A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants and bridges.
Root canal treatment is one of the most common dental procedures that we perform in our office. For most people the idea of a root canal sounds like a painful experience but the procedure is actually painless and can save your natural tooth while preventing the need for the patient to have dental implants or bridges. In order to understand a root canal procedure you must firstly understand the anatomy of the tooth . Under the white enamel there exists a hard layer called dentin. Underneath the dentin is a soft tissue called pulp. This pulp contains blood vessels, nerves and connective tissue which all help the the root of the tooth to grow during development. When a tooth is full developed it can survive without the pulp because it continues to be nourished by the tissues that surround it.
An infection or inflammation of the pulp can be caused by trauma to the tooth, cracks, a possible deep decay or failed dental restorations. Sometimes the dentist can see this visibly due to the swelling and sometimes by the symptoms such as temperature sensitivity or gum and tooth pain. The dentist must perform a non surgical root canal in order to eliminate the diseased pulp. Once the injured pulp is removed and the root canal is thoroughly cleaned and sealed.
The dentist can perform endodontic treatment in one or two visits, sometimes more. This will involve the following steps : Firstly the dentist will examine the patients tooth and perform x-rays and administers local anesthetic. Once the tooth is numb, a protective sheet is placed called a dental dam. This will isolate they tooth and keep it free from saliva during the procedure preventing the canals from becoming reinfected.
The dentist will then make a very small opening in the crown of the tooth. He will use very small instruments to clean the pulp from the root canalks and the pulp chamber. Once this is done the dentist will the root canals with a bio-compatible material known as 'gutta percha' which is a rubber like material derived from a plant. This bio compatible material is used with an adhesive cement and placed in order to completely seal the root canals. The temporary filling is used to close the opening . this is then removed by the dentist once the tooth is restored.
Upon your final visit you must return to the dentist to have a crown or another type of restoration placed onto the tooth in order to protect and restore the tooth to its full function. If there is a lack of sufficient stricture that holds the crown in place then the dentist may place a post inside the tooth in order to stabilize and hold it.
The Root canal treatment ( also known as root canal therapy)
The space inside the tooth is known as the pulp chamber. This is where the root canal system and the pulp exists which is the vital tissue that keeps the tooth alive. Inside the pulp exists the connective tissues, the nerves and the blood vessels.
Root canal treatment is also known as endodontic treatment. This treatment is needed when the pulp becomes inflamed or infected. This can happen for many reasons but could happen due to repeated dental procedures on a tooth or possible traumatic damage such as a crack or a fracture on the root. The presence of gum disease can also cause root canals that become infected and require root canal treatment.
Any one of the above can cause acute inflammation of the pulp which can cause swelling inside the tooth and a build up of pressure, which can lead to tooth pain and eventually irreversible damage to the patient pulp. Once the pulp inside the tooth dies, the pain dissipates however it can return quickly spreading infection into the jawbone.
Normally whatever is causing the root canal or pulpal disease it will be necessary to perform a root canal procedure in order to save the tooth. In most cases root canals will be dealt with at New Rochelle Dental Arts. In extreme cases you will be referred to an endodontist.
Initially the dentist will remove the decay and the source of infection that has caused the pulp to become infected. Firstly the dentist must determine whether the patients lost tooth structure can be restored. If a tooth fracture has reached the pulp or the cause of the infection is gum disease then it may be more difficult to save the tooth.
During the root canal procedure the following steps will be taken.
The dentist will apply local anesthesia via injections that will numb the tooth that is to be treated and the surrounding tissues. If the pulp is inflamed it could be painful and may take longer to numb. The dentist will wait until it is fully numb before he starts the treatment.
Use of the Dental dam
A dental dam is placed on the infected tooth in order to isolate if from the rest of the mouth. This is composed of a thin sheet of rubber or vinyl and is placed over the affected and adjacent teeth. The tooth that is being treated protrudes through the hole punched into the dental dam and this allows the root canal treatment to be carried out in a sterile environment, where no bacteria from from the mouth or saliva can reinfect the area.
The dentist will drill a small access hole through the surface (biting) of the infected tooth from or behind a front tooth. This will allow him access to the pulp chamber and the root canals for treatment.
The dead pulp tissue that is diseased has to be removed from the tooth using specially designed tools that can clean out the root canals and the pulp chamber. This is not a painful process for the patient. The area is numbed beforehand and connective tissue is either already dead or dying. Once all of the pulp and the nerves are removed the patient can no longer feel pain.
The dentist will use special materials to disinfect the canals and clean them using anti-bacterial solutions.
The dentist will reshape the canals using tiny flexible instruments that will allow them to receive root canal fillings and sealed. The root canals will become washed and cleaned again in order to remove the root canal debris before sealing them.
The dentist will select root canals that will fit exactly into the root canals that he has freshly prepared. The dentist uses the rubber like material called 'gutta percha' that he uses to fill the canal space. As the material is thermoplastic the dentist will heat the material and compress it against the walls of the root canals in order to seal them. He with the use an adhesive cement called a sealer along with the 'gutta percha' in order to fill the canal space. It is important that the dentist reseals the canals in order to prevent them from becoming re-infected with bacteria.
The dentist will then place a temporary or permanent filling in order to seal the access hole that is made to treat the canals. He will then remove the dental dam. If the tooth structure is weak the dentist will place a post inside the tooth in order stabilize it and keep the tooth in position.
Once root canal treatment is completed.
Root canal filling material which is known as ‘gutta percha’ is placed into the canals and the tooth is sealed with a temporary filling that prevents it from contamination. The crown is usually placed over the tooth in order to protect and seal it from contamination.
Once the procedure has been completed an antibiotic may be prescribed in order to treat or prevent and infection. It is important that the patient follows the instructions of the dentist carefully taking the antibiotics at regular intervals. There are minimal after effects to a root canal treatment. This may include slight soreness. This can be alleviated using aspirin or prescription medication.
Once the root canal has been performed your tooth will need a permanent restoration – either a filling or a crown if the structure of the tooth has been damaged and we need to replace tooth structure. This is an important step and many as there is much research to show that root canals are recontaminated with bacteria from the mouth and the infection around the tooth could reoccur.
The root canal system in a patients tooth is akin to the root of a plant going into the ground. The whole system needs to be sealed during a root canal treatment in order for it to be successful long term. Root canals are very small spaces and microscopic instruments are used in order to complete the root canal process. It is important for patients to know that root canals save teeth and do not cause pain but actually relieve it.
When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of 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.
The cost associated with this procedure can vary depending on factors such as the severity of damage to the affected tooth and which tooth is affected. In general, endodontic treatment is much less expensive than tooth removal and replacement with an artificial tooth.