Learn About - Root Canal Pain After

An Abscessed Tooth Is a Bacterial Infection

Tooth pain is what usually brings someone with a dental abscess into the dentist's office. These teeth infections can be painful affairs, sometimes accompanied by shooting pains up and down the face. Even if you hate going to the dentist, you'll find that abscessed tooth pain is far worse.

Tooth abscesses are often accompanied by swelling in the cheek or oral tissues. However, sometimes abscessed teeth may have no visible swelling or little pain, so it's important not to wait until you're in severe pain to see a dentist.

If you're diagnosed with an abscessed tooth, you generally have two treatment options: get a root canal, or have the tooth extracted. The tooth infection is deep down inside the tooth root, and the only way to cure it is to clean it out.

Root canal treatment lets you save a tooth even when the tooth's root has become infected. An endodontist or root canal dentist will open up your tooth, clean out the infected pulp inside, and replace the damaged tissue with an inert material. Once a dental crown is placed, you're left with a tooth that looks and feels just like all the others in your mouth.

Tooth extraction is also known as "pulling a tooth." Thanks to modern dental anesthetics, it's not as painful as cartoons might lead you to believe. Your dentist will explain your options for replacing the tooth. Some people opt for dental implant surgery, while others choose a dental bridge or partial denture.

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Endodontics: What Happens at a Root Canal Appointment?

At the root canal treatment appointment, whether it is an emergency visit or a regularly scheduled visit, the patient will be cared for by various members of a trained and professional team. A primary goal of the dental team is to make certain that the patient is comfortable physically and emotionally during every stage of treatment. In addition to relieving tooth pain, if present, the goals of endodontic treatment are to eliminate endodontic disease and move the patient towards a state of health. With modern endodontic techniques, these goals can generally be achieved. Root canal treatment may take one or more visits to complete and usually progresses through the following stages:

1. The dentist reviews the findings and recommendations from the examination and consultation visit. If any additional radiographs are needed before starting treatment, they may be taken at this time.
2. The patient is typically given a local anesthetic. With newer techniques and devices, these anesthetics can usually be administered painlessly. The tooth can be made "profoundly" numb so that the patient is completely comfortable during treatment.
3. After achieving the required level of anesthesia, the dentist "isolates" the tooth using a "dental dam." This is a sheet of rubber material that fits over the tooth to be treated and forms a tight seal around it. The rubber dam serves to keep the saliva away from the area being treated and it also prevents the various disinfecting and cleaning solutions used during the procedure within the tooth from entering the mouth.
4. After the tooth has been isolated, the dentist prepares a window (an "access" opening) through the biting surface of the tooth in order to gain access into the diseased root canal space.
5. Once the access preparation is complete, the dentist begins to "clean" the root canal space by removing the diseased pulp tissue, bacteria, and related irritants. This is done using special solutions and small flexible instruments, called "files." The solutions penetrate and clean areas of the canal where the instruments cannot physically reach.
6. As the root canal system is being cleaned, it is also being "shaped." Shaping is the process of enlarging the root canal space in such a way that it can be thoroughly cleaned and subsequently filled and sealed. A root canal space that is not properly shaped may still harbor bacteria.
7. Following cleaning and shaping procedures, the root canal space is ideally filled and sealed in all its dimensions by a dentist. This is most commonly accomplished using a sealing cement in combination with a unique material called "gutta percha." Gutta percha is a special material that can be softened with heat and then pressure molded to precisely fill the root canal space.
8. Once the tooth is three-dimensionally sealed, it is generally "provisionalized" (temporarily restored) until a more long-lasting protective restoration can be placed. A protective restoration helps minimize the chances of future tooth fracture.

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