Root Canal FAQ

What is a Root Canal Treatment?

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, 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. 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?

Dental pulp contains the tooth’s nerve endings and blood vessels, extending all the way to the root.

When a tooth’s nerve tissue or pulp is damaged, it breaks down and bacteria can cause an infection or abscessed tooth (a pus-filled pocket that forms at the end of the roots of the tooth). It can also cause a swelling that may spread to other areas of the face, neck, or head, or bone loss around the tip of the root and in some cases there might be drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into 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 Root Canal Is Needed?

Dental pain can take many forms and can seriously impact upon your quality of life. Symptoms can include toothache and sensitivity to hot or cold food and drinks, sharp pain when biting down on food or even a dull aching pressure in the jaw. Facial swelling may also occur, and the infection may also spread to the gums, causing an abscess.

As the infection progresses, the tooth may begin to darken in colour, taking on a grey or black appearance.

In rare cases, a dental pulp infection may not present with any noticeable symptoms, and your dentist may identify it on a dental radiograph before you are even aware of it.

What Happens During a Root Canal?

First, an X-ray is taken to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Then a local anaesthetic is administered to the patient to ease any anxiety and make the treatment pain-free and comfortable. The tooth is then isolated through the use of a rubber dam (a sheet of rubber around the tooth). This is used for sterilisation purposes and to ensure no more bacteria can enter into the infected 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 a series of flexible Titanium rotary files, which will also shape the canals. Titanium is noted to be of an excellent biocompatible level with humans, and this material also minimises the risk of infection or possible fractures to the teeth during treatment. The tooth is periodically disinfected with powerful disinfectant to ensure sanitation, further reducing any chance of infection.

Once the tooth is thoroughly cleaned, it is sealed. The procedure may need one or more visits, for instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up and seal the cavity with a temporary filling between appointments.

At the next appointment, to fill the interior of the tooth, a sealer paste and a rubbery material (gutta percha) is placed into the tooth’s root canal and are covered by a filling.

The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other 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.

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 or paracetamol. Most patients can return to their normal activities the next day.

Until your root canal procedure is completely finished and the permanent filling is in place and/or the crown, it’s wise to minimize chewing on the tooth under repair. This is to 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, floss, and use an antiseptic mouthwash as you regularly would and see your dentist at normally scheduled intervals.

How Successful Are Root 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.

What are The Complications of a Root Canal Treatment?

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 root canals in a tooth (leaving one of them uncleaned), an undetected crack in the root of a tooth, a defective or inadequate dental restoration that has allowed bacteria to get past and into the inner aspects of the tooth and recontaminate the area, or 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 procedure is an apicoectomy or root-end resection. 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.

What are the Alternatives to a Root Canal Treatment?

Without Endodontic treatment the only other alternative is to have the infected tooth removed, and replace it with an implant, a fixed bridge or a removable 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. None of these alternatives is anywhere near as effective as being able to actually keep the original tooth.

Not only is Endodontic treatment often the best option, it is also an extremely cost-effective way to treat teeth with damaged pulp, as it is usually less expensive than extraction and placement of a bridge or an implant. Endodontic treatment also has a very high success rate, with many root canal treated teeth lasting a full lifetime after the procedure.

How Can I Prevent Having a Root Canal Treatment Done?

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, therefore, 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.