What is a root canal?
A root canal is the most common dental procedures performed in our office. This treatment can save your natural teeth and prevent the need for dental implants or bridges.
At the center of your tooth is pulp. The pulp is a collection of blood vessels, nerves, and connective tissue that help to initially build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and fractures, or repeated dental procedures on the tooth. Symptoms of the infection can include swelling around the tooth, sensitivity to temperature, discomfort when chewing with the tooth, and spontaneous pain. If you experience any of these symptoms, your dentist may recommend root canal therapy to eliminate the diseased pulp.
How is a root canal performed?
I will anesthetize (numb) your tooth to eliminate discomfort. The injured and/or diseased pulp is removed and the root canal system is thoroughly cleaned and sealed. This treatment may be completed in one or more visits depending on the treatment required. Success for this type of treatment ranges from 80 to 98 percent depending upon the severity of disease. If your tooth is not amenable to endodontic treatment or the chance of healing is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment.
What happens after treatment?
When your root canal therapy has been completed, a record of your treatment will be sent to your general dentist. You should contact their office for a final restoration within one week of completion at our office. Any delay in the placement of a permanent restoration can exert a negative influence on the outcome of root canal therapy. Your general dentist will decide what type of restoration is necessary to protect your tooth, but in most circumstances a full coverage restoration (such as a crown) will be recommended. It is rare for endodontic patients to experience post-operative complications after root canal therapy or microsurgery. However, if a problem does occur, you should contact our office as soon as possible.
How much will it cost?
The cost associated with root canal therapy can vary depending on multiple factors. Severity of damage to the affected tooth, the tooth which is affected, and history of previous root canal procedures can all affect the cost. In general, endodontic treatment is much less expensive than tooth removal and replacement with an artificial tooth. You will be informed of the cost prior to the initiation of treatment.
Healthy Root Canal
Diseased Root Canal
 
Tooth Cleaned and Shaped
Post-Treatment Care
Congratulations! By saving your tooth with root canal treatment, you have made a significant step towards better oral health. This guide is intended to answer questions you may have about the post-operative period and to give you information on how to preserve the health of your tooth following root canal treatment.
What should I expect following endodontic treatment?
The root canal system inside your tooth has been thoroughly cleaned, and the irritated tissue and bacteria that have caused you to need root canal treatment are gone. It is normal to feel some tenderness in the area over the next few days as your body undergoes the natural healing process. You may also feel some tenderness in your jaw from keeping it open for an extended period of time. These symptoms are temporary and usually respond very well to over-the-counter pain medications. It is important for you to follow the instructions on how to take these medications. Remember that narcotic medications, if prescribed, may make you drowsy, and at least eight hours should pass prior to operating dangerous machinery or driving a car after taking them. Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed. However, if you have severe pain or pressure that lasts more than a few days, contact our office.
Guidelines for Post-Treatment Care
- Do not eat anything until the numbness in your mouth wears off. This will prevent you from biting your cheek or tongue.
- Do not chew or bite on the treated tooth until you have had it restored by your dentist.
- Be sure to brush and floss your teeth as you normally would.
- If the opening in your tooth was restored with a temporary filling material, it is not unusual for a thin layer to wear off in-between appointments. However, if you think the entire filling has come out, contact your endodontist.
- Contact your dentist right away if you develop any of the following:
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- a visible swelling inside or outside of your mouth;
- an allergic reaction to medication, including rash, hives or itching (nausea is not an allergic reaction);
- a return of original symptoms; or
- your bite feels uneven.
 Taking Care of Your Tooth
Root canal treatment is only one step in returning your tooth to full function. A proper final restoration of the tooth is extremely important in ensuring long-term success. Contact your dentist within two weeks to arrange your next appointment. If your tooth is being treated in more than one visit by an endodontist, do not return to your dentist for the final restoration until the root canal treatment is completed.
What the Future Holds
The tooth that has had appropriate endodontic treatment followed by a proper restoration can last as long as your other natural teeth. After the tooth has been restored, you need only practice good oral hygiene, including brushing, flossing, regular checkups and cleanings. Your dentist or endodontist may periodically x-ray the tooth to ensure that healing has occurred. Occasionally, a tooth that has undergone endodontic treatment does not heal or pain continues. At times, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, repeating the endodontic procedure can save the tooth.
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What is a dental extraction?
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A tooth that is severely damaged may need to be removed. Depending on the level of infection or how compromised the tooth is, I may refer you to an oral surgeon to make sure you get the best treatment possible. An oral surgeon has specialized training as well as specialized instruments to facilitate an easier and more comfortable extraction.
Before removing your tooth, your dentist will give you a local anesthetic to numb the area where the tooth will be removed. A stronger, general anesthetic may be used, especially if several or all of your teeth need to be removed. General anesthetic prevents pain in the whole body and will make you groggy or sleep through the procedure.
After the tooth is removed, you may need stitches. You can gently bite down on a cotton gauze pad placed over the wound to help stop the bleeding. The removed tooth can be replaced with an implant, a denture, or a bridge. A bridge is a replacement for one or more (but not all) of the teeth and may be permanent or removable.
What To Expect After Surgery
In most cases, the recovery period lasts only a few days. The following will help speed recovery:
- Take painkillers as prescribed by your dentist or oral surgeon.
- Rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain. Make your own salt water by mixing 1 tsp (5 g) of salt in a medium-sized glass [8 fl oz (237 mL) ] of warm water.
- Change gauze pads before they become soaked with blood.
- Relax after surgery. Physical activity may increase bleeding.
- Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.
- Do not lie flat. This may prolong bleeding. Prop up your head with pillows.
- Avoid rubbing the area with your tongue.
- Continue to carefully brush your teeth and tongue.
The dentist will remove the stitches after a few days.
Why It Is Done
Removing a tooth is necessary when decay or an abscessed tooth is so severe that no other treatment will cure the infection.
How Well It Works
Removing the tooth can help keep infection from spreading to other areas of your mouth.
Risks
Dental surgery can allow bacteria in the mouth to enter the bloodstream and cause infections in other parts of the body. People who have difficulty fighting off infections may need to take antibiotics before and after dental surgery. This includes those who:
- Have damaged or artificial heart valves.
- Were born with heart defects.
- Have had bacterial endocarditis, an infection of the lining of the heart.
- Have diabetes or another disease that causes an impaired immune system.
- Have liver disease (cirrhosis).
- Have artificial joints, such as a hip replacement.
- Take steroids for other conditions, such as Crohn's disease or asthma.
What To Think About
An extraction should be done as soon as possible to avoid the spread of infection and more serious problems. In cases in which a root canal treatment might not save the tooth, your dentist may recommend that the tooth be removed and a bridge or implant installed.Â
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What is a crown?
A crown is a restoration that I prescribe to fix badly broken teeth or a tooth that has been root canal treated. A crown is cemented over top of the tooth after it has been prepared. Badly broken teeth can result from large cavities, root canal treatment and trauma as well. Sometimes crowns are placed on teeth that are cosmetically unacceptable by the patient. By doing a crown, I can alter the shape, contour, color and bite of the original tooth so that patients are happy with its function as well as its appearance.
Crowns also sometimes require additional procedures based on the existing condition of the tooth such as a root canal, crown lengthening surgery, and teeth buildups. Please consult me if you have any questions about crowns or bridges. Crowns can be made of gold, porcelain, or metal/porcelain which is called a porcelain fused to metal crown(PFM). The decision on the material is based on the position of the tooth, the demand for esthetics, and what type of chewing forces the crown would be subjected to.
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What is a bridge?
A bridge replaces one or more teeth. It often follows after a hopeless tooth has been extracted(removed).
To put in a bridge, I have to prepare and reshape the teeth on both sides of the missing tooth. The bridge consists of the replacement tooth and two crowns (caps) on each side. The crowns will fit over the prepared teeth to support the replacement tooth. This typically requires two appointments and you will be placed in temporaries at the end of the first appointment until the lab fabricates your bridge.