Need a Root Canal? Find Out What is Involved

What is root canal treatment?

If your dentist has told you that you need a root canal, you may have doubts about how this treatment is performed and what its purpose is. You may also be a little nervous because there is a lot of misinformation about it, but don't worry, we are going to tell you everything you need to know about one of the most common treatments in the dental office. The team at Dentista perform this treatment on many of our patients in the Noranda, Morley and Beechboro areas. If after this article, you wish to find out more, please check out our page on root canals here.

First, let's get to know a little about the internal anatomy of the teeth:

Do you know what dental pulp is?

The pulp is a tissue found inside the teeth. It is a nucleus formed by blood vessels, nerves and connective tissue and that is why it can cause severe pain when infected.

This pulp can be located both in the pulp chamber (which is the space in the center of the tooth that corresponds to the dental crown) and in small canals called radicular canals. These canals branch from the pulp chamber downwards, that is, towards the roots of the tooth.

Teeth can have one or more radicular canals. Front (central and lateral incisors and canines) have one or two; premolars may have one, two or three; and molars may have three or more.

When there is dental pain due to the pulp being infected and inflamed, the intensity may increase with time or this symptom may even disappear, although if the latter occurs it does not mean that the infection has disappeared, but on the contrary, it may be due to the death of the pulp (necrosis) and the extension of the infection to the apex (tip) of the root deep under the gum.

When bacteria reach the pulp, a dental abscess can occur which, in addition to destroying the tissue that surrounds the apex of the tooth, can in turn generate systemic problems to your health. Therefore, when the pulp is infected, it is necessary to perform a root canal treatment as soon as possible and thus prevent this condition from progressing and becoming more complicated.

Inner workings of root canal treatment

What is root canal treatment?

This procedure aims to remove infected pulp tissue (which as mentioned may also be necrotic) and bacteria found in both the pulp chamber and radicular canals through a series of steps.

And by eliminating this infected pulp, the affected tooth is saved, thus extending its time in the oral cavity, which in turn has a positive impact on functions such as chewing, digestion of food, phonation of words and also favors dental esthetics.

What does this mean? Thanks to root canals it is possible to avoid having to extract the tooth and at the same time, by eliminating the source of infection, the painful symptomatology also disappears.

Is root canal painful?

Although there is the idea that it is a painful procedure, the truth is that in most cases patients do not feel any discomfort. It should be borne in mind that the root canal pain that may occur in some cases is not due to the treatment but to the infection.

When may a root canal treatment be indicated?

• As mentioned above, this treatment is performed when the pulp and radicular canals are infected. This infection may be the result of severe and deep decay that was not treated in time, but progressed to the pulp tissue.

• Cracked and defective dental restorations that allow bacteria to penetrate and come in contact with the pulp.

• In some cases of trauma and dental blows.

• And other conditions such as internal root resorption.

Depending on the complexity of the case, your general dentist may perform root canal treatment or may refer you to a root canal specialist: the endodontist.

What are the symptoms I may have if I need a root canal?

As you know, the most characteristic symptom is pain of varying intensity in the affected tooth (although this pain can radiate to other areas). This intensity usually varies from moderate to severe and may decrease or intensify due to various factors such as:

• Whether it is daytime or nighttime (it usually increases in the evening hours).

• When chewing food and consuming hot or cold beverages.

Other signs and symptoms are:

• Noticeable swelling and increased sensitivity in the gum surrounding the affected tooth.

• Loss of color of the affected tooth that appears opaque. If this occurs it is because the pulp has lost its vitality, that is, there is decomposition of nerve and blood tissue (pulp necrosis).

How is a root canal performed?

First of all, the dentist will ask you a series of questions about the symptoms you present, fill in your medical history and examine your oral cavity to evaluate the signs and perform vitality tests on the affected tooth.

They will also perform an x-ray of this tooth to determine the depth of the lesion, the presence or not of an abscess and evaluate other aspects related to the anatomy of the tooth such as the number of canals, the curvature of the root, etc.

The root canal procedure is usually performed under local anesthesia to avoid pain when extracting the pulp, and after applying it the dentist places a rubber dam to isolate or separate the tooth from the rest of the mouth to prevent the patient from aspirating any small instrument or liquid used during the treatment, among other reasons.

A rubber dam is placed over the teeth to stop infection

To access the pulp, the dentist makes a hole in a specific part of the crown of the tooth and then proceeds to remove it with an instrument of various sizes called endodontic file. And while scraping the inner walls of the radicular canal with the file, the dentist will also clean with a liquid called hypochlorite, which is a disinfectant solution.

The aim of this is to ensure that no infected tissue or bacteria remain in the chamber or in the canals and thus avoid reinfection.

Depending on how advanced the lesion is, this treatment can be performed in one or several sessions. If more than one is required, the dentist will place a temporary filling to keep the tooth closed until the next appointment.

an endodontic file cleans out the pulp from the tooth

It is important to mention that this temporary filling is not as resistant as the permanent one, so it is mandatory to go to the next appointment. If the treatment is left unfinished, the risk of root canal infection is very high.

Once the cleaning of the radicular canals is finished, the dentist will proceed to fill them with a material called gutta-percha and place a permanent filling to seal the tooth, this filling can be made of composite or amalgam.

the inner tooth is cleaned out to remove bacteria

If there is little tooth tissue left, the dentist may suggest the placement of a crown, especially if it was in a posterior tooth since they receive the greatest load of chewing forces. It is important to keep in mind that after a root canal treatment the teeth are more fragile since there is no pulp and no blood supply in that area, so a crown is usually indicated to reinforce the tooth structure.

Although there is another alternative to root canal such as extraction of the tooth, it will always be a better option to try to save it -unless due to a great loss of dental tissue it is no longer feasible to do so and extraction should be chosen-.

When we opt for root canal and it is carried out successfully we are also avoiding other problems that can arise when we decide to extract the tooth, such as:

o Migration of neighboring teeth, which in turn produces changes in the bite.

o Difficulty in chewing food.

o Loss of jaw volume.

o Need to place a bridge or dental implant, and it is well known that the root canal cost and complexity is lower.

After root canal therapy, it is necessary to take care of your teeth with proper brushing and flossing technique. It is also recommended that you visit your dentist periodically for a check-up to evaluate your progress through an oral examination and an x-ray since in cases when the root canal is infected, it must be redone.