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Understanding Root Canals – you can save your natural teeth with endodontic therapy …Root Canal Treatment

Root canal therapy fits under the special dentistry area known as endodontics.  Endodontics literally means dentistry within the tooth itself. The procedure treats disorders of the pulp (the soft tissue inside the crown and roots made up of blood vessels, nerves and lymph vessels that keep your tooth nourished).  It restores your tooth to a comfortable state by removing the damaged tissue and replacing it with a substance that will help preserve the function of the tooth.

There are many reasons that a root canal may be needed but the most common cause is the uncontrolled process of tooth decay.  When tooth decay begins, it penetrates the outer layer of enamel and creates a cavity.  If that process is not stopped, the decay will continue toward the nerve of the tooth.  Other causes include a fracture that exposes the pulp, traumatic injury such as a blow to the tooth, a cracked or loose filling or repeated fillings in a tooth and occasionally from gum disease.  Regardless of the initial cause, the tooth pulp becomes irritated and an abscess (infection) can occur.  Bacteria from your saliva grow within the tooth pulp, causing pressure and pain.  The inflammation and infection spread down the root canal, often causing sensitivity to hot or cold foods, throbbing, aching, or pain when you chew.  Eventually the pulp dies, causing the bone around the tooth to be destroyed.  Your bone may become infected and abscessed as the bacteria escapes through the root openings.  The bone will break down and your periodontal ligaments may swell and loosen your tooth, making it feel higher than the others and quite mobile.

The Procedure

Once it has been determined that root canal treatment is necessary, you will be scheduled for one or more appointments.  Your visits may last one to two hours, and you may receive local anesthesia.  A rubber dam may be used to isolate your tooth and prevent bacteria from entering it.  The goal of the root canal therapy is to improve the health of your damaged tooth by removing the pulp from your root canals through a small opening in the crown.  Then the canals are sealed with special materials to prevent bacteria from reaching your bone.  Your dentist then restores the outside of your tooth so it will function properly and have a healthy appearance.  After root canal therapy, your tooth continues to be nourished by your surrounding gums and bones.

Stages:

A.  Cleaning and shaping your root canals

First, your dentist makes an opening in your tooth and removes any filling and decay.  Then, the unhealthy pulp is removed with tiny, flexible files.  By using delicate up and down motions, your dentist gently cleans and smooths your canals to prepare them for the canal-filling materials.

B.  Filling your root canals

After the pulp has been removed from your root canals and they have been smoothed, your dentist may fill the canals with tiny cone-shaped pieces of gutta-percha, a firm, rubber-like material, or use another dental material.  A sealer-cement is used to seal the filling material into place.

C.  Restoring your tooth

After the inside of your tooth has been treated the outside will be restored to protect your tooth’s underlying structures and to give it a healthy appearance.  If your tooth needs extra support, some of the gutta-percha may be removed and a post inserted before the filling and crown are applied.

CARE FOLLOWING TREATMENT

Once the root canal has been completed, you should be aware of discolouration and brittleness.  A root canal treated tooth may undergo a change in colour.  While this is of no great medical concern, it may be an issue especially if the tooth is located at the front and highly visible when you smile.  A non-vital, root canal treated tooth is also more brittle than a vital one and this makes it more susceptible to fracture.  Therefore, we recommend that your root canal teeth be crowned (capped) following treatment.

Occasionally, a tooth that has undergone root canal treatment fails to heal or pain continues despite therapy.  Some of the special complications that can occur include accessory canals (large side canals coming off the main canal that cannot be cleaned out), badly curved or cracked roots and narrow canals that prevent thorough cleaning and sealing of the damaged tooth.  Sometimes, for unknown reasons, tissues simply fail to heal or a tooth that initially responds to root canal therapy becomes painful or diseased months or years later.  Retreatment may be necessary in these cases.  If you would like further information please call North Hill Dental Center in Richmond Hill, Ontario at 905-508-2244.