Root canal therapy, also known as endodontic treatment, is a procedure that removes the inflamed or infected pulp found in the chamber and canals of a tooth, cleans and shapes the canals of a tooth, and fills the canals with a special material called gutta percha. By removing the infected tissue the natural tooth can become healthy again and be kept in the mouth.
Objectives
- To keep the natural tooth in the mouth.
- To alleviate pain.
- To allow for optimal chewing distribution and function.
- To maintain the aesthetics of the smile.
- To avoid dental crowding and malocclusions.
Indications
RCT may be recommendended when the following signs and symptoms are present:
- When there is a deep cavity that courses with intense pain when chewing, or pain that is spontaneous.
- Lingering sensitivity when drinking hot or cold beverages.
- When there is a sensation of pressure or throbbing in the affected tooth.
- Swelling in the surrounding gum and cheek.
- There may be purulent material (pus) coming out of the affected gum.
- The tooth discolors (darkens).
- X-ray shows an abscess next to the root end of the tooth.
- Defective and/or broken deep restorations proximal to pulp chamber.
Process
Root canal treatment is done under local anesthesia and should not involve any pain/discomfort during the procedure. It is generally done in one appointment, although depending on the tooth and severity of infection, two appointments may be needed.
Before starting the treatment the dentist or endodontist will perform a diagnostic exam to evaluate the tooth and surrounding soft tissue via clinical and radiographic assesments and its response to cold, palpation, and percussion stimuli.
On the day of the procedure, the dentist first numbs the tooth and then proceeds to insert a dental dam to protect the oral cavity and isolate the tooth to be treated. The dentist then makes an access opening through the top side the tooth (through the enamel and dentin) removing any decay in the process until it reaches the pulp chamber and begins to remove the infected pulp.
The infected pulp is removed using special files that are small enough to enter the small canals of a tooth. In addition to the files, antibacterial irrigants are used to aid in removing most of the bacteria in the pulp chamber and canals.
After the canals are cleaned, they are filled with a material called gutta-percha and cement. The remaining tooth is then filled with either a temporary restoration, or a definitive restoration i.e. crown. It is important to note that if the tooth is packed with a temporary filler, the patient should plan to return to the office for a definitive restoration within 2 weeks or per the dentist instructions. Temporary fillers lack adequate seal, strength and resistance properties and over time can place the tooth at higher risk for fractures and/or bacterial recontamination.
Following a root canal therapy, it is recommended to restore the tooth with a crown (especially if it is a molar or premolar), as this will reestablish optimal masticatory function, strenght and aesthetics.
Indications for the patient after root canal treatment
- Immediately after a root canal procedure, the patient will continue to feel numbness for a few more hours. Care must be taken to prevent accidental biting of the lip and/or cheek.
- Being a procedure that does not involve major complications, the patient can resume their daily work without having to rest.
- It is recommended that the patient avoid chewing on the side where the tooth is located (this if the procedure has taken more than 1 appointment and has not yet been completed).
- After the treatment is completed, it is prudent for the patient to eat only soft foods that do not require much chewing for one or two days while any sensitivity disappears. Also, jaw soreness is expected to occur and should dissipate in a few days.
- Your dentist may prescribe you a few medications. Please follow your dentist specific instructions.
Endodontic treatment vs. Tooth extraction
In the end, nothing can wholly replace your natural tooth. Therefore, one main point in favor of root canal treatment is that it allows the natural tooth to be kept in the mouth. Keeping the natural tooth also avoids the need to plan for dental implant or bridge treatments, which can be relatively more costly and time consuming options. If a tooth can be kept, then keeping it is always the best option.
Would you like to know more about our root canal therapy process? Need help deciding if saving your tooth/teeth is the best option for you? Contact us to schedule an appointment today!