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An Endodontist Explains "What Is A Root Canal"?

We use our teeth so much during the day that we often forget how complex they are, that is, until we feel pain. Underneath each tooth is a soft tissue area, called the pulp, that carries nerves, veins, arteries, and lymph vessels. These are all channels of connection between our teeth and the rest of our bodies. These connections run from the top of the tooth down to its root by way of a root canal. Each tooth has at least one root canal, but may have as many as four or five, depending on the number of roots below that tooth.

How Do Root Canal Problems Occur?

When a tooth is cracked or has a deep cavity, saliva and the bacteria in it can get to the tooth pulp. An infection is likely to result and, without root canal treatment by endodontist, the pulp will die. The infection may cause pus to gather at the tip of the root, creating an abscess that can attack the bone. The abscess must be cleaned up to prevent deterioration, and the damaged tooth pulp must be removed by a root canal dentist.

Problems That Cause Root Canal Pain

When the pulp is damaged or dead, pressure is created inside the tooth. That pressure creates pain when you bite down on the tooth, chew on it, or when it feels the heat or cold of food and drinks.

Saving the Tooth with a Root Canal

Repairing the root canal is the way to save the entire tooth. The other alternative is to pull the tooth entirely. However, leaving that space empty may create other problems, like making chewing and biting more difficult. Teeth may also shift their position if missing teeth are not there to hold the space. If you decide to have the dentist pull the tooth and replace it with a denture or bridge, the cost will be significantly more than the cost of a root canal procedure.

What Is Root Canal Therapy and How Is It Performed?

To prevent further damage, ease any discomfort, and save the tooth, your dentist or endodontist (a dentist specializing in treating the tooth pulp) will perform a root canal procedure. Without endodontics therapy, tooth loss will occur. This therapy requires one or more dental visits to complete, depending on the extent of the infection.

Endodontists will first administer medication to make sure you will be comfortable. An opening is made in the top of your tooth and the diseased pulp removed. The root canal will be thoroughly cleaned and enlarged so it can be filled with a material that prevents bacteria from re-entering. Your tooth will not be permanently sealed until the infection has cleared. When the root canal is filled and the infection is gone, your tooth may need to be covered with a crown that will look and function just like your original tooth.

Root canal therapy is a tooth-saver. It has a very high rate of success (more than 90%)! To follow up, your dentist or endodontist will make sure that the root canal is intact and that the infection has cleared.

Endodontists recognize that root canal therapy has an image problem. Part of this is due to the type of treatment available more than a half-century ago when local anesthetics weren't as effective. It was also before the advent of antibiotics used to control the infection and pain associated with it. Research and technology now offer your endodontist valuable ways to reduce patient pain and anxiety during the root canal procedure. Probably, the greatest factor contributing to this negative perception is that people wait until they are in pain before seeking treatment. Obviously, regular visits are an important preventive measure.

With modern therapy, root canal treatment can be approached with confidence -- getting to the root of the problem, but without the pain.

By Brian J. Gray, DDS, MAGD, FICO

Root Canals: Everything You Ever Wanted to Know

Why are root canals done?

Root canal therapy is required when the nerve of the tooth becomes irreversibly damaged. This damage can occur from decay, trauma, or a crack in the tooth.

What is a common root canal symptom?

Pain, swelling, and sensitivity to hot or cold. Another indication of nerve damage is the tooth becoming darker in color. Sometimes, it can only be diagnosed with an x-ray or other tests by an endodontist.

What is done during a root canal procedure?

The purpose of root canal therapy is to clean out the infected tooth pulp tissue within the roots. After all the nerve has been removed, the canals are filled with a sealer.

How long will the procedure take?

Generally, root canals take one or two appointments for a front tooth (anterior), and two or three appointments for a back tooth (posterior). A tooth can have from one to four roots; all of the roots must be treated. Difficult cases may require even more visits.

Will the tooth need any more work after the treatment is finished?

Yes, the tooth will require a permanent restoration. This could range from a simple filling to a large build-up with posts and pins. The tooth is more brittle after a root canal treatment and therefore is more susceptible to fracture. If the filling is large, the tooth may need a crown as well. A crown protects the tooth from breaking.

Isn't it simpler to take out the tooth?

It may seem simpler to have the damaged tooth removed; however, it is really much healthier and more economical to save it. If the extracted tooth is not replaced, the teeth next to it can drift into the empty space. Replacing an extracted tooth involves either expensive bridgework or a partial denture.

Will the root canal procedure hurt?

During the actual treatment, your tooth will be numb as it would be for simply filling a cavity. The treatment is usually started because the tooth is sensitive; it may take a day or two for the tooth to get back to normal. Generally a mild painkiller is enough to keep you comfortable during this time. If something stronger is needed, your endodontist will prescribe it. If the tooth is badly infected, an antibiotic may be needed as well.

How much will it cost?

The cost of root canal treatment and therapy varies with the number of canals which need to be treated. There will be a separate charge for the restoration, depending on the extent of the procedure. Your dentist will be glad to discuss the charges with you for all the expected treatment.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.