- What is a
- Why Does Tooth Pulp Need to Be Removed?
- What Damages a Tooth's Nerve and Pulp in the First Place?
- What Are the Signs That a
- What Happens During a
- How Painful Is a
- What Should One Expect After the
- How Successful Are
Canals?
- Complications of a
- Cost of a
- Alternatives to a
-
Root Canal Prevention
What is a
Root Canal ?
A
tooth that is badly decayed or becomes
infected. During a
, the nerve and pulp are removed and the inside of the
tooth is cleaned and
sealed. Without treatment, the tissue surrounding the
tooth will become infected and
abscesses may form.
"Root canal"
is the term used to describe the natural cavity within the center of the tooth.
The pulp or pulp chamber is the soft area within the root canal.
The tooth's nerve lies within the root canal.
A tooth's nerve is not vitally important to a tooth's health and function
after the tooth has emerged through the gums. Its only function is sensory -- to
provide the sensation of hot or cold. The presence or absence of a nerve will
not affect the day-to-day functioning of the tooth.
Why Does Tooth Pulp Need to Be Removed?
When a tooth's nerve tissue or pulp is damaged, it breaks down and bacteria
begin to multiply within the pulp chamber. The bacteria and other decayed debris
can cause an infection or
abscessed tooth. An
abscess is a pus-filled pocket that forms at
the end of the
roots of the tooth. An abscess occurs when the
infection spreads all the way past the ends of the
roots of the tooth. In addition to an abscess, an
infection in the
-
Swelling that may spread to other
areas of the face, neck, or head
-
Bone loss around the
tip of the
-
Drainage problems extending
outward from the
skin.
What Damages a Tooth's Nerve and Pulp in the First Place?
A tooth's nerve and pulp can become irritated, inflamed, and infected due to
deep decay, repeated dental procedures on a tooth, and/or large fillings, a
crack or chip in the tooth, or trauma to the face.
What Are the Signs That a
Sometimes no symptoms are present; however, signs you may need a
-
Severe
toothache pain upon chewing or application of pressure
-
Prolonged sensitivity/pain to heat
or cold temperatures (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
What Happens During a
Root Canal
A root canal requires
one or more office visits and can be performed by a dentist or endodontist. An
endodontist is a dentist who specializes in the causes, diagnosis, prevention,
and treatment of diseases and injuries of the human dental pulp or the nerve of
the tooth. The choice of which type of dentist to use depends to some degree on
the difficulty of the root canal procedure
needed in your particular tooth and the general dentist's comfort level in
working on your tooth. Your dentist will discuss who might be best suited to
perform the work in your particular case.
The first step in the procedure is to take an
X-ray to see the shape of the
canals and determine if there are any signs of
infection in a surrounding bone. Your dentist or endodontist will then use local
anesthesia to numb the area near the tooth. Anesthesia may not be necessary,
since the nerve is dead, but most dentists still anesthetize the area to make
the patient more relaxed and at ease.
Next, to keep the area dry and free of
saliva during treatment, your dentist will
place a rubber dam (a sheet of rubber) around the tooth.
An access hole will then be drilled into the tooth. The pulp along with
bacteria, the decayed nerve tissue and related debris is removed from the tooth.
The cleaning out process is accomplished using
canals. Water or
sodium hypochlorite is used
periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it is sealed. Some dentists like to
wait a week before sealing the tooth. For instance, if there is an infection,
your dentist may put a medication inside the tooth
to clear it up. Others may choose to seal the tooth the same day it is cleaned
out. If the
At the next appointment, to fill the interior of the tooth, a sealer paste
and a rubber compound called gutta percha is placed into the tooth's
The final step may involve further restoration of the tooth. Because a tooth
that needs a
weakness, a
crown, crown and post, or other
restoration often needs to be placed on the tooth to protect it, prevent it
from breaking, and restore it to full function. Your dentist will discuss the
need for any additional dental work with you.
How Painful Is a Root Canal?
Root Canal procedures have the reputation of being painful. Actually, most
people report that the procedure itself is no more painful than having a filling
placed.
What Should One Expect After the Root Canal?
For the first few days following the completion of a Root Canal, 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 such as
ibuprofen (Advil,
Motrin) or
naproxen (Aleve). Most patients can
return to their normal activities the next day.
Until your Root Canal procedure is completely finished -- that is to say, the
permanent filling is in place and/or the crown, it's wise to minimize chewing on
the tooth under repair. This step 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.
As far as oral health care is
concerned, brush and floss as you regularly would and see your dentist at
normally scheduled intervals.
How Successful Are Root class="prxsthM42">Canals?
Root Canal treatment is highly successful; the procedure has more than a 95%
success rate. Many teeth fixed with a Root Canal can last a lifetime.
Also, because the final step of the Root Canal procedure is application of a
restoration such as a crown or a filling, it will not be obvious to onlookers
that a Root Canal was performed.
Complications of a Root Canal
Despite your dentist's best efforts to clean and seal a tooth, new infections
might emerge after a Root Canal. Among the likely reasons for this include:
-
More than the normally anticipated
number of
canals in a tooth (leaving one of them uncleaned)
-
An undetected crack in the
-
A defective or inadequate dental
restoration that has allowed bacteria to get past the restoration into the
inner aspects of the tooth and recontaminate the area
-
A breakdown of the inner sealing
material over time, allowing bacteria to recontaminate the inner aspects of
the tooth
Sometimes retreatment can be successful, other times endodontic surgery must
be tried in order to save the tooth. The most common endodontic surgical
procedure is an apicoectomy or Root-end resection. This procedure relieves the
inflammation or infection in the bony area around the end of your tooth that
continues after endodontic treatment. In this procedure, the gum tissue is
opened, the infected tissue is removed, and sometimes the very end of the Root
is removed. A small filling may be placed to seal the Root Canal.
Cost of a Root Canal
The cost varies depending on how severe the problem is and the tooth
affected. Many dental
insurance policies at least partially cover
endodontic treatment. A ballpark estimate for the Root Canal treatment itself
(not including a dental restoration following the procedure) performed by a
general dentist could range from $500 to $1,000 for an incisor and $800 to
$1,500 for a molar. The fees charged by endodontists could be up to 50% higher.
Alternatives to a Root Canal
Saving your natural teeth is the very best option, if possible. Your natural
teeth allow you to eat a wide variety of foods necessary to maintain proper
nutrition. The Root Canal procedure is the
treatment of choice.
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 not only are more expensive than a Root Canal
procedure but require more treatment time and additional procedures to adjacent
teeth and supporting tissues.
Root Canal Prevention
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. Trauma resulting from a
sports-related injury can be reduced by wearing a
mouth guard.
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