Root Canal Procedure


Root Canal Defined

Root canal is a treatment performed to repair and save a tooth that is either infected or badly decayed internally. The words ‘root canal’ describes the cavity inside the center of the tooth that is usually filled with pulp and contains the tooth’s nerves. The root canal procedure is performed to remove the pulp and affected or damaged nerve tissue within a tooth’s pulp chamber.

The nerve and pulp of a tooth can become irritated, inflamed, and infected because of decay, repeated dental procedures and/or large fillings, a crack or chip in the tooth, or trauma to the face. Once a tooth’s pulp and nerve tissue are damaged, they are no longer useful. These cells can breed additional bacteria that further decay the tooth.

By removing the inside contents, the tooth can then be cleaned and sealed. With less chance of infection, teeth and gums are less likely to encounter further pain and abscess from infection.

Signs That You May Need a Root Canal

There may or may not be clear or urgent signs. Dr. Bihary will examine, and use x-ray to take a look inside the gum, to determine the need for root canal. Some signs may include:

  • Discoloration (a darkening) of the tooth
  • Persistent or recurring pimple on the gums
  • Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
  • Severe toothache pain upon chewing or application of pressure
  • Swelling and tenderness in the nearby gums

Tooth Pain

How Bad is an Abscess?

Some people try to live with dental pain, often letting serious problems go unchecked. This can result in infection, pain, and abscessed teeth and gums. An abscess is a pus-filled pocket that forms at the end of the roots of a tooth.

Other problems an infected tooth can cause are:

  • Swelling and nerve pain that can spread to other areas of the face, neck, or head.
  • Loss of bone around the tip of the root
  • Drainage of puss and blood, coming out from the root and gum
  • A hole through the side of the tooth, draining into the gums or through the cheek.

The longer a patient leaves serious dental problems go untreated, it generally results in the need for more extensive work, like a root canal. Know that it may take more than one office visit to do a root canal procedure. Depending on severity, even though the tooth may be saved, further work of a cosmetic nature may need to be performed. Dr. Bihary will review these possibilities with you.

What to Expect with a Root Canal Procedure

A general dentist may choose to perform the root canal procedure. Depending on the amount and severity of the work, patients may be referred to an endodontist, who specializes in the human dental pulp and nerves of the tooth. The dentist or endodontist will usually use a local anesthesia to numb the mouth area where he or she will work, which is more for your comfort.

Depending on who you ask, root canal procedures have a reputation of being painful. They can really be more of an inconvenience because of the repeated visits and scraping involved. Most people report that the procedure itself is no more painful than having a filling placed.

While the local anesthesia takes effect, the area around the tooth is prepared to keep it dry and saliva-free while the doctor works. A bit of rubber may be placed in addition to using the suction tool. A hole is drilled into the tooth. The pulp, decayed nerve tissue, and any other debris or bacteria are removed using files that scrape out the sides of the canals. Water or sodium hypochlorite is used to flush away the debris periodically during scraping.

After cleaning, the tooth is sealed. Based on the condition of your tooth and surrounding gum, the dentist may need to put medication inside. The hole may also be sealed the same day it is cleaned. If a tooth is not completed in the one appointment and needs additional treatment, a temporary filling is placed to keep out saliva and food between visits.

For filling the tooth interior, the doctor will use a sealer paste and a place a rubber compound into the root canal. The hole is then covered with a filling. The doctor will also review the final step for restoring your tooth, depending on its overall condition. This may include a crown, crown and post, or other arrangement that will protect it from further damage or breaking.

After the Root Canal

The tooth and work area around it may be sensitive for a few days and feel inflamed, particularly if there was pain or infection present before it was done. Pain medication available over-the-counter generally relieves the discomfort, and most people return to normal activities the next day.

If a temporary filling is holding things in suspense until the next visit or you are waiting for a crown that will strengthen your tooth, it may be best to chew less on the tooth being repaired. This way, there is less chance of complicating or breaking the tooth being restored. Patients may maintain regular oral care of brushing and flossing until you see the dentist again.

Root canal treatments carry a 95% success rate, and repaired teeth can go on to last a lifetime. The use of a crown or other restoration will make it less obvious that a root canal was done.

Are There Dangers or Complications?

While a root canal is done in effort to clean, seal, and save a tooth, there can be a new infection afterwards, which can be caused by:

  • Not scraping a root, which then carries infection
  • An unseen crack in the root of the tooth
  • Defective or inadequate restoration, allowing bacteria to recontaminate
  • Breakdown of the inner sealing material, allowing bacteria to recontaminate

In some cases, the tooth may be retreated or scraped and cleaned out again. If needed, an endodontist may do surgery to try to save the tooth, where he or she will do a root-end resection. The apicoectomy procedure relieves infection in the bony area at the end of your tooth that continues to be inflamed after treatment.

How Much Can a Root Canal Cost?

Actual cost of the procedure can be different, based on the severity of the work being performed. Most insurance policies will cover part or most of the endodontic treatment. An average estimate for the root canal cost for the treatment done by a general dentist, which does not include the restoration or cosmetic work afterward, depending on the tooth, can be from $500 to $1,500. Specialist work done by an endodontist may have fees that run 50% higher.

Are There Any Other Alternatives?

The doctor will review your options with you. Root canals are preferred to save your natural teeth because they are important in maintaining proper nutrition. If your tooth is too damaged, the only alternative is to extract the tooth and replace it with a bridge, implant, or removable partial denture so chewing function is restored.

The extraction and use of these other alternatives can end up being more expensive than root canal, usually require more treatment and healing time, and include additional work to adjacent teeth and supporting tissues to keep those teeth from shifting over time.

Proactive patients can prevent the need for root canal by proper dental care and oral hygiene. Trauma-related mouth injuries caused by sporting activities can be reduced by wearing a mouth guard. Talk with Dr. Bihary about the steps you can take to prevent root canal today!

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