by Dr. H. Kopel
Comedians are wrong, there are many things worse than getting a root canal.
In fact, root canals are usually painless procedures just like fillings or crowns. That’s because once local anesthetics are placed and profound anesthesia achieved the nerve is blocked from sending pain signals to the brain regardless of the procedure being done to the tooth. Inside every tooth there is a nerve and accompanying blood vessels which can become inflamed or infected.
A root canal is simply removing the nerve, cleaning the canal space, preparing the canal space and finally putting the root canal filling inside the root. This is accomplished by making a small hole through the top of the tooth or crown and using a special material called gutta percha to fill in the space previously occupied by the nerve.
Root canals are typically done in one visit. However if the tooth is badly infected a preliminary procedure called Open and Medicate or Open and Drain is done first. Basically the root canal procedure is started to provide infection and pain control for the patient. Then the remainder of the root canal procedure is done a subsequent appointment.
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Teeth that are deeply cracked, heavily restored, or severely decayed may develop inflammation and infection. Root canal treatment may be necessary to save them.
Infectious microorganisms usually enter the tooth through a leaky dental restoration, such as a crown or large filling, a fissure, tooth decay, or, occasionally, through an exposed tooth root. Once in the jawbone, these microorganisms can cause swelling and significant discomfort.
Root canal therapy removes the microorganisms and seals the tooth against future bacterial invasion.
A rubber safety dam is placed. A high-speed dental handpiece is used to gain access to the tooth for the instruments used to treat the infection.
To clean, shape, and enlarge the hollow root canals where microorganisms have settled, a series of specialized instruments are used.
Disinfectant solutions are used to flush out the micro-organisms and to lubricate the shaping instruments. The goal is to remove all of the infected tooth structure and to widen the canals to such an extent that the root canal filling materials can be easily placed in the canals.
Once the root canals have been shaped and completely irrigated, absorbent paper points are used to dry the canals.
The root canals are filled with rubber points. The points are coated with sealing cement for a hermetic seal. Rubber points are packed into root canals and melted.
Sometimes, if needed to strengthen the core of the tooth, the dentist will enlarge one or more of the sealed canals to make room for the placement of structural posts. The posts typically extend to within five millimeters of the root tips of the root, which are now sealed. The tooth access hole is filled and the posts are cemented into the canal.
What is a root canal?
A root canal is a dental procedure that involves removing the infected or damaged pulp (nerve) inside a tooth, cleaning and disinfecting the root canal system, and then filling and sealing the space.
Why is a root canal needed?
Root canals are performed to treat teeth with infected or inflamed pulp caused by deep decay, a cracked tooth, repeated dental procedures, or trauma.
How do I know if I need a root canal?
Common signs that may indicate the need for a root canal include severe tooth pain, sensitivity to hot or cold, swelling, tenderness, or a pimple on the gums.
Is a root canal painful?
The procedure is performed under local anesthesia, so you shouldn’t feel pain during the root canal. After the procedure, some discomfort is normal, but it can be managed with over-the-counter or prescribed pain medications.
How long does a root canal take?
The duration of a root canal procedure can vary depending on the tooth’s complexity and the severity of the infection. Generally, it takes one to two appointments.
What happens during a root canal?
The dentist or endodontist (root canal specialist) accesses the pulp chamber, removes the infected pulp, cleans and shapes the root canals, fills them with a biocompatible material, and seals the tooth.
Can I drive home after a root canal?
In most cases, you should be able to drive yourself home after a root canal, especially if only local anesthesia was used. However, if you received sedation, it’s advisable to have someone accompany you.
Are there alternatives to a root canal?
The primary alternative is tooth extraction, but it’s generally recommended to preserve natural teeth whenever possible. Extracted teeth may need replacement with dental implants, bridges, or dentures.
How successful are root canals?
Root canals have a high success rate, and treated teeth can last a lifetime with proper care. Regular dental check-ups and good oral hygiene are essential for long-term success.
Is a crown necessary after a root canal?
In many cases, a crown is recommended to protect and strengthen the tooth after a root canal, especially for back teeth. The crown helps prevent fractures and restores the tooth’s functionality.
If you suspect you may need a root canal or have questions specific to your situation, it’s best to consult with a dentist or endodontist for a thorough examination and personalized advice.