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The white outside portion of a tooth is the
"enamel".
Inside the enamel is a second hard layer, the "dentin". A small
chamber exists at the center of the dentin, the " pulp
chamber". Inside the
pulp chamber is the " tooth pulp", a soft tissue made up of nerves, arteries,
and veins. The pulp extends from the pulp chamber to the tip
of the root through a narrow channel called the " root
canal". In general, teeth in the front of the
mouth have only one root canal, while teeth in the back have two, three or
four root canals.
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Root
Canals - Painless Or Not:
Prior
to beginning the procedure to perform the root canal, your Dentist will
have made the entire area numb. Therefore, since you are numb during
the procedure, you probably will not feel
anything. Most root canal patients (approximately 75 percent) also
experience no discomfort following the procedure. The discomfort
that is experienced
by the remaining 25 % is usually caused by the infection that made
the root canal necessary, not by the root canal. Following the
procedure, your Dentist will likely provide you with a prescription for
medication to stop the infection and relieve any associated discomfort.
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Determining If You Require A Root
Canal:
When the nerve of a tooth becomes
infected, root canal treatment can save the tooth. Some of the
symptoms that can assist you in determining if you are a candidate for a
root canal, are:
 | heat and cold
sensitivity |
| swelling and
pain |
| a bad taste in your
mouth |
It
is also possible that you may experience no
symptoms at all, and not realize that you have a dental problem.
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Tooth Infection:
Tooth
infection originates from deep cavities
that allow germs to get into the pulp chamber. These germs cause
infection, and the pulp dies. The pus from the infection eventually builds
up at the root tip and makes a hole in the bone. This is called an
abscess.
A blow to a tooth may also cause the
pulp to die and then become infected. An infected tooth will never heal on
its own, and as it gets worse, it will continue to be a source of
infection that weakens your entire immune system, and can affect your entire
body. This damage to the bone and the swelling inside the bone can also be
excruciatingly painful, and even life-threatening. Years ago, the
only remedy for an infected
tooth was extraction; however today, your tooth can be saved with
root canal treatment.
Root Canal Treatment:
Root canal treatment and subsequent
tooth restoration usually involves three steps.
| First, your dentist removes
the infection to promote healing. |
| Next, he places a post to
strengthen the tooth. |
| Finally, he crowns the tooth
to protect it. |
Your
Dentist desires the entire procedure
to be comfortable for you, so his initial concern is to make sure the area
is thoroughly numb. Then, he will place a "rubber
dam" around your tooth to isolate it from the balance of your mouth.
This rubber dam protects you by keeping debris from falling to the back of your throat.
It
also keeps the tooth dry and accessible so your Dentist can achieve a
superior result.
To access the infection, an opening is made through the top of the tooth
down into the pulp chamber. Using a dental file, your Dentist (or
endodontist) carefully cleans out the infected tissue and shapes the
canals to receive the filling material. X-rays are taken to make sure that
all of the infected pulp is removed.
At
times it is necessary to strengthen
a tooth with a post, and if so, the post is cemented down inside one of the root
canals.
Making
a crown is the last step in restoring your tooth. It protects your
tooth and gives you back your smile.
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Apicoectomy:
An apicoectomy is a minor surgical
procedure that becomes necessary when root canal treatment has not completely
healed an infected tooth.
After
root canal treatment, an abscess, which is a hole in the bone at the tip
of the root, will at times continue to grow. To stop the infection, a small
incision is made in the gums. Your Dentist will remove the infection
followed by sealing the
tip of the root. Once this has been
completed, the infection
will heal, new bone will grow in, and the tooth will be healthy again.
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Alternatives To A Root Canal:
Once the pulp of a tooth becomes
infected, the choices for remedy become limited.
| delay
treatment |
| have the tooth
extracted |
| save
the tooth with root canal treatment |
The
problem with delaying treatment is that an infected tooth will NEVER heal
on its own, and this can lead to a variety of very serious problems.
As the
infection spreads down the tooth and into your jawbone, the pain may
become excruciating. It could even put you in the hospital and threaten
your life!
An extraction is only a short-term
solution. While it does remove the source of infection, it sets off a
chain reaction of shifting teeth, which causes other dental problems.
The
only way to save your tooth is to remove the infection with root canal
treatment.
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Following
A Root Canal:
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Root
canal therapy often takes two or more appointments to complete. A
temporary filling or crown is placed to protect the tooth between
appointments.
After each appointment when anesthetic
has been used, your lips, teeth and tongue may be numb for several hours.
Avoid any chewing until the numbness has completely worn off to keep from
biting the inside of your mouth or tongue.
Between appointments,
it is quite common (and
not a problem) for a small portion of your temporary filling to wear away
or break off. However, if the entire filling falls out, or if a temporary crown
comes off, call your Dentist immediately so that it can be replaced.
It is
quite normal to experience some
discomfort for several days after receiving root canal therapy, especially
when chewing. To control your discomfort, take pain medication as recommended.
In the event antibiotics have been prescribed, continue to take them for the indicated
length of time, even if all symptoms and signs of infection are no longer
present.
To further reduce pain and swelling,
rinse three times a day with warm salt water. The salt solution can
be prepared simply by dissolving a teaspoon of salt
in a cup of warm water, then rinse-swish-expell.
To protect the tooth and help keep your
temporary in place:
| Avoid eating sticky foods (especially gum). |
| Avoid hard foods and hard substances, such as ice, fingernails and
pencils. |
| If possible, chew only on the opposite side of your
mouth. |
It is
extremely important to brush and
floss normally. Usually, the last step after root canal treatment is the
placement
of a crown on the tooth, because a crown covers and protects the tooth from
breaking in the future.
If your bite feels uneven, if you have persistent pain, or
in the event you have any questions or concerns, it is recommended that
you call your Dentist immediately.
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