Root
Canal Therapy
What is a root canal?
Underneath your tooth's outer enamel and within the dentin is an area
of soft tissue called the pulp, which carries the tooth's nerves,
veins, arteries and lymph vessels. Root canals are very small, thin
divisions that branch off from the top pulp chamber down to the tip
of the root. A tooth has at least one but no more than four root canals.
Why do I feel pain?
When the pulp becomes infected due to a deep cavity or fracture
that allows bacteria to seep in, or injury due to trauma, it can
die. Damaged or dead pulp causes increased blood flow and cellular
activity, and pressure cannot be relieved from inside the tooth.
Pain in the tooth is commonly felt when biting down, chewing on
it and applying hot or cold foods and drinks.
Why do I need root canal therapy?
Because the tooth will not heal by itself. Without treatment, the
infection will spread, bone around the tooth will begin to degenerate,
and the tooth may fall-out. Pain usually worsens until one is forced
to seek emergency dental attention. The only alternative is usually
extraction of the tooth, which can cause surrounding teeth to shift
crookedly, resulting in a bad bite. Though an extraction is cheaper,
the space left behind will require an implant or a bridge, which
can be more expensive than root canal therapy. If you have the choice,
it's always best to keep your original teeth.
What is a root canal procedure?
A root canal is a procedure done to save the damaged or dead pulp
in the root canal of the tooth by cleaning out the diseased pulp
and reshaping the canal. The canal is filled with gutta percha,
a rubber like material, to prevent recontamination of the tooth.
The tooth is then permanently sealed with possibly a post and/or
a gold or porcelain crown. This enables patients to keep the original
tooth.
What is involved in root canal therapy?
Once your general dentist performs tests on the tooth and recommends
therapy, he or she can perform the treatment or refer you to an
endo-dontist (a pulp specialist). Treatment usually involves one
to three appointments.
First, you will probably be given a local anesthetic to numb the
area. A rubber sheet is then placed around the tooth to isolate
it. Next, a gap is drilled from the crown into the pulp chamber,
which, along with any infected root canal, is cleaned of all diseased
pulp and reshaped. Medication may be inserted into the area to fight
bacteria. Depending on the condition of the tooth, the crown may
then be sealed temporarily to guard against recontamination, or
the tooth may be left open to drain, or the dentist may go right
ahead and fill the canals.
If you're given a temporary filling, usually on the next visit
it's removed and the pulp chamber and canal(s) are filled with rubber like
gutta percha or another material to prevent recontamination. If
the tooth is still weak, a metal post may be inserted above the
canal filling to reinforce the tooth. Once filled, the area is permanently
sealed. Finally, a gold or porcelain crown is normally placed over
the tooth to strengthen its structure and improve appearance.
What are the risks and complications?
More than 95 percent of root canal treatments are successful. However,
sometimes a case needs to be redone due to diseased canal offshoots
that went unnoticed or the fracturing of a canal filing instrument
used-both of which rarely occur. Occasionally, a root canal therapy
will fail altogether, marked by a return of pain.
What happens after treatment?
Natural tissue inflammation may cause discomfort for a few days,
which can be controlled by an over-the-counter analgesic. A follow-up
exam can monitor tissue healing. From this point on, brush and floss
regularly, avoid chewing hard foods on the treated tooth, and see
your dentist regularly.
This information was compiled for you by the Academy
of General Dentistry. Your dentist cares about long-term dental
health for you and your family and demonstrates that concern by
belonging to the Academy of General Dentistry. As one of the 37,000
general dentists in the United States and Canada who are members
of the Academy, your dentist participates in an ongoing program
of professional development and continuing education to remain current
with advances in the profession and to provide quality patient treatment.
Visit the AGD's web site at www.agd.org. To find a dentist, please
call 877/2X-A-YEAR (877/292-9327). You have permission to photocopy
this page and distribute it to your patients.
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