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Root canal therapy is an important tool in a dentist’s arsenal to save and maintain our teeth. For many it is a scary procedure we try to avoid, but with a little knowledge, it can take some of the fear away and put your mind at ease. A root canal should not be avoided due to fear, understanding what to expect and why may help you get the treatment you need when you need it.

Root Canal Therapy Frequently Asked Questions

What Is Root Canal Therapy?

Root Canal Therapy (also referred to as root canal treatment or endodontic treatment)  is a dental procedure in which the diseased, decayed tooth, or damaged nerve of a tooth is removed and the inside areas (the nerve and canals within the roots) are cleaned, filled and sealed permanently to avoid infection. Without treatment, the surrounding tissues of the tooth (including the gums and bone) will become infected and a dental abscess can form.

A tooth’s nerve and blood vessel provide nutrients and hydration to a tooth as well as sense of temperature. It provides the sensation of hot or cold. The absence of a nerve will affect the strength of a tooth and make it become more brittle and susceptible to fracture if not protected by a crown.

How Do I Know If Root Canal Therapy Is Needed?

Common symptoms related to an infected tooth include tooth sensitivity (to hot or cold temperatures or even both), sensitivity to touch, toothache/sharp pain when chewing, swelling in the area of the tooth, or a bad taste in the mouth. These symptoms need to be evaluated by a dentist immediately to prevent further pain or damage.

What If I Ignore My Symptoms? Will They Just Go Away?

If the symptoms are ignored and treatment is not begun, the inflammation can progress to infection. Infection will continue to invade the tissues and tooth causing the tooth to become more painful and may become a health threat. Once the tooth “dies”, there are only two choices: extract the damaged tooth or perform root canal therapy.

How Is My Tooth Restored After Root Canal Therapy?

Depending on the extent of the damage to the tooth, your dentist can recommend a dental composite restoration to close the tooth or in most cases recommend a dental crown to protect the tooth against future damage. Over time, the tooth with the root canal therapy will dehydrate. This will make the tooth brittle and more susceptible to fracture/breaking. Most often, a crown is placed after root canal treatment is completed to protect the tooth and restore full function.

Is Root Canal Therapy Painful?

Typically, root canal therapy should cause no more discomfort than a simple dental filling). The pain most people associate with root canal therapy is due to the infection that develops. Root canal therapy actually relieves the pain by removing the dental infection and pressure.

What Are The Advantages Of Root Canal Therapy?

Saving the natural tooth with root canal treatment has many advantages:

-Efficient Chewing.

-Maintains Normal Biting Force And Sensation.

-Natural Looking Appearance.

-Protects other teeth from excessive wear or strain.

Root Canal Therapy helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last as long as other natural teeth and often for a lifetime.

Are There any Risks Or Complications?

Over 90 % of root canal therapy procedures are successful. However, there is a chance of a failed root canal. Sometimes the root canal therapy needs to be redone due to diseased canal offshoots that went unnoticed, the fracture of a filing instrument, or a fracture or perforation in the root. The signs of a root canal therapy failure are marked by a return of pain, pressure, and sensitivity.

Is There An Alternative To Root Canal Therapy?

There are other options. One includes extracting the infected tooth. Then the question becomes how to replace the tooth. A few options are possible and these include a dental bridge and a dental implant. The success rate of root canal therapy is over 90% so it is an excellent option to save your own natural tooth if at all possible.

What Can You Expect After Root Canal Therapy?

Most patients feel some sensitivity for a few days afterward. For many it is easily relieved with an over the counter pain medication (aleve or ibuprofen).

Can Root Canal Therapy Be Avoided?

Some tips include maintaining good dental hygiene, see your dentist and hygienist regularly, eat a well balanced diet, and wear a custom made sports mouthguards to decrease dental trauma. Root canals, unfortunately, are not entirely unavoidable, and may happen even with good hygiene and care.

Root Canal Therapy Conclusion

Many are fearful of the root canal therapy procedure but in reality it is not the horror that many believe it to be. Root canal therapy is an easy way to save your teeth in the event of dental trauma, decay, or dental infection. Knowing what to expect can go a long way to alleviating any fears you may have. It is important to save your natural teeth whenever possible.

