Keeping you up to date with the latest dental information.
Baby Bottle Tooth Decay
Bleach Your Teeth
Dentures: Get Your Smile Back
Extraction of Wisdom Teeth
Fluoride and Your Health
Nutrition & Dental Health
Porcelain Laminate Veneers
Pregnancy and Oral Health
Root Canal Therapy
Temporomandibular Disorders TMJ/TMD
The Right Time for Braces
Tooth Decay: A Preventable Disease
Women's Dental Health
Your Child's First Dental Visit
Your Child's Teeth and Gums: Tips for Parents
Root Canal Therapy
What is a root canal?
Underneath your tooth's outer enamel and within the dentin is an area of soft
tissue called the pulp, which carries the tooth's nerves, veins, arteries and
lymph vessels. Root canals are very small, thin divisions that branch off from
the top pulp chamber down to the tip of the root. A tooth has at least one but
no more than four root canals.
Why do I feel pain?
When the pulp becomes infected due to a deep cavity or fracture that allows bacteria
to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased
blood flow and cellular activity, and pressure cannot be relieved from inside
the tooth. Pain in the tooth is commonly felt when biting down, chewing on it
and applying hot or cold foods and drinks.
Why do I need root canal therapy?
Because the tooth will not heal by itself. Without treatment, the infection will
spread, bone around the tooth will begin to degenerate, and the tooth may fall
out. Pain usually worsens until one is forced to seek emergency dental attention.
The only alternative is usually extraction of the tooth, which can cause surrounding
teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper,
the space left be hind will require an implant or a bridge, which can be more
expensive than root canal therapy. If you have the choice, it's always best to
keep your original teeth.
What is involved in root canal therapy?
Once your general dentist performs tests on the tooth and recommends therapy,
he or she can perform the treatment or refer you to an endodontist (a pulp specialist).
Treatment usually involves one to three appointments.
First, you will probably be given a local anesthetic to numb the area. A rubber
sheet is then placed around the tooth to isolate it. Next, a gap is drilled from
the crown into the pulp chamber, which, along with any infected root canal, is
cleaned of all diseased pulp and reshaped. Medication may be inserted into the
area to fight bacteria. Depending on the condition of the tooth, the crown may
then be sealed temporarily to guard against recontamination, or the tooth may
be left open to drain, or the dentist may go right ahead and fill the canals.
If you're given a temporary filling, usually on the next visit it's removed and
the pulp chamber and canal(s) are filled with rubber-like gutta percha or another
material to prevent recontamination. If the tooth is still weak, a metal post
may be inserted above the canal filling to reinforce the tooth. Once filled, the
area is permanently sealed. Finally, a gold or porcelain crown is normally placed
over the tooth to strengthen its structure and improve appearance.
What are the risks and complications?
More than 95 percent of root canal treatments are successful. However, sometimes a case needs
to be redone due to diseased canal off¬†shoots that went unnoticed or the fracturing of a canal filing instrument used-both
of which rarely occur. Occasionally, a root canal therapy will fail altogether,
marked by a return of pain.
What happens after treatment?
Natural tissue inflammation may cause discomfort for a few days, which can be
controlled by an over-the-counter analgesic. A follow-up exam can monitor tissue
healing. From this point on, brush and floss regularly, avoid chewing hard foods
on the treated tooth, and see your dentist regularly.
Sources: A Consumer's Guide to Dentistry, by Gordon J. Christensen, DDS, MSD,
Ph.D. Mosby Year Book, Inc., 1994; Practical Endodontics: A Clinical Atlas, by
Edward Besner, BS, DDS, et al., Mosby-Year Book, Inc., 1994; Your Teeth Can Be
Saved by Endodontic Treatment, American Dental Association, 1992; Pathways of
the Pulp, by Stephen Cohen, MA, DDS, FICD, FACD, et al., Mosby-Year Book, Inc.,
1991. Endodontic Practice, 11th ed., by Louis I. Grossman, et. al., Lea and Febiger,
This information was compiled for you by the Academy of General Dentistry. Your
dentist cares about long-term dental health for you and your family¬†and demonstrates that concern by belonging to the Academy of General Dentistry
as one of the 32 000 general dentists in the United States and Canada who are
members of the Academy. Your dentist participates in an ongoing program of professional
development and continuing education to remain current with advances in the profession
and to provide quality patient treatment.
AGD Impact, January 1996
Posted† October† 1,† 2000 † [TCJ]