Painless Dentistry Palo Alto, CA

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 Canal Frequently Asked Questions

Q. Why would I need a root canal?

A. When the nerve of a tooth becomes irreversibly damaged -- due to decay, trauma, or a crack in the tooth -- you'll need root canal treatment.

Q. How can the dentist tell if I need a root canal?

A. Often nerve damage causes tooth pain, swelling and sensitivity to hot or cold. You may also notice that the tooth is becoming darker in color. Sometimes, it can only be diagnosed with an X-ray or other tests.

Q. What happens during a root canal?

A. During root canal treatment, the dentist cleans out the infected pulp tissue within the roots. After all the nerve has been removed, the canals are filled with a sealer.

Q. How long will it take?

A. Usually, root canal therapy takes 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 and all the roots must be treated.

Q. After the root canal is finished, will the tooth need more work?

A. The tooth is more brittle after a root canal and requires a permanent restoration. This could range from a simple tooth filling to a large build-up with posts and pins. If the tooth filling is large, the tooth may also need a dental crown to protect the tooth from breaking.

Q. Why not just take out the tooth?

A. It's usually healthier and less expensive to save the tooth with root canal treatment. Replacing an extracted tooth involves either expensive bridgework or a partial denture. If the tooth is extracted and not replaced, adjoining teeth can move into the empty space, creating even more problems.

Q. Will root canal treatment be painful?

A. Your tooth will be numb during the treatment. If your tooth was aching or sensitive prior to treatment, it may take a few days for the tooth to get back to feeling normal. You can take a mild painkiller during that time. If it's necessary, something stronger will be prescribed. If the tooth had been badly infected, you may need to take an antibiotic.

Q. How much will it a Root Canal cost?

A. The cost of root canal treatment usually depends on the number of canals which are infected and need treatment. There will be a separate charge for the restoration, which will vary from the cost of a simple filling to a crown. All expected treatment charges will be discussed with you before treatment.

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