Tooth decay (also called dental cavities) is the destruction of tooth structure. It can affect both the enamel (outer layer) and the dentin layer (inner layer) of the tooth. Tooth decay is the most common cause of loss of teeth and it affects almost everyone at some point in their lives. Tooth decay is also the second most common disease in the U.S. (the common cold is first).  Luckily, cavities can be easily prevented.

It is normal for bacteria to be present in the mouth. Certain types of bacteria are able to attach to hard surfaces in the mouth like the enamel that cover the teeth. If these bacteria are not removed, they are able to multiply and grow in number until a colony forms. Proteins that are present in the saliva also mix in and the bacteria colony becomes a whitish film (plaque) on the enamel.

These bacteria feed on sugars and starches from the food like chocolates, sticky sweets, ice cream, milk, cakes, and even fruits, vegetables and juices, producing acid as a byproduct. This acid then erodes the tooth enamel slowly dissolving the tooth. A cavity is formed causing a hole or break in the tooth structure. If not fixed at this stage, the tooth decay can progress further reaching the dentin where it can spread even quicker. The cavity can progress very quickly after entering the dentin. This can lead to a larger issue of a dental abscess if untreated.

Unfortunately for the patient, this process moves very slowly so there may not be any pain or tooth sensitivity until the cavity becomes quite big.

Preventing Tooth Decay

-Maintain a regimen of Dental Hygiene. This is a necessity to prevent tooth decay. A good dental hygiene program includes regular visits to dentist and hygienist, brushing after every meal (with a fluoride containing toothpaste), and flossing at least once a day. You should especially remember to brush before bed. Food can get stuck in between our teeth when we eat. If the food particles are not removed, it can lead to tooth decay. Flossing at least once a day is the best way to remove food from in between the teeth.

-Eat well balanced nutritious meal and limit snacking. Stay away from carbohydrates such as candy, pretzels and chips. These can remain on the tooth surface. If sticky foods are eaten, brush your teeth soon afterwards. Eating fruits and vegetables for snacks and limiting the amount of sugary drinks and foods will help to prevent plaque from forming on the teeth.

-Supplemental Fluoride. Fluoride can strengthen your teeth. Your dentist may recommend a daily fluoride rinse (ACT anticavity rinse is an example) as part of your dental hygiene. This will help in cavity prevention.

Fluoride Rinse - ACT

Prevent Tooth Decay – ACT Fluoride Rinse

regimen.

-Dental Sealants. These can prevent some tooth decay. Sealants are ultra thin coatings applied to the top (chewing) surfaces of the molars. This coating helps prevent the build up of plaque in the deep grooves on these molars. Sealants are generally applied on the children’s teeth soon after the molars erupt into the mouth. Adults can also benefit from the use of sealants if they have a high risk for decay or have deep grooves in the molars and premolars.

-Antiseptic Mouth Rinse. There are several antiseptic mouth rinses on the market that have been clinically proven to reduce plaque. These include Listerine or Crest Pro Health. Rinsing with either of these mouth rinses after brushing or eating can help in cavity prevention. They work by reducing the number of bacteria present in mouth as well as acting as a rinse to wash away plaque and film on teeth.

-Sugarless Gum. Chewing sugarless gum will help prevent tooth decay by stimulating salivary flow. In studies xylitol has shown to temporarily slow down the growth of bacteria that causes tooth decay. There are several brands of xylitol gum including epic, wrigley’s, and trident.

To reduce tooth decay, eating less sugar, regular cleaning and flossing are all needed to keep the bacteria that causes tooth decay from getting out of control. Tooth decay is preventable and treatable in most stages. Diligent dental hygiene along with regular dental visits will keep you cavity free!

tooth decay prevention

 

 

Root Canal Therapy (also called root canal treatment or endodontic treatment)  is a dental procedure in which the diseased or damaged nerve (pulp) of a tooth is removed and the inside areas (the nerve or pulp chamber and root canals) are cleaned, filled and sealed permanently to avoid infection. Without treatment, the surrounding tissues of the tooth (including the gums and bone) will become infected and a dental abscess can form.

A tooth’s nerve and blood vessel provide nutrients and hydration to a tooth as well as sense of temperature. It provides the sensation of hot or cold. The presence or absence of a nerve will affect the routine functioning of a tooth. Over time the tooth with the root canal dehydrates which makes the tooth brittle and more susceptible to fracture. Most often, a crown is placed after root canal treatment is completed to protect the tooth and restore full function.

Root canal therapy is considered by many to be the most feared dental procedure. Does that surprise you?  Surveys completed by the American Association of Endodontists reveals that most people with a fear of the dentist are based on others’ experience and not their own.

The inaccurate information they receive about root canal therapy prevents patients from making a properly informed decision regarding their teeth.  Many patients will ask that a tooth be extracted rather than experience a root canal procedure.

Painless DentistryRoot canal treatment is needed when the nerve or pulp tissue becomes inflamed or infected. The inflammation or infection can occur from a number of ways: Decay that extends into the pulp chamber, repeated dental procedures on the tooth, or a fracture or chip in the tooth that allows bacteria to spread into the pulp chamber. Also, a traumatic 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 a dental abscess.

Root canal therapy is almost always recommended because a tooth is causing pain from a condition that is irreversible. Pulpitis (inflammation of the pulp), an infected pulp, broken teeth, or a slowly dying nerve are all common reasons for root canal therapy.

Root canal therapy is used to alleviate pain. Most people who have root canal therapy admit they did not experience any pain during the appointment and felt better afterward.

Signs that a root canal may be necessary include pain, prolonged sensitivity to temperature (hot or cold), tenPainless Dentistryderness to touch and chewing, darkening or discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes, bone and surrounding gingival tissues. Sometimes, no symptoms are exhibited.

Root Canal Therapy generally requires one or more visits to the dentist and can be performed by either a dentist or a specialist called an endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice is generally up to the dentist on who will perform the root canal. The reasons the dentist may send you to the endodontist include: degree of difficulty of the tooth involved and need for a microscope, re treatment of a Painless Dentistryprevious root canal, and the patients preference. You and your dentist will discuss who is best suited to complete this treatment for you.

The first step is to take an X-ray (if one has not been already taken during the diagnosis) to see the shape of the root canals and determine if there are any indications of infection in the surrounding bone tissues. Your dentist or endodontist will then use a local anesthetic to numb the area surrounding the tooth. Anesthesia is not always necessary but generally preferred by patient.

Once numb, the pulpal tissue along with bacteria, the decayed nerve tissue and related debris are cleaned out from the inside of the tooth and roots. Tiny instruments called dental files are used to measure the length of the root canal and to shape and clean the inside of each root. Sterile water, peroxide, or sodium hypochlorite are used periodically to flush away the debris and kill bacteria..

Once the tooth is thoroughly cleaned, each root canal is filled to the end with a rubbery compound called gutta percha and sealed . The process essentially is like a cork to prevent bacteria and fluid from re-entering the tooth, and keep it sterile. Some dentists like to wait a week before sealing the tooth. This will give the Painless Dentistryinflammation a chance to settle down. Some prefer to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed to keep out contaminants like saliva and food until the next appointment.

The final step may involve a more extensive restoration of the tooth. Generally a tooth that needs a root canal often is one that has a large filling or extensive decay. Even when decay was not a factor, the root canaled tooth is weaker than a ”live” tooth. Therefore, 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 back to full function again. After restoration, you will not notice any difference in its function or form. You and your dentist will discuss this need further and decide together the best course of action for you.

Root canal therapy is highly successful and has more than a 95% success rate. Many teeth repaired with a root canal can last a lifetime.

Most root canals are performed to relieve the pain of toothaches caused by pulpal inflammation or infection. With modern techniques and anesthetics, most patients report that they do not feel any pain once the procedure is underway. Root canal procedures have the reputation of being painful. Usually most patients report that the procedure itself is no more painful than having a routine filling placed.

For a few days following treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over the counter or prescription medications or an antibiotic if an infection was present. Follow directions given to you very carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your dentist.

As noted above, the pain from root canals in modern dentistry is from the infection that presents to the dentist and the actual procedure should be pain and worry free. Best defense against developing a toothache is to see your dentist regularly, maintain proper oral hygiene, and call your dentist if you have any pains or discomfort.

Radiograph of RCT

Xray of completed root canal

A dental abscess is an infection of the mouth, face, throat, or jaw that begins as a tooth infection or cavity. Generally these infections are caused by poor dental health and can be the result of lack of proper and timely dental care. A Dental abscess may also occur in people with medical conditions such as autoimmune disorders (Sjögren’s syndrome and similar conditions)  or conditions that weaken the immune system (diabetes, following radiation or chemo from cancer). A dental abscess can also be triggered by minor trauma in the oral cavity…such as a fractured tooth. Openings in the tooth enamel allow bacteria to infect the nerve tissue (the pulp) in the center of the tooth. Infection may spread out from the root of the tooth and out to the surrounding bones supporting the tooth.

A dental abscess occurs when there is an infection to a small area of tissue and the body is able to seal off the infection and keep it from spreading further. White blood cells (the body’s defense mechanism against certain infections) travel through the walls of the blood vessels in the area of the infection and collect within the damaged tissue. When this happens pus forms (A generally viscous, yellowish-white fluid  formed in infected tissue, consisting of white blood cells, cellular debris, and necrotic tissue). This pus pocket is the dental abscess, which is represented by inflammation, redness, and pain.

Dental Abscess

X-ray showing Dental Abscess

The inflamed area can burst, allowing the pus to drain out, but it will come back if the cause of infection is not removed. The bacteria and host cells cause quick destruction of connective tissues around the tooth and into the jawbones as the dental abscess develops. The pain is constant and may be described as gnawing, sharp, shooting, or throbbing. Putting pressure or something warm on the tooth may induce extreme pain. There may be a swelling present at either the base of the tooth, the gum, and/or the cheek, which can be alleviated by applying an ice pack. A Dental abscess can be acute or chronic. Acute abscess are the most painful. A chronic dental abscess may produce a dull pain with intermittent swelling, but can develop into an acute abscess at any point. Sometimes the infection can progress to the point where swelling threatens to block the airway, causing difficulty breathing. A dental abscess can also make you feel ill, with nausea, vomiting, fevers, chills, and sweats.

In some patients, a dental abscess may penetrate the bone and start draining into the surrounding tissues creating a localized facial swelling. it is also possible for the lymph glands in the neck will become swollen and tender in response to the infection. It may even feel like a headache as the pain can shift from the infected location. Generally, the pain does not travel across the face, only up or down as the nerves that serve each side of the face are separate.

A dentist can determine by a thorough examination, if you have a drainable dental abscess. X-rays of the teeth are usually necessary to show smaller abscesses that may be at the deepest part of the tooth. The objective of any treatment is to remove the infection, save the tooth (if possible), and prevent further complications.

The most frequently seen types of a dental abscess are:

1) Periapical abscess. These are located at the apex of an infected tooth surrounding the roots. This type of dental abscess can occur on any tooth that has severe decay or is broken or chipped.

Dental Abscess

Dental Abscess

2) Periodontal abscess. These are located in the periodontal ligament (PDL) surrounding the tooth. This type of dentalabscess will commonly involve the mandibular and maxillary first molars, maxillary incisors, and cuspids, followed by maxillary second molars.

Treatment of a dental abscess can include:

-A Regimen of antibiotics may be given to fight the infection. Along with drainage of the infected area (if it has not already begun to drain).

-Endodontic or Root Canal Therapy (RCT) can be performed if the dentist feels the tooth can be saved. Even after the root canal therapy is completed, the dentist may want to see the patient periodically to ensure the area is healing properly.

-Teeth that cannot be restored must be extracted, followed by curettage of all apical soft tissue to remove necrotic infected tissue..

An untreated dental abscess can be life threatening and should not be taken lightly. Timely treatment usually allows the dentist to be able to cure the infection. The tooth can usually be saved in many cases but not all. Prompt treatment of dental cavities reduces the risk of a dental abscess. Teeth that have been subject to trauma should be examined immediately by the dentist.