Dental Treatments - Root Canal

Causes

The most common causes of pulp damage or death are:
• A cracked tooth
• A deep cavity
• An injury to a tooth, such as a severe knock to the tooth, either recent or in the past
Once the pulp is infected or dead, if left untreated, pus can build up at the root tip in the jawbone, forming an abscess. An abscess can destroy the bone surrounding the tooth and cause pain

How is a Root Canal Done?

Root canal treatment consists of several steps that take place over several office visits, depending on the situation. These steps are:
• First, an opening is made through the back of a front tooth or the crown of a molar or pre-molar.
• After the diseased pulp is removed (a pulpectomy), the pulp chamber and root canals are cleaned, enlarged and shaped in preparation for being filled.
• If more than one visit is needed, a temporary filling is placed in the crown opening to protect the tooth between dental visits.
• The temporary filling is removed and the pulp chamber and root canal permanently filled. A tapered, rubbery material called gutta-percha is inserted into each of the canals and is often sealed into place with cement. Sometimes a metal or plastic rod is placed in the canal for structural support.
• In the final step, a crown is usually placed over the tooth to restore its natural shape and appearance. If the tooth is very broken down, a post may be required to build it up prior to placing a crown.

How Long Will the Restored Tooth Last?

Your treated and restored tooth/teeth can last a lifetime with proper care. Because tooth decay can still occur in treated teeth, good oral hygiene and regular dental exams are necessary to prevent further problems.
As there is no longer a pulp keeping the tooth alive, root-treated teeth can become brittle and are more prone to fracture. This is an important consideration when deciding whether to crown or fill a tooth after root canal treatment.
To determine the success or failure of root canal treatment, the most relied-upon method is to compare new X-rays with those taken prior to treatment. This comparison will show whether bone continues to be lost or is being regenerated.

For small cavities in front teeth, your dentist may place a tooth-colored filling after a root canal. The hole drilled in the back of the tooth to find the canal also will need a filling. Usually, your tooth will need a crown. The crown can be made in the dentist’s office using a special machine or created in a dental laboratory. Crowns can be all metal, porcelain fused to metal, or all ceramic.
First, your dentist will have to build up a foundation to strengthen the tooth and support the crown. This buildup is called a core. To help hold the core in place, your dentist may have to use a post. A post is a metal or ceramic rod.
There are two ways to put a post and core in a tooth. The post can be pre-made and used with a core material that is built up around it. Or the post and core can be custom-made in one piece to fit your tooth.
This second type is used when a significant amount of the tooth is lost. The custom-made post will take two dental visits. During the first visit, your dentist prepares the tooth and takes an impression so the post and core can be made. During the second visit, your dentist cements the post and core to the tooth. Finally, a crown is made and cemented onto the tooth, post and core.
When you think about a root canal, you likely envision a painful dental treatment that requires a fair bit of recovery. A root canal is normally done when there is a problem, such as inflammation or infection, which can result in tooth decay, a cracked tooth or a continued need to treat the area. Undergoing a root canal helps prevent pain and the possibility of developing an abscess. For many people, the procedure goes off without a hitch, but root canal complications are a risk of the surgery and understanding them before you have surgery helps prepare you for the recovery period. Fortunately, the procedure isn’t always as painful as you might expect and you can return to your normal day-to-day activities soon after.

Pain

Because a root canal involves cleaning and repairing the root area of a tooth, you’re likely to feel some pain in the days following the procedure. This might range from a dull ache to a sharp pain, but it shouldn’t be so bad that it debilitates you. However, if some bacteria remains behind after the canal is cleaned, it can grow and result in pain down the road. If the area feels better, then begins to hurt again, contact your dentist right away for follow-up treatment in the area.

Additional Problem Areas

In some cases, you might have more than one root that’s causing you problems. If one of the canals is missed, bacteria can remain, which can result in the need for a repeated root canal. Having a second surgery in the same area is bit more involved because your dentist has to remove the fillings and any crowns or implants that were placed in order to get to the roots of the tooth.

Undetected Crack in the Root

A missed crack in the root of your tooth is one of the root canal complications that can lead to bacterial growth and the possibility of further treatment. If your dentist doesn’t notice a small crack in the root of your tooth, it leaves the area exposed to the reintroduction of bacteria in the area.

Defective Materials

Over time, the inner seal placed during a root canal can erode, which allows bacteria to transfer back into the root of your tooth. This is a complication your dentist is likely to warn you about so you can take proper care of the area to prevent this or slow the process. However, in some cases, a defective restoration occurs and allows bacteria back into the canals.

What to Do

When you have a root canal, it’s important to have it done at a reputable location by a dentist with experience performing the procedure. Follow after-care instructions very carefully to promote adequate and proper healing. Notify your dentist right away if something doesn’t feel right or you’re worried that the root canal wasn’t fully successful. A follow-up can help detect possible problems and treat them before they get worse.

Please feel free to take the opportunity to ask any questions regarding the nature and purpose of crowns and/or bridge treatment.