What is a Root Canal?
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.
“Root canal” is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s nerve lies within the root canal.
A tooth’s nerve is not vitally important to a tooth’s health and function after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.
Why Does Tooth Pulp Need to Be Removed?
When a tooth’s nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:
- Swelling that may spread to other areas of the face, neck, or head.
- Bone loss around the tip of the root.
- Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.
What Damages a Tooth’s Nerve and Pulp in the First Place?
A tooth’s nerve and pulp can become irritated, inflamed, and infected due to deep decay, repeated dental procedures on a tooth, and/or large fillings, a crack or chip in the tooth, or trauma to the face.
What Are the Signs That a Root Canal Is Needed?
Sometimes no symptoms are present; however, signs you may need a root canal include:
- Severe toothache pain upon chewing or application of pressure.
- Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed).
- Discoloration (a darkening) of the tooth.
- Swelling and tenderness in the nearby gums.
- A persistent or recurring pimple on the gums.
What Happens During a Root Canal?
A root canal requires one or more office visits. The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Dr, Almaawi will then use local anesthesia to numb the area near the tooth. Next, to keep the area dry and free of saliva during treatment, a rubber dam (a sheet of rubber) will be placed around the tooth.
An access hole will then be drilled into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it is sealed. This may be done in one or two visits and depends upon the infection. If it is not completed in one visit, a temporary filling is placed in the exterior hole in the tooth to keep out contaminants like saliva and food between appointments. To fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth’s root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.
The final step will involve further restoration of the tooth. A crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function.
What Should You Expect After the Root Canal?
For the first few days following the completion of a root canal, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications such as ibuprofen (Advil,Motrin) or naproxen (Aleve). Most patients can return to their normal activities the next day.
Until your root canal procedure is completely finished — that is to say, the permanent filling is in place and/or the crown, it’s wise to minimize chewing on the tooth under repair. This step will help avoid recontamination of the interior of the tooth and also may prevent a fragile tooth from breaking before the tooth can be fully restored.