What is a Root Canal Treatment?
A root canal is one of the most common dental procedures performed. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
To understand root canal treatment, it helps to understand the anatomy of a tooth and its surroundings. Within the core of every tooth are hollow spaces and channels containing a soft tissue organ called the pulp. The pulp is sometimes referred to as "the nerve". Pulp tissue is largely comprised of blood vessels, nerve endings, and connective tissue. The blood vessels and nerves enter the pulp tissue through tiny openings at the tips of each root. A thin membrane called the "periodontal ligament" surrounds the entire root surface of the roots and connects the tooth to the surrounding jawbone.
The pulp is a very vulnerable tissue and can easily become diseased for a variety of reasons. Symptoms can range from none to excruciating pain. In the early stages of pulpal disease, the pulp tissue is inflamed and sensitivity to cold or hot is often the hallmark symptom. The ligament is often also inflamed causing pain when biting or chewing. Irreversible inflammation progresses to necrosis (death) and infection of the pulp. The process of necrosis often causes spontaneous pain and toothache. Infection spreads into the surrounding bone and gum tissues through the root openings, forming an "abscess". Since the blood supply no longer functions in a necrotic pulp, bacteria thrive within the confined space, safe from antibiotics or the immune system. For this reason, a tooth that has a diseased pulp should either be extracted or receive root canal treatment to eliminate this inevitable source of infection.
After a thorough examination, the endodontist, we will administer local anesthesia to eliminate discomfort. In addition, we will provide nitrous oxide analgesia or oral conscious sedation, if indicated. After the tooth is numb, a protective sheet called “dental dam” is placed over the area of interest to isolate the tooth and keep it clean and free of saliva during the procedure. This dental dam acts as a protective barrier to prevent any root canal cleaning solution or instruments from dislodging into the oral cavity. Once the plastic shield is firmly in place, the root canal procedure will begin with the access or opening of the crown portion of the tooth on the biting surface. Various small endodontic instruments are used to clean the pulp chamber and shape the root canals prior to filling the canal systems.
Root canal treatment involves the meticulous removal of diseased pulp tissue and debris. The canals are mechanically shaped and the remaining pulp spaces are chemically disinfected. Once the diseased tissue or infection is removed from within the tooth, the tissues around the tooth can heal.
After the canal systems are cleaned and shaped, the canals are sealed off with a root canal filling material called gutta-percha in order to prevent salivary bacteria from contaminating the disinfected root canal spaces. Gutta-percha is a rubber-like material that is solid at body temperature but is moldable when heated or compacted. This allows the material to form a custom seal in the root canals, and prevent the percolation of bacteria, contamination, and secondary infection.
What Happens After Treatment?
When your root canal therapy has been completed, a temporary material will be placed in the access hole of the crown. Your restorative dentist will receive a record of your treatment and radiographs. The root canal treated tooth needs to receive a permanent restoration within 2-3 weeks, a period of healing, to prevent any bacterial leakage into the recently root canal treated tooth. During this time the tooth has a temporary restoration. Please contact your restorative dentist to schedule a follow-up appointment for permanent restoration. Your restorative dentist will decide on what type of permanent restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond. To prevent further decay, continue to practice good dental hygiene. With proper root canal treatment and restoration of the tooth, healing can occur and the health of the tooth can be maintained.