A root canal is a treatment used to repair and save aÂ toothÂ that is badly decayed or becomes infected. During aÂ root canal procedure, the nerve and pulp are removed and the inside of theÂ toothÂ is cleaned and sealed. Without treatment, the tissue surrounding theÂ toothÂ will become infected and abscesses may form.
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 orÂ abscessed tooth. AnabscessÂ 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 drainageÂ into theÂ skin.
Sometimes no symptoms are present; however, signs you may need a root canal include:
- SevereÂ 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
A root canal requires one or more office visits and can be performed by our dentist or endodontist at Davinci Dental Clinic. The first step in the procedure is to take anÂ X-rayÂ to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone.
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 orÂ sodium hypochloriteÂ is used periodically to flush away the debris. Once the tooth is thoroughly cleaned, it is sealed. If there is an infection, your dentist may put a medicationÂ inside the tooth to clear it up. Others may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep out contaminants like saliva and food between appointments.
At the next appointment, 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. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or otherÂ weakness, aÂ crown, crown and post, or other restorationÂ often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function.
Root canal treatment is highly successful; the procedure has more than a 95% success rate.
Despite your dentist’s best efforts to clean and seal a tooth, new infections might emerge after a root canal. Among the likely reasons for this include:
- More than the normally anticipated number of root canals in a tooth (leaving one of them uncleaned)
- An undetected crack in the root of a tooth
- A defective or inadequate dental restoration that has allowed bacteria to get past the restoration into the inner aspects of the tooth and recontaminate the area
- A breakdown of the inner sealing material over time, allowing bacteria to recontaminate the inner aspects of the tooth
Sometimes retreatment can be successful, other times endodontic surgery must be tried in order to save the tooth. The most common endodontic surgical procedure is an apicoectomy or root-end resection. This procedure relieves the inflammation or infection in the bony area around the end of your tooth that continues after endodontic treatment. In this procedure, the gum tissue is opened, the infected tissue is removed, and sometimes the very end of the root is removed. A small filling may be placed to seal the root canal.
Alternatives to a Root Canal
Saving your natural teeth is the very best option. The only alternative to a root canal procedure is having the tooth extracted and replaced with aÂ bridge,Â implant, or removable partial dentureÂ to restore chewing function and prevent adjacent teeth from shifting.