Learn About - Is Root Canal Necessary

Toothache - Why Won't My Tooth Pain Go Away?

There are many causes of toothache and pain in the area of the mouth. When experiencing tooth pain and/or swelling, it is important to see your dentist to have the area evaluated. The pain and/or swelling is most often related to a disease process that originates within a particular tooth.

The pulpal tissue within the tooth can be irritated by bacteria, external traumatic events, repetitive or extensive dental procedures, or even periodontal disease which can lead to a toothache. When this irritation occurs, the pulpal tissue reacts by becoming inflamed. Since the pulpal tissues and the tissues supporting the tooth have a rich supply of nerve fibers, the inflammatory process can cause pain as these nerve pathways are stimulated. Additionally, the pulp tissue is encased inside tooth structure and it cannot swell and expand in reaction to injury like tissues in other areas of the body. When the injured pulp tissue attempts to swell within the confined root canal space, the pressure buildup can cause a significant toothache.

Pain originating from the dental pulp can be either "spontaneous" or "elicited." Spontaneous pain occurs without an identifiable stimulus, whereas elicited pain occurs only in specific situations. Elicited pain requires a specific stimulus such as drinking cold or hot fluids or biting on the tooth.

As is typical anywhere in the body, the initial stages of a disease process do not always cause symptoms. Millions of teeth have irreversible pulpal disease yet the patients have no clinical symptoms. Most of these situations will become evident when the dentist obtains a thorough history, does a clinical examination, performs specific tooth tests, and takes a series of well-angulated radiographs. It is important to note that pulpal disease can refer pain to other areas within the head and neck.

If the results of the endodontic examination indicate that root canal disease is not the source of the patient's symptoms, then the dentist must consider other possibilities. When attempting to identify the source or cause of facial pain and/or swelling, the dentist must consider that the symptoms could actually originate in a tooth (endodontic disease), the gum tissues (periodontal disease), the muscles (myofacial pain), the joints (TMJ), the sinuses (sinusitis), or even the surrounding vascular (blood vessels) or nerve tissues. Tooth pain requires an accurate diagnosis so that the proper treatment can be recommended. At times, various medical and dental specialists may need to be consulted before an accurate diagnosis can be determined.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

+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.

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.