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Ask the Experts
Whose knees do not quake at the thought of a “root canal?” Pain and cost spring to mind. But how many of us even know what a “root canal” really is?
Root canal therapy, also known as endodontic therapy, is a dental treatment for removing infection from inside a tooth. It can also protect the tooth from future infections.
It is carried out in the pulp of the tooth, which is the root canal.
What is root canal treatment?
A “root canal” is not a treatment, but part of a tooth. It is the hollow section of a tooth that contains the nerve tissue, blood vessels, and other cells, also known as the pulp.
A tooth consists of a crown and roots. The crown is mainly above the gum, while the roots are below it. The roots attach the tooth to the jawbone.
Inside the crown and the root, or the root canal, is the pulp. The pulp nourishes the tooth and provides moisture to the surrounding material. The nerves in the pulp sense hot and cold temperatures as pain.
The name of the dental procedure commonly referred to as a “root canal” is actually endodontic therapy, which means “inside the tooth.”
However, the term “root canal” has come to be commonly used to talk about the procedure.
Root canal therapy is done in three steps, and it takes between one and three sessions to complete.
- Cleaning the root canal – First, the endodontist removes everything that is inside the root canal. With the patient under local anesthesia, the endodontist makes a small access hole on the surface of the tooth and removes the diseased and dead pulp tissue with very small files.
- Filling the root canal – Next, the endodontist cleans, shapes and decontaminates the hollow area, using tiny files and irrigation solutions. Then, the tooth is filled with a rubber-like material, using an adhesive cement to seal the canals completely. After root canal therapy, the tooth is dead. The patient will no longer feel any pain in that tooth because the nerve tissue has been removed, and the infection has been eliminated.
- Adding a crown or filling – The tooth will be now more fragile than it was before. A tooth with no pulp must receive its nourishment from the ligament that attaches the tooth to the bone. This supply is adequate, but in time, the tooth will become more brittle, so a crown or filling offers protection. Until the crown or filling is complete, the patient should not chew or bite on the tooth.
Treatment often takes only one appointment, but if there are curved canals, multi-canals, or large infections, this could take one or two additional appointments.
How painful is it?
One of the great fears about this kind of treatment is that it will be painful, but the treatment that is carried out by a trained endodontist should be relatively painless.
The pain that is felt comes from the infection and not from the treatment. The treatment does not cause pain; it helps to alleviate it.
The endodontist will relieve the pain of the procedure by numbing the tooth and surrounding area with local anesthesia.
After the treatment, some tenderness is normal. This is temporary, and over-the-counter pain medication may be enough to relieve it. If needed, prescription drugs, such as codeine, are available.
The endodontist may prescribe an antibiotic to treat or prevent infection.
Saving a tooth with a root canal is relatively cost-efficient.
The other option is extraction, and the cost of an implant or bridge to replace the tooth afterward is usually more expensive. Extraction can also lead to malocclusion, or misaligned teeth and difficulty in chewing.
As with any procedure, complications can occur.
- Sometimes the endodontist only finds three root canals in a tooth that has four. If one canal remains untreated, the infection might continue and spread into the bone.
- The endodontist must make sure the filling material goes far enough into the canal, to fill it up. If the root canal is not properly sealed, the infection could return.
- During the procedure, the root of the tooth may crack, or the instruments can break in the canal or perforate the canal. This makes it hard to fill the tooth effectively.
If complications occur, your endodontist will try to correct the problem and complete the root canal.
To avoid complications, patients should always follow the endodontists instructions. If an antibiotic is needed, it is important to finish the entire prescription.
While all endodontists are dentists, less than three percent of dentists are endodontists. Just like a doctor in any other field, endodontists are specialists because they have completed an additional training beyond dental school. Their additional training focuses on diagnosing tooth pain and root canal treatment and other procedures relating to the interior of the tooth. In many cases, a diseased tooth can be saved with endodontic treatment. For this reason, endodontists proudly refer to themselves as Specialists in Saving Teeth.