to prevent further damage.
Endodontics is the branch of dentistry that deals with tooth pulp, commonly referred to as “the nerve.” This involves the assessment, diagnosis, and treatment of dental diseases that affect the pulp. Teeth that are inflamed, infected, cracked or traumatized will typically require endodontic therapy, more commonly known as a root canal. It’s true that root canals have a thoroughly undeserved bad reputation, but it’s also true that today, root canals are typically painless, easy and highly successful.
Your first visit is typically an endodontic evaluation. This includes 1 or more X-rays, a discussion about any symptoms you may be experiencing, specific testing of the teeth in the area and discussion about possible treatments, including their advantages and disadvantages. If your dentist thinks root canal therapy is a good solution to treat your tooth, a typical appointment will last 60 – 90 minutes, depending on the complexity of your tooth.
Root canals are safe and predictable. They involve freezing the area being treated, placing a rubber dam over the affected tooth, a little drilling (usually less than 5 minutes), and then cleaning the inflamed or infected pulp tissue out of the tooth. Sometimes a root canal will take more than one visit. If that’s the case, your dentist will pack some medicine into the roots of your tooth and then place a temporary filling in the hole. After 2-3 weeks, you will return to have the tooth cleaned out again and the roots filled with a rubber material called gutta percha. It is important to recognize the pain may go away after initial cleaning appointment, but not all of the bacteria have been removed, so not coming back to have the procedure completed can often end result in an even larger infection, sometimes requiring hospitalization. It is imperative to the success of the root canal to place a filling in the roots.
Following root canal, roughly half of the people will experience no pain, while the other half will experience mild-moderate pain that they can manage with over-the-counter medications like ibuprofen or acetaminophen. About 5% of people experience moderate-severe pain and require prescription medications. Please call any time with questions or concerns about your treatment.
Lastly, all teeth will require a buildup (commonly known as a filling) to close the hole created to remove the nerve. Most teeth will require a crown after root canal, so it is important that you see your dentist shortly after your treatment is completed. Delay of this process may result in the tooth breaking, so this procedure should not be delayed. Studies show that teeth that are restored within 2 weeks of root canal treatment have the highest success rates.
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