Root Canal Therapy

Root canal treatment is needed for two main reasons: infection or irreversible damage to the pulp.

An untreated cavity is a common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it opens into the root canal system, allowing bacteria to infect the pulp. The pulp also can become damaged from trauma, a fracture or extensive restorative work, such as several fillings placed over a period of time. Removing the pulp is called endodontic treatment, but it is often referred to as root canal treatment or root canal therapy.

Before                          After

In many cases, when the pulp is inflamed, but not infected, it will heal and return to normal. Your dentist may want to monitor the tooth to see if this happens before doing root canal treatment. Sometimes, though, the pulp remains inflamed, which can cause pain and may lead to infection.

Once the pulp becomes infected, the infection can affect the bone around the tooth, causing an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty canals with an inert material. If an infected or injured tooth that needs root canal treatment is ignored, not only can you lose the tooth, but also the infection can spread to other parts of your body.

The reason for doing root canal treatment is often a large cavity. The tooth often is weakened, but if the tooth is covered with a crown after the root canal or, in some cases, restored with tooth-coloured composite filling material, the tooth can last the rest of your life.

Signs and Symptoms

If you have an infection of the pulp, you may not feel any pain at first. But if left untreated, the infection will cause pain and swelling. Some indications that a tooth may need a root canal are:

* A tooth that hurts significantly when you bite down on it, touch it or     push on it

* Sensitivity to heat

* Sensitivity to cold that lasts longer than a couple of seconds

* Swelling near the affected tooth

* A discoloured tooth, with or without pain

* A broken tooth

Length of Treatment

Root canal treatment can be done in one or more visits, depending on the situation. An infected tooth will need several appointments to make sure that the infection is eliminated. An uncomplicated root canal treatment often can be completed in one visit.

Measuring and Cleaning the Root Canals

Measuring
First, your dentist or endodontist will numb the area around the tooth. You also may receive sedation, such as nitrous oxide, or your dentist may offer other anxiety-reducing techniques if you feel you need them. He or she will make a hole in the top or back of your tooth to get to the pulp chamber and remove some of the diseased pulp. Then the root canals have to be measured.

Your dentist needs to know how long the canals are so he or she can make sure all the diseased tissue is removed and the entire canal is cleaned.

Also, the material used to fill the canal after it is cleaned needs to fill the entire canal.

Cleaning
After the canals have been measured, your dentist or endodontist will use the specially designed instruments to clean out the diseased pulp. After the pulp has been removed, the canal is cleaned with an antiseptic solution, which helps to treat the source of the infection.

For root canal treatment to be effective, all the canals within the tooth must be cleaned. Once the canals have been thoroughly cleaned and the endodontist or dentist has made sure that the infection has been removed, the roots are filled. A temporary filling is then placed to cover the new root filling. The crown of the tooth should then be restored with a permanent filling or crown within a relatively short time.

After Root Canal Treatment

Your tooth will be sore for two to three days after the procedure, and your dentist will tell you to avoid chewing on the affected side. The worse the infection and inflammation was prior to root canal treatment, the sorer the tooth will be after treatment. You can take over-the-counter pain relievers to ease the discomfort.

Possible Complications

As with most invasive medical or dental procedures, complications can occur.

* the oxygen in the air will trigger some bacteria to start growing, causing inflammation and pain.   

* Bacteria may get pushed out through the tips of the roots causing inflammation and possibly infection.

* A root canal treatment can puncture the side of the tooth.

* A root canal may be missed or an entire canal may not be fully cleaned out.

In most cases, you will not experience any pain during the root canal procedure. Your dentist will completely numb your tooth and the surrounding area. If this doesn't seem to be working, alert your dentist right away. Some people fear the anaesthetic injections more than the procedure itself, but numbing gels and modern injection systems have made injections virtually painless. Let your dentist know immediately and he or she can modify the technique to avoid repeating the pain.

In addition to anaesthetic, you may receive sedation, such as nitrous oxide.

Information supplied by www.colgate.com