Root Canal Treatment

Our philosophy is that the best teeth are your own, and we try to ensure you do not lose any tooth that can be restored. Root canal treatment is frequently the only way to save a badly damaged tooth, when the only other option is to have your tooth removed. Keeping your tooth helps to prevent your other teeth from drifting out of line and causing jaw problems or gum disease. Saving a natural tooth avoids having to replace it with either a bridge or an implant.

Root Canal Treatment is also called endodontics, and is the process of removing the infected, injured or dead pulp from a tooth, and filling the space left behind.

Teeth are made up of three hard layers:

  1. enamel
  2. dentin
  3. cementum

There is a space inside the hard material of each tooth. It is called the root canal system and it is filled with soft dental pulp made up of nerves and blood vessels that help the tooth grow and develop. Once a tooth is fully-grown, it can survive without a pulp. If the pulp of a tooth becomes infected, a root canal (or endodontic treatment) is needed. When this treatment is performed, the pulp is removed.

During your regular check-up, we check for infection and damage to teeth, even though you may not notice any signs of tooth trouble. If trouble is spotted and you need a root canal, we may do it, or refer you to a dental specialist with at least two years of extra university training in this area. Root canal specialists are called endodontists. If your child’s baby (or primary) tooth pulp is damaged, a procedure called a pulpotomy will be done in place of a root canal treatment.

When Might I Need a Root Canal?

The pulp inside a tooth can be damaged by cracks in the tooth, deep cavities or accidents. Germs (or bacteria) can get into the tooth and lead to infected tooth pulp. This situation may cause pain and/or swelling. Sometimes, the pulp becomes infected or dies, but does not cause any pain.

We may notice:

  • changes in the colour of the tooth,
  • changes in your gums, or
  • changes picked up by a dental X-ray.

Sometimes, if a great deal of dental work is needed, we can tell from your exam and X-rays that the pulp of a tooth is not likely to survive. In all these cases, root canal treatment can ease or prevent symptoms, and save the tooth.

How it is done

Step 1 We will give you “freezing” (or anesthetic). In some unusual cases, anesthetic is not needed.

Step 2 We will place a rubber dam around the tooth. This dam protects the tooth from germs in your saliva while the work is being done.

Step 3 We will make a small opening in the tooth to reach the root canal system and the damaged pulp.

Step 4 We will take out the pulp by cleaning and enlarging the root canal system with very fine dental tools (or instruments), similar to tiny pipe cleaners and roto-rooters.

Step 5 After it has been cleaned and disinfected we will fill and seal the root canal system with a rubber-like material (called gutta-percha).

Step 6 We will then seal the opening of the tooth with a temporary filling. The permanent restoration may be a filling or crown, and is done as a separate procedure.

Things to Consider

Root canal treatment may be completed in one appointment, or it may take two or more visits. It depends on the complexity of the root canal system and on the degree of pulp damage. Sometimes, if the infection has spread from the tooth to the bone (or abscess), the infection may have to be drained before the root can be filled.

After root canal treatment, your tooth may be tender for one or two weeks. Bad pain or swelling are not common. If the pain is severe, please call us.

After a root canal, your tooth has to be fixed (or restored) to look, feel and work as much like a natural tooth as possible. We may use a filling or a crown to restore your tooth. It depends on the strength of the part of the tooth that’s left. A back tooth will likely need a crown, because chewing puts a great deal of force on back teeth. If not enough of the tooth is left, we may use a post to help hold the crown on. A tooth that has become dark may be bleached, crowned or covered with a veneer.

You can still get a cavity or gum disease after a root canal. It does not protect your tooth from other types of damage.

Root Canal Re-treatment and Root Canal Surgery

Most of the time, a root canal is a success, but in some cases, a second root canal is needed. This procedure is called re-treatment. The root canal filling material is taken out, and the canal is recleaned, reshaped and refilled.

We may recommend root canal surgery when a regular root canal cannot be done, or when it has not worked. Surgery is done to:

  • check the end of the root for cracks (or fractures);
  • remove parts of the root that could not be cleaned during regular root canal treatment;
  • clear up an infection that did not heal after regular treatment.

All dentists learn to do root canal treatment in dental school, but because re-treatment and surgery are more complex, we may refer you to an endodontist. Most of the time, a tooth that has had a root canal can be saved, but there are cases where all efforts to save a tooth fail and the tooth must be extracted.

Adapted from CDA Your Oral Health

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