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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 Canal Dentist, Tooth Pain and Endodontic Disease

What Are the Most Common Symptoms of Endodontic Disease?

Endodontic disease can manifest itself with a wide variety and combination of symptoms. Common symptoms of endodontic disease include:

• Lingering tooth sensitivity to cold liquids.
• Lingering tooth sensitivity to hot liquids.
• Tooth sensitivity to sweets.
• Tooth pain to biting pressure.
• Tooth pain that is referred from a tooth to another area, such as the neck, temple, or the ear.
• Spontaneous toothache, such as that experienced while reading a magazine, watching television, etc.
• Constant or intermittent tooth pain.
• Severe tooth pain.
• Throbbing tooth pain.
• Tooth pain that may occur in response to atmospheric pressure changes, such as when flying or scuba diving.
• Tooth pain that may occur in response to postural changes, such as when going from a standing to a reclining position.
• Tooth Swelling.

If you have any of these symptoms, it would be wise to see your dentist because you might have root canal disease or another dental problem.

Some of these endodontic disease symptoms may also be attributable to decay, defective fillings, periodontal diseases, cracked teeth, or other tooth or bite-related problems.

On other occasions, the symptoms may even be caused by disorders that are not related to the teeth.

Why May Endodontic Disease Cause Swelling?

When the pulpal tissue becomes severely diseased and necrotic, the resultant infection can spread from inside the tooth into the adjacent bone and soft tissues. As a result, swelling can occur in the tissues immediately surrounding the tooth.

If this situation is not treated and the endodontic disease process is not kept under control by the body's defenses, the infection can begin to spread into other tissue spaces, such as those around the eye or in the neck. In some situations, this can become a serious medical emergency.

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

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