Endodontic Therapy

Root Canal Therapy

A root canal is needed when the nerve tissue, or pulp tissue, becomes infected.  The pulp is full of nerves, connective tissues, and blood vessels, which extend into the center of the tooth and exit through canals at the apices, or tips, of the roots. When this nerve tissue becomes infected, the first indication may range from mild tooth sensitivity, to intense pain.  If left untreated, the pain may go away as the nerve tissue dies, however the infection does not and may result in tooth loss or systemic issues.

 What is a Root Canal?

 A root canal procedure also known as endodontic therapy, is a procedure in which the infected nerve tissue is removed from the tooth and replaced with a filling material.

The first part of the root canal therapy is getting the area numb with local anesthetics.  If the tooth is severely infected, it may require extra anesthetic to completely numb the area, however the doctor will ensure the tooth is completely numb before beginning the procedure.  

Next, a small opening is made in the top of the tooth to give the doctor access to the pulp chamber and root canals.  Then, tiny instruments, called files, are used to remove dead and dying tissue from inside the narrow passages.  These passages are then cleaned, disinfected, and filled with a safe, inert material.  Finally, the opening in the tooth is filled with a build up material and post to provide structural support to the tooth and prevent contamination.  Following an endodontic procedure, it may be necessary to have a restoration (such as a crown) placed on the tooth to restore it to full function and aesthetic appearance.  After that, with proper care the restored tooth should last for many years.

Why do I need a root canal?

There are several reasons the nerve tissue in a tooth could become infected.  The most common cause is when tooth decay is left untreated 

and progresses through the first two layers of tooth structure allowing bacteria into the pulp tissue.  Once infected, the tooth may or may not become symptomatic, depending on the type of bacteria infecting it.  If the tooth is symptomatic, it may be pressure or temperature sensitive, and/or have spontaneous pain (ie. no stimulus).  

If the tooth is asymptomatic, or the symptoms have subsided, and is left untreated an endodontic abscess may form, which could cause further systemic issues if left unchecked.  

Other causes for root canal therapy include root resorption, a cracked tooth, dental trauma, or if a tooth that was previously treated with a root canal becomes reinfected.  The dentist will use a combination of clinical and radiographic evidence to make a diagnosis on the tooth in question.

What do I do after I’ve had a root canal?

After a root canal treatment, it’s important to avoid eating or drinking anything until the anesthesia has worn off.  It is not uncommon for the tooth to be sore for the first few days after a root canal, and the doctor may recommend taking an anti inflammatory depending on the severity of the infection and the length of the procedure.  Avoid chewing on the tooth while this sensitivity lasts.  After the root canal procedure is complete, the tooth should be crowned to maintain its structural integrity.  This may be done the same day or at a separate visit.