Have you been told that you need a root canal? Does hearing “root canal” set off alarm bells and create a wave of anxiety for you?
Well, there is no need to panic. According to the American Association of Endodontists, more than 15 million teeth receive root canals annually. Let’s answer some of the questions you may have about root canals.
What is a root canal?
To put it simply, a root canal is a dental procedure. It is done by a general dentist or an endodontist, which is a highly trained dentist who specializes in tooth pain, disease, and infection. A root canal can usually be completed in one to two visits.
Root canals have been performed since the mid-1800s. Luckily, dental advances have come a long way during the last two hundred years. Today, root canals are relatively painless and require little to no recovery time.
Anatomy of a tooth
Before getting into the specifics of the root canal procedure, it is helpful to have a basic understanding of the tooth and its various parts.
The crown is the top of your tooth. It is the part that you see above your gum line. In other words, it is part of your tooth that you brush every morning and night.
The root is the portion of your tooth that sits below the gum line in the bone socket. It helps to attach your tooth to your jawbone.
The outer layer of the tooth above the gum line is enamel. Enamel is made up of a hard mineral. It is hard to protect everything underneath it in your tooth. Below the gum line, this outer layer is called cementum. It differs slightly from the enamel.
Below the tough outer layer is dentin. Dentin is the middle layer of the tooth. It is made up of calcified, hard tissue. Throughout this tissue are tiny tubules. Dentin makes up the majority of the tooth’s structure.
Under the dentin is a soft, living tissue containing connective tissue, blood vessels, and nerves. This soft tissue is called the pulp. The pulp is contained in the pulp chamber. The portion of the pulp chamber in the tooth’s root is the root canal.
Root canal procedure
A root canal is needed when the pulp becomes infected or inflamed. This usually occurs because bacteria have made their way into the pulp. Over time, the bacteria cause an infection or tooth abscess.
Mayo Clinic explains that a root canal is needed “to repair and save a badly damaged or infected tooth instead of removing it.” A root canal eliminates the bacteria from the infected tooth. Steps are then taken to prevent reinfection to save the tooth.
Let’s take a closer look at the steps involved in a root canal.
Step 1: Diagnosis
Before your dentist or endodontist can determine if a root canal is needed, they will take a set of dental x-rays. This allows them to see what is going on as well as the extent of the damage. If the x-rays show that a root canal is an appropriate treatment, they will proceed with the remaining steps.
Step 2: Local anesthesia
Your dentist will begin the procedure by giving you local anesthesia. This will minimize any pain or discomfort throughout the rest of the root canal.
First, they will use numbing medication on your gum. This will numb an area near the infected tooth. When the area is numb, they will inject a local anesthetic. You may feel a sharp pinch with this injection, but it will pass quickly. When the anesthetic has taken effect, the infected tooth and the surrounding area will be numb.
Ask your healthcare provider for other options if needed. For example, nitrous oxide (laughing gas) can be administered to help you relax before they begin with the anesthesia.
Step 3: Pulp removal
Once the area is numb, your dentist will place a dental dam around the tooth. A dental dam is a square piece of stretchy plastic. Its purpose is to isolate the area and to protect it during the procedure.
Next, the dentist will drill a small opening in the crown. This will allow them to access the pulp chamber to remove the infected pulp.
Using small dental instruments called files, your dentist will carefully remove the pulp. This includes the tissue, blood vessels, and nerves that make up the pulp. They clean out the canals of the tooth to ensure no infection remains.
The pulp can be removed from inside a tooth because it is no longer needed. The function of tooth pulp is to help the tooth’s root grow. Once a tooth is completely developed, it no longer needs the pulp. Your tooth can get its nourishment from surrounding tissue.
Step 4: Canal preparation
Once the pulp is removed, the canals are dried and prepared for the next step. If needed, the dentist may use a topical antibiotic to treat the infection and protect the tooth against reinfection.
As needed, the canals are reshaped to prepare the tooth for a permanent filling.
Step 5: Temporary filling
When the tooth’s canal is empty and prepared, the dentist will fill your tooth with gutta-percha. This is a flexible, rubbery material that is used in dental fillings.
Your dentist will then create a temporary tooth filling. This soft material will temporarily seal the tooth to prevent bacteria from getting into the tooth. It will also keep the canals dry.
After the root canal, your dentist will most likely recommend a crown to protect your now fragile tooth. A dental crown is an artificial tooth usually made of gold or porcelain. It is custom-made to look like the tooth it will replace. If recommended, your dentist will take molds and prepare the tooth during this stage. When ready, it is placed like a cap on top of the damaged tooth. Sometimes instead of a crown, a permanent filling is suggested.
A follow-up appointment is usually scheduled to check on the tooth and to place the permanent filling or crown.
Your dentist will recommend using an over-the-counter pain medication if you feel any discomfort. You may notice sensitivity in the area for a few days, but it will subside quickly. Your dentist will also recommend that you avoid chewing with the tooth until the permanent filling or crown is done.
Step 6: Permanent filling or crown
Within a couple of days to a week, you’ll see your dentist and follow up on the root canal. They will check that the infection is gone. If everything looks good, they will proceed with placing the permanent filling or the crown to seal the tooth.
Anesthetic is usually not needed for this final step of the root canal. Check with your dentist if you have any concerns.
Why would you need a root canal?
Now that we have gone over what goes into a root canal, let’s discuss why you might need one and the symptoms you might experience if you do.
As we’ve already stated, a root canal is needed because the pulp becomes infected or inflamed. Here are several common reasons that may result in you needing a root canal:
Tooth decay: This can often be the result of poor oral hygiene where an untreated cavity further deteriorates the tooth and exposes the interior to bacteria.
Tooth damage: This can result from traumatic injury to the mouth or a cracked tooth where the pulp is damaged or exposed to bacteria.
Internal resorption: This is a condition where your tooth dies and resorbs itself from the inside out.
Multiple dental treatments on the same tooth: Having multiple procedures on the same tooth places stress on the tooth. Over time, the pulp can be damaged and allow bacteria to infect it.
Here are common symptoms you may experience if you need a root canal:
- Toothache that persists, especially when chewing or biting
- Temperature sensitivity that lingers, especially to hot or cold
- Swollen gums
- Swollen jaw
- Pimples on the gums
- Chipped or cracked tooth
Keep in mind that symptoms may be the result of various types of dental issues. The only way to know that you need a root canal is to schedule an appointment with your dentist.
Durango Dental is available to answer any questions you may have about root canals. Their state-of-the-art office is equipped with modern technology to provide the right treatment for you based on your dental needs. Dr. Belt has received extensive training and continues to meet and exceed set standards. If you live in the Durango area, call 970-259-3112 to schedule an appointment today with Dr. Belt and his team.