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Endodontic Treatment


In the past you would probably lose a tooth if the tooth had a diseased or injured nerve. Today you may save that tooth with a special dental procedure called root canal therapy. Inside each tooth is the pulp which provides nutrients and nerves to the tooth. It runs like a thread down through the root. The pulp tissue dies when the pulp is diseased or injured. If you don't remove this pulp tissue, your tooth will get infected and you could lose it. The root canal is cleaned and sealed off to protect it after the dentist removes the pulp. Then dentists place a crown over the tooth to help make it stronger.

A root canal is usually a simple procedure with little or no discomfort involving one to three visits to a dentist. Most patients report that having root canal treatment today is as unremarkable as getting a filling. The best news is that it can save your tooth and your smile!

What is a root canal treatment?

Our participating dentists use a root canal procedure to save the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The soft tissue around the tooth contains nerves, blood vessels, and connective tissue. Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment has given our participating dentists a safe way of saving teeth.

Why do I need root canal treatment?

The simple answer is because your tooth will not heal by itself. The infection will spread without treatment. The bone around the tooth will begin to degenerate and the tooth may fall out. Pain usually worsens until you are forced to seek emergency dental attention. The only alternative is usually extraction of the tooth which can cause surrounding teeth to shift crookedly resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal treatment. If you have the choice, it's always best to keep your original teeth.

What causes pulp nerve damage?

There are two common causes of pulp nerve damage. Physical irritation is generally brought on by aggressive tooth decay reaching down to the nerve or through deep fillings which allows harmful bacteria to reach the nerve resulting in infection and decay. Receiving a blow to a tooth can also cause damage to sensitive nerve tissue within the tooth. Compare dental insurance and dental plan to see how you can save with these dental covers.

What are the symptoms of pulp nerve damage?

There are several common symptoms of pulp nerve damage. Each individual may experience the symptoms differently. These symptoms may include:

  • pain in the tooth when biting down
  • tooth pain while chewing
  • oversensitivity of the teeth with hot or cold drinks
  • facial swelling

The symptoms of pulp nerve damage may resemble other oral health conditions. You should consult a participating dentist for a diagnosis.

Why do I feel pain?

Pulp can die when it becomes infected due to a deep cavity or fracture as it allows bacteria to seep in. Pulp can also die because of injury due to trauma. Damaged or dead pulp causes increased blood flow and cellular activity and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks.

What is a 'root canal'?

Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp which carries the tooth's nerves, veins, arteries and lymph vessels. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.

What is the 'dental pulp'?

The pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.

What happens if the pulp gets injured?

The pulp dies when it is diseased or injured and can't repair itself. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp. Germs can cause an infection inside the tooth. Pus builds up at the root tip in the jawbone when not treated and forms a "pus-pocket" called an abscess. An abscess can cause damage to the bone around the teeth.

What does treatment involve?

Treatment often involves from one to three visits to our participating dentists. A dentist or endodontist will remove the diseased pulp during the treatment. The pulp chamber and root canal(s) of the tooth are then cleaned and sealed.

Here's how your tooth is saved through treatment:

  1. An opening is made through the crown of the tooth.
  2. An opening is made through the crown of the tooth into the pulp chamber.
  3. The pulp is then removed. The root canal(s) is cleaned and shaped to a form that can be filled.
  4. The pulp is removed and the root canals are cleaned, enlarged and shaped.
  5. Medications may be put in the pulp chamber and root canal(s) to help get rid of bacteria and prevent infection.
  6. A temporary filling will be placed in the crown opening to protect the tooth between dental visits. Your dentist may leave the tooth open for a few days to drain. You might also be given medicine to help control infection that may have spread beyond the tooth.
  7. The pulp chamber and root canals are filled and sealed.
  8. The temporary filling is removed and the pulp chamber and root canal(s) are cleaned and filled.
  9. The final step usually involves a gold or porcelain crown placed over the tooth. An endodontist performing the treatment will recommend that you return to your dentist for this final step.
  10. The crown of the tooth is then restored.

What is an 'endodontist'?

An endodontist is a dentist with special training in diagnosing and treating problems associated with the inside of the tooth.  They do only endodontic procedures in their practices because they are specialists. They perform routine as well as difficult and very complex endodontic procedures including re-treatment of previous root canals that have not healed completely and endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

How long will the restored tooth last?

Your restored tooth could last a lifetime assuming you continue to care for your teeth and gums. Regular checkups will be necessary. Your tooth will remain healthy as long as the root(s) of a treated tooth are nourished by the tissues around it.

Are there any risks?

If root canal therapy is suggested by a dentist then is important to have a tooth treated as soon as possible.  An infection that is allowed to continue is likely to result in the formation of an abscess at the root of the tooth. This will lead to destruction of the underlying bone tissue and may make it impossible to save the tooth. The infection can also spread to adjacent teeth and could result in blood poisoning, fever, swelling in the face and neck and a general ill feeling. 

More than 95 percent of root canal treatments are successful. Sometimes a case needs to be redone due to diseased canal offshoots that went undetected or the fracturing of a canal filing instrument used. This rarely occurs. A root canal therapy that has not been completed correctly is marked by a return of pain.

What happens after treatment?

Natural tissue inflammation may cause discomfort for a few days. This can be controlled by an over-the-counter analgesic. A follow-up exam will be to monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth, and see your dentist regularly.

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