A root canal is a treatment used to repair and save a tooth that is badly decayed and has become infected. During the procedure, the nerve is removed and the inside of the tooth is cleaned and sealed.
What are the signs that you need a root canal?
You may experience the following symptoms:
- Severe toothache pain upon chewing or application of pressure
- Prolonged sensitivity/pain to heat or cold temperatures (even after the hot or cold has been removed)
- Discoloration (a darkening) of the tooth
- Swelling and tenderness in the nearby gums
- A persistent or recurring pimple on the gums
Sometimes, however, no symptoms are present.
The root canal procedure
The first step is for Dr. Farahmand to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. He then uses local anesthesia to numb the area near the tooth.
Next, to keep the area dry and free of saliva during treatment, the doctor places a rubber dam (a sheet of rubber) around the tooth.
An access hole is then drilled into the tooth. The bacteria, the infected nerve tissue and related debris are removed from the tooth. The cleaning-out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it needs to be sealed. The interior of the tooth is filled using a sealer paste, and a rubber compound called gutta percha is placed into the tooth’s root canal. The doctor then fills in the exterior access hole that was created at the beginning of the treatment.
The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often has a large filling or extensive decay or other weakness, a crown or other type of restoration may be required to protect the tooth, prevent it from breaking and restore it to full function. Dr. Farahmand will discuss the need for any additional dental work with you.
What should you expect afterwards?
The root canal procedure should relieve the pain you feel. Until your root canal procedure is completely finished — that is to say, the permanent filling is in place and/or the crown is place — you should try to minimize chewing on the tooth under repair. This will help avoid recontamination of the interior of the tooth and also may prevent a fragile tooth from breaking before the tooth can be fully restored. For the first few days following the procedure, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications like ibuprofen (Advil, Motrin) or naproxen (Aleve). Most patients can return to their normal activities the next day.
Brush and floss as you regularly would and see the dentist at normally scheduled intervals. Because the final step of the root canal is application of a restoration such as a crown or a filling, it will not be obvious to others that the procedure was done.
Root canal treatment is highly successful — the procedure has more than a 95% success rate, and many teeth repaired with a root canal last a lifetime.
Alternatives to a root canal
Saving your natural teeth is always the best option, so the root canal procedure is generally the preferred treatment.
The only alternative to a root canal procedure is having the tooth extracted and replaced with a bridge, implant, or removable partial denture to restore chewing function and prevent adjacent teeth from shifting. These alternatives are generally more expensive than a root canal procedure and they require more treatment time and additional procedures to adjacent teeth and supporting tissues.
Since some of the reasons why the nerve of a tooth and its pulp become inflamed and infected are due to deep decay, repeated dental procedures on a tooth and/or large fillings, following good oral hygiene practices (brushing twice a day, flossing at least once a day, and scheduling regular dental visits) may reduce the need for a root canal procedure.