What is a Root Canal?
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. Without treatment, the tissue surrounding the tooth will also become infected and abscesses may form. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed.
“Root canal” is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s nerve lies within the root canal.
A tooth’s nerve is not vitally important to its health and function after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.
Why Does Tooth Pulp Need to Be Removed?
When a tooth’s nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:
- Swelling that may spread to other areas of the face, neck, or head
- Bone loss around the tip of the root
- Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.
What Damages a Tooth’s Nerve and Pulp in the First Place?
A tooth’s nerve and pulp can become irritated, inflamed, and infected due to deep decay, repeated dental procedures on a tooth, and/or large fillings, a crack or chip in the tooth, or trauma to the face.
What Are the Signs That a Root Canal Is Needed?
Sometimes no symptoms are present; however, signs you may need a root canal include:
- Severe toothache pain upon chewing or application of pressure
- Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
- Discoloration (a darkening) of the tooth
- Swelling and tenderness in the nearby gums
- A persistent or recurring pimple on the gums
What Happens During a Root Canal Treatment at Reva Dental?
A root canal will require one or more office visits. The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. Your dentist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but your dentist will generally anaesthetise the area to ensure you are relaxed and at ease.
Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth. An access hole will then be drilled into the tooth. The pulp, along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it is sealed. In some cases your dentist may decide to wait before sealing the tooth – for instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. In most cases however the tooth will be sealed on the same day it is cleaned out.
Next, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth’s root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.
The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown or may need to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your Reva dentist will discuss the need for any additional dental work with you.
How Painful Is a Root Canal?
Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed.
What Should One Expect After the Root Canal?
For the first few days following the completion of a root canal, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications such as ibuprofen (e.g. Advil). Most patients can return to their normal activities the next day.
Until your root canal procedure is completely finished — that is to say, the permanent filling is in place and/or the crown, it’s wise to minimize chewing on the tooth under repair. This step will help avoid recontamination of the interior of the tooth and also may prevent a fragile tooth from breaking before the tooth can be fully restored.
How Successful Are Root Canals?
Root canal treatment is highly successful; the procedure has more than a 95% success rate. Many teeth fixed with a root canal can last a lifetime. Also, because the final step of the root canal procedure is application of a restoration such as a crown or a filling, it will not be obvious to onlookers that a root canal was performed.
Alternatives to a Root Canal
It goes without saying that saving your natural teeth is the best option, if possible. The only procedural alternative to a root canal is having the tooth extracted and replaced with a bridge, implant or removable partial denture to restore chewing function and prevent adjacent teeth from shifting. However these alternatives are generqlly more expensive than a root canal procedure and require more treatment time and additional procedures to adjacent teeth and supporting tissues.
Root Canal Prevention
Since some of the reasons why the nerve of a tooth and its pulp become inflamed and infected are due to deep decay, repeated dental procedures on a tooth and/or large fillings, following good oral hygiene practices (brushing twice a day, flossing at least once a day, and scheduling regular dental visits) will reduce the need for a root canal procedure. Trauma resulting from a sports-related injury can be reduced by wearing a mouthguard.
Ask your dentist’s advice on root canal procedures; you can call Reva Dental in Kilkenny on (056) 7763786 to schedule your appointment. You may be eligible for a free check-up; see www.revadental.ie