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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

Tooth Pain Can Drive a Sane Person Mad

Tooth pain is one of the most unpleasant sensations the human body can produce. But dental pain serves an important purpose: it's your body's way of telling you that there is a problem with your oral health.

Teeth pain can indicate all sorts of dental maladies. Painful teeth can be a result of tooth decay and dental cavities. Swollen and painful gums suggest gingivitis or periodontal disease. Jaw pain may come from TMJ disorder. Sensitive teeth could be a result of crooked teeth that need braces or orthodontics.

Your general or family dentist can help you discover the source of your oral pain, decide on a course of treatment, and recommend a dental specialist if you need one.

If Your Tooth Hurts, You May Need a Root Canal

A tooth abscess is a bacterial infection inside of your tooth and oral tissues, and it's a common cause of oral pain and swelling. It happens when bacteria are able to creep inside the tooth as a result of injury, decay, gum disease, or damaged dental work.

Once the inside of a tooth -- the "tooth pulp" -- gets infected, it needs to be removed so the infection does not spread further. This is the goal of root canal therapy.

During root canal treatment, a root canal dentist or endodontist opens up the infected tooth, exposing the pulp within. The infected tissue is manually removed. The inside of the tooth is then filled with endodontic material that cannot get infected.

Once a dental crown is attached to the top of the tooth, your tooth is almost as good as new! It will look and feel like the rest of your teeth, and it's still totally attached. You'll just need to practice good oral hygiene to prevent any future dental infections.

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