The natural cavity in the center of the tooth that houses the pulp chamber and the many nerves and nutrients necessary for the stability of the tooth is called the root canal. An exploration of the anatomy of the tooth unveils that under the hard enamel on the outside of the tooth is a second hard layer of tissue called the dentin, which also protects the tooth from decay.
The root canal is at the center of this complex structure. There can be more than one root canal for any given tooth, and these canals connect to each other and to the surface of the tooth to form a matrix of support within the tooth structure and are dependent on each other for good dental health.
If there is a cavity or crack in the tooth, bacteria can enter through this opening, pierce the enamel and dentin layers and cause the pulp inside of the canal to become infected. This infection can lead to severe pain since the nerves to the teeth are enmeshed in the soft pulp. Untreated, this infection can move to the gums and the jaw, with the final result being tooth loss or even permanent bone loss.
When there is a constant pain in the tooth, increased sensitivity to hot or cold, or swelling and tenderness of the gums, it may be time for a dental root canal procedure to relieve the pain and to repair the tooth. A visit to your dentist can provide you with the information you need to decide on whether a root canal is an appropriate treatment for you.
Common Questions About a Root Canal Procedure
If you are prescribed a root canal, you are one of the millions who have this procedure to repair and save their teeth.
However, the idea of having a root canal can conjure up negative stories from friends and family, and if you are even a little anxious about seeing your dentist with the prospect of having a root canal you might need some guidance as to what to expect throughout this common practice.
1. How is a Root Canal Performed?
The inside of the tooth has many blood vessels, nerves, and connective tissue that helps the tooth grow during its development. When the tooth is mature, it is not necessary to maintain the inner pulp because the tissues around the tooth can now nourish the tooth. The tooth can survive without the pulp.
When the dentist performs the root canal, they remove the decay and infected pulp material from the root canal and clean and disinfect the inside of the tooth. The canal is then filled with a permanent filling, and the tooth is sealed. This procedure is completed using the appropriate anesthesia to ensure a painless and efficient experience. The entire procedure can be done in one or two appointments depending on the extent of decay and the condition of the tooth.
2. Why is the Root Canal Necessary?
When the nerves, connective tissue, and blood vessels in the pulp of the tooth become inflamed, there is swelling and increased pressure on the tooth. Although the tooth can withstand minor irritations caused by decay if left untreated the inside of the tooth can become gangrenous leading to an irreversible infection. A tooth that is gangrenous does not have normal blood circulation, and the nerves do not perform in a regular pattern.
Once the pulp is infected and there is a decay in the tooth’s enamel, it can sometimes be repaired by removing the decay and filling the hole in the tooth. If the infection has progressed too far or when the decay has reached the pulp, then the symptoms of pain and discomfort are very severe, the patient develops a condition known as apical periodontitis. This condition will not go away without using the root canal procedure to remove it. If left, it will evolve into the tooth’s major roots and even into the jawbone that might require more extensive oral surgery.
3. What is the Actual Procedure?
The first steps taken by the dentist are to make sure that the root canal treatment is necessary. X-rays are taken of the teeth and the roots to inspect the extent of the infection and to identify the number and shape of roots and which roots are affected. This examination also uncovers any other issues that may lead to problems after the root canal has been done, and the dentist can make adjustments in the treatment. The normal steps in the procedure are as follows:
- The dentist drills a hole through the surface of the tooth into the pulp.
- Special needles and disinfectants are used to clean the interior of the tooth.
- The infected tissue is removed from the tooth using both mechanical and chemical procedures. Calcium hydroxide, a strong alkaline substance, is placed in the canal to kill any remaining microbes that are causing the infection.
- There is the possibility that the dentist will give you some time to heal and to confirm that the infection has been stopped.
- The same procedure may be repeated depending on the overall condition of the tooth.
- A filling is placed on the tooth to seal the canal from any further infection. You may require additional appointments to fit a crown to restore the tooth’s structure, integrity, appearance, and function.
4. How Does Root Canal Treatment Save the Tooth?
Your tooth will continue to function like any other tooth once the inside has been cleaned and protected. Your dentist may recommend a crown for those teeth that have to do most of the chewing and grinding action in the process of eating, and this will be discussed with other options.
5. Will I Feel Pain During or After the Root Canal?
The techniques of modern dentistry have evolved to where most patients do not feel much pain or discomfort during a root canal procedure. Just having the original pain of the infected tooth removed, may in itself, be a relief that overshadows any minor irritations or sensations as the dentist completes the work.
After the treatment, the tooth may be sore or sensitive, especially if there was a severe infection before the procedure was performed. This condition can be relieved with over-the-counter medications, advice from your dentist, and there are even some common home remedies that could be used to counteract the pain and promote healing. There is always the possibility that the tooth may feel a little different when you are eating, but that is normal due to the tenderness around the tooth, the new filling or crown, and the fact that you are not avoiding using the tooth as you might have when there was a pain to deal with. However, if there is a sustained amount of pain, swelling, or other signs of infection, you should contact your dentist immediately.
6. What Factors Influence the Outcome of a Root Canal?
Millions of root canals are performed every year by many qualified dentists and endodontists. The usual result is successful when the infection has been removed, and the tooth looks good and can be used normally. There is never a guarantee that a root canal will always be a final relief for a problem with a tooth, but the better prepared you are in other ways will make it more likely to be the remedy you are seeking.
Any infection in the body is best cured when the person is in good health. This factor can determine how quickly the body heals and how complete the healing process is. Some diseases like cancer, diabetes, and medications for other conditions such as arthritis and heart disease can weaken the body’s defense system making the tooth infection harder to remove.
The Anatomy and Frequency of Root Canals
Dentists can sometimes be challenged by the formation of various roots that the teeth have especially when there are multiple roots. Molars can have four roots, whereas premolars can have one or two roots, and incisors only one. The number, location, and the shape also determine the difficulty of the procedure, with some roots being calcified and more challenging to clean and disinfect. Roots can be straight, crooked or angled and this can cause difficulty in reaching the infection.
The Extent of the Infection
If the infection that originated in the pulp of the tooth spreads to the jawbone, the root canal procedure can usually reverse the infection in the jawbone, but the result can be unpredictable. The patient’s overall health or other infections may lead the dentist to recommend the tooth’s extraction rather than performing the root canal. There are certain types of bacteria like Streptococcus mitis that are hard to remove with just the medicines used for the root canal, and this factor can determine future actions and treatments.
Restoring the Tooth for Normal Use
Once the root canal has been completed, the tooth is restored, and the patient can use it normally. Sometimes a crown or filling replaces the enamel that has been destroyed from the infection, or in cases where the tooth has been damaged gold or ceramic filling can be used to make sure the tooth will stand up to constant use. The dentist is an expert and even an artist at restoring the appearance of damaged teeth, and you will be pleased with the final result once you have lost the pain, felt the strong tooth, and see the result in the mirror. This is one of the most important positive factors in having a root canal done.
7. Will the Tooth Need Any Special care or Additional Treatment?
Most dentists will suggest that you do not use the tooth normally until the surface has been completely restored. If there is not a permanent seal and filling, then the tooth could fracture so you should follow the directions given to you by your doctor. Maintaining good oral hygiene by regular brushing, flossing, and regular cleanings and check-ups will ensure a long life for your repaired tooth.
8. Can A Root Canal Fail?
A root canal can fail for many reasons, and all of them can be addressed and corrected. If the canal was not properly and thoroughly cleaned, there is a chance that the infection can recur, and you may require a root canal retreatment. The procedure is the same as the original root canal and has a high success rate. The crown can also fracture leaving the tooth exposed to the same bacteria that caused the infection in the first place. If there is any unusual pain or similar discomfort in the tooth after the root canal, this should be checked out as soon as possible by the dentist.
9. Will a Tooth Turn Black After a Root Canal?
The most important reason for repairing a damaged or decayed tooth may be to enhance the patient’s appearance by improving their smile. Improving one’s smile can have very positive effects on self-confidence and personal well-being. A tooth that has had a root canal can sometimes become slightly discolored or develop intrinsic stains where there is internal bleeding in the tooth, and the inner side of the tooth turns yellow or darkens. Currently, there are many solutions to this condition including professional teeth whitening treatment. Your dentist can advise you on the best methods available.
If you have a painful tooth that you think may need the attention of a dentist to evaluate whether or not you may need a root canal treatment, then it is wise to make an appointment as soon as possible. Waiting too long to address the problem can compound the condition in your tooth leading to severe infection and even bone loss. Contact us right away if you are having severe pain or swelling around a tooth or if you think you may need a root canal procedure. Call us at (248)-626-0772.