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Endodontic (root canal) treatment
What is endodontic (root canal) treatment?
“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth.
To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development.
Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
What are the signs of needing endodontic treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.
How does endodontic treatment save the tooth?
During root canal treatment we will remove the inflamed or infected pulp, carefully clean and shape the inside of the canal, a channel inside the root, then fill and seal the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Will I feel pain during or after the procedure?
We use modern techniques and anesthetics (‘novocaine’) to guarantee you will be comfortable during the procedure.
For the first few days after treatment, your tooth may feel sensitive to pressure, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Antibiotics may be prescribed as well depending on your condition.
Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, we ask that you call and inform us.
Endodontic treatment can often be performed in one or two visits and involves the following steps:
1. We will examine and take radiographs (‘x-rays’) the tooth, and determine the treatment needed. After we discuss all your options with you we will administer local anesthetic. When the tooth is numb, we will places a small protective sheet called a “rubber dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
2. An opening will be made in the crown of the tooth. Very small instruments will be used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. After the space is cleaned and shaped, we will fill the root canals with a rubber-like biocompatible material called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling will be placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
4. After the final visit with us you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
How much will the procedure cost?
The cost will be discussed before any treatment is rendered. It will vary depending on which tooth is affected. Most dental insurance policies provide some coverage for endodontic treatment. Our staff will check your insurance coverage, explain it to you and inform you of what your expected portion will be.
Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth should be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.
Will the tooth need any special care or additional treatment after endodontic treatment?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration within a few weeks. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.
Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.
What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, there may be additional very narrow or curved canals that could not be treated during the initial procedure.
Can all teeth be treated endodontically?Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost.
Information contained on this page courtesy of American Association of Endodontists