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Root canal and pain go hand in hand in many people’s minds. Generally our fears and anxiety stem from others telling us their experiences and not from our own. A root canal (also referred to as RCT or root canal therapy) is a dental procedure where the damaged nerve (also called the pulp) of a tooth is removed. Following removal of the nerve, the canals of the tooth are cleaned and sterilized. Following this cleaning process the canals are filled and sealed permanently to avoid future dental infection. If treatment is not undertaken, the dental infection will affect the tooth along with surrounding oral structures (like gums and bone tissues) and a dental abscess can form in the area as the infection looks to escape.

The reason for the removal of the tooth’s nerve is because these nerves (along with associated blood vessels) is responsible with providing hydration and nutrients to our teeth. They also give us the ability to sense hot and cold.

Surveys year after year find that root canal therapy is considered the most feared of all dental procedures. These surveys also found people’s views on root canal therapy is based on what others have told them and not their own individual experiences. This leads to people believing mostly inaccurate stories about root canals. It is the fear of the unknown as I like to call it.

Is Root Canal Painful Or Can It Be Painless?

A root canal is necessary when the nerve of a tooth develops inflammation or becomes infected. This inflammation or dental infection can develop in a number of different ways:

Tooth decay that pushes into the area of the nerve or pulp chamber.

Fracture or chip in the tooth that gives bacteria a pathway to spread into the tooth’s nerve canal.

Trauma. 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.

A tooth causing pain of this type is irreversible. To save the tooth a root canal must be performed.

Signs and symptoms that a root canal is probably necessary can include pain, extended sensitivity to temperature (either hot or cold or both), tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes, bone and surrounding gingival tissues. In some cases, no outward dental symptoms are present at all

A root canal usually requires one or more visits to the dentist and can be performed by either a general 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. Your dentist will generally make the call on who should perform the root canal. You will be referred to endodontist if any of the following are needed:

-Degree Of Difficulty. Some teeth have anatomy that is slightly abnormal which makes the canals of the tooth harder to access.

-Re treatment of a previous root canal.

-Patient’s preference.

You and your dentist will discuss who is best suited to complete this root canal for you and make the best, informed decision for your dental treatment.

Root Canal Procedure

Is Root Canal Painful marielaina Perrone DDS Las vegasTake an X-ray if one has not already been taken. This will give your dentist a chance to evaluate the anatomy and shape of the tooth’s canals. It can also show the presence of a dental infection.

Anesthetic. Your dentist will use a local anesthetic to numb the surrounding areas to give you pain relief and also allow the procedure to be completed pain free. Some patients