Endodontic Treatment (Root Canal)
Why Would You Need Root Canal Treatment?
Root canal treatment is needed for two main reasons: infection or irreversible damage to the pulp.
An untreated cavity is the most common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it opens into the pulp chamber, allowing bacteria to infect the tooth. Infections inside teeth do not respond to antibiotic treatment. The inflammation caused by the infection restricts the tooth’s blood supply, so antibiotics in the bloodstream can’t reach the infection very well. The reduced blood supply also limits the pulp’s ability to heal itself. Often times an antibiotic will be given as a preventive to keep infection from moving into the soft tissues of the face.
The pulp also can become damaged from trauma, a fracture or extensive restorative work, such as several fillings placed over a period of time. Sometimes, a common dental procedure can cause the pulp to become inflamed. For example, preparing a tooth for a crown sometimes leads to the need for root canal treatment. In many cases, when the pulp is inflamed, but not infected, it will heal and return to normal. Dr. Warren may want to monitor the tooth to see if this happens before doing root canal treatment. Sometimes, though, the pulp remains inflamed, which can cause pain and may lead to infection.
Once the pulp becomes infected, the infection can affect the bone around the tooth, causing an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty canals with an inert material. If root canal treatment is not done, the tooth may have to be extracted.
It is better to keep your natural teeth if at all possible. If a tooth is missing, neighboring teeth can drift out of line and can be overstressed. Keeping your natural teeth also helps you to avoid more expensive and extensive treatments, such as implants or bridges. If an infected or injured tooth that needs root canal treatment is ignored, not only can you lose the tooth, but also the infection can spread to other parts of your body.
Signs and Symptoms
If you have an infection of the pulp, you may not feel any pain at first. But if left untreated, the infection will cause pain and swelling. In some cases, an abscess will form. Eventually, the tooth may need to be extracted. Some indications that a tooth may need a root canal are:
- A tooth that hurts significantly when you bite down on it, touch it or push on it
- Sensitivity to heat
- Sensitivity to cold that lasts longer than a couple of seconds
- Swelling near the affected tooth
- A discolored tooth, with or without pain
- A broken tooth
To determine whether your tooth needs root canal treatment, Dr. Warren will perform clinical tests on the tooth to determine the health of the nerve, evaluate an x-ray of the affected tooth, and evaluate the soft tissues.
Length of Treatment
Root canal treatment can be done in one or more visits, depending on the situation. An infected tooth may need several appointments to make sure that the infection is eliminated. Some teeth may be more difficult to treat because of the position of the tooth, because they have many and curved root canals that are difficult to locate, or for other reasons. An uncomplicated root canal treatment often can be completed in one visit.
Various procedures and technologies are used to access and remove the soft tissue located in the internal spaces (canals). Dr. Warren will access the pulp chamber and remove the inflamed or infected pulp with small instruments that follow the internal curvature of the roots. The canals are carefully cleaned, shaped, and disinfected with an antibacterial medication. Once the canals are cleaned and dried, a cement and rubberized filling material are placed in the canal space to seal off the root. Once completed, the root canal will be more prone to resisting another infection in that tooth.
Complications can sometimes occur during an endodontic procedure. Although uncommon, complicating factors can effect the outcome of the procedure. Listed below are a few possibilities:
- Inflammation and pain
- Resistant bacteria that does not resolve after treatment may need to be treated again or surgically
- If a root or canal is curved badly, the fine instruments that are used may perforate (create a hole) the side of the tooth
- A canal may not be visible and may be missed completely
- Calcifications (hardening) of the canals may make it impossible to completely remove all of the affected tissues
- An instrument may become separated in the canal and be unable to be retrieved
- Filling material and medications may enter the space around the roots and cause inflammation
Endodontic treatment is a very safe and effective method of restoring a tooth that has become infected or severely broken down. Dr. Warren can answer any of your questions when discussing this form of treatment.