As an endodontic patient, what should I expect?
What is a root canal?
A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges. Removal of the infected and dying nerve, cleaning shaping and sealing of the canals are all vital parts of the root canal procedure.
How is a root canal performed?
This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 95% of cases. We use local anesthesia to eliminate discomfort. You will be able to drive home after your treatment, and you probably will be comfortable returning to your normal routine.
Post Appointment Information
When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation during treatment and the previous condition of your tooth. This tenderness is normal and is no cause for alarm. Do not chew food on the affected side until your endodontic therapy is completed and your tooth is covered with a protective restoration provided by your dentist. You may continue your regular dental hygiene regimen. Discomfort may be alleviated by taking ibuprofen (Advil), aspirin, or acetaminophen (Tylenol) as directed.
Note: Do not hesitate to call the office if you have any concerns about your procedure and follow-up care.
With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.
Once retreatment has been selected as a solution to your problem, the Doctor will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. The Doctor will now clean and disinfect your canals and carefully examine the inside of the problematic tooth. Once cleaned, the Doctor will fill and seal the canals and place a temporary filling in the tooth.
At this point, you may need to return to your dentist as soon as possible in order to have a new crown or restoration placed on the tooth to restore full functionality.
Injuries to the mouth can cause teeth to be pushed back into their sockets. Your endodontist or general dentist may reposition and stabilize your tooth. Root canal treatment is usually started within 7 to 10 days of the injury and a medication, such as calcium hydroxide, will be placed inside the tooth. Eventually, a permanent root canal filling will be placed.
If an injury causes a tooth to be completely knocked out of your mouth, it is important that you are treated immediately! If this happens to you, keep the tooth moist. If possible, put it back into the socket. A tooth can be saved if it remains moist. You can even put the tooth in milk or a glass of water (add a pinch of salt.) Your Endodontist may start root canal treatment based upon the stage of root development. The length of time the tooth was out of your mouth and the way the tooth was stored, may influence the type of treatment you receive.
An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:
This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth.
In this case, the unhealthy pulp is removed. The Doctor places medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. So it is important to have the tooth properly restored by your dentist.
Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.
The diagram illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent re-infection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function. Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended.
Cracked teeth demonstrate many types of symptoms, including pain when chewing, temperature sensitivities, or even pain upon the release of biting pressure. It is also common for pain to come and go, making it difficult to diagnose the cause of discomfort. Chewing can cause movement of the cracked pieces of your tooth, and the pulp within the tooth becomes irritated. At the same time, when biting pressure is released, the crack can close quickly, resulting in sharp pain. Eventually, the pulp will become damaged and the tooth will consistently hurt, even when you are not chewing. It is possible that cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.
These are tiny cracks that only affect the outer enamel of the tooth. These cracks are more common in adults. These types of cracks are superficial and are usually of no concern.
When a cusp becomes weakened, a fracture may result. The cusp may break off or be removed by a dentist. A fractured cusp rarely damages the pulp, so root canal is not necessary. Your dentist will usually restore the tooth with a full crown.
A split tooth is usually the result of an untreated cracked tooth. It can be identified by a crack with distinct segments. This type of tooth can never be saved intact. Yet, the position and extent of the problem will dictate whether any portion of the tooth can be saved. Sometimes, endodontic re-treatment by the Doctor and restoration by your dentist can be used to save a portion of the tooth.
This type of crack extends from the chewing surface of the tooth and vertically migrates towards the root. In some cases, the crack may extend below the gum line. It is possible for the crack to extend further into the root. Damage to the pulp is commonplace. In this case, root canal treatment is usually necessary. A cracked tooth that is not treated will worsen, resulting in the loss of the tooth. Therefore, early detection is essential.
Vertical Root Fracture
A vertical root fracture begins at the root and extends towards the chewing surface of the tooth. Unfortunately, they show minimal symptoms and may go unnoticed. Treatment involves endodontic surgery if a portion of the tooth can be saved by removal of the fractured root. Otherwise the tooth will have to be extracted.
After years of development the microscope has finally become an integral part for endodontic care. With higher levels of magnification and superior illumination, the doctor can now prepare to complete root canal procedures quickly and efficiently. Advanced microscopes have increased the performance and predictability of endodontic procedures and has enhanced our capabilities to perform clinical procedures that previously were unpredictable, and frequently impossible to accomplish. Overall, the microscope is a technologically advanced method for patient care, patient education, and for building confidence in endodontic therapy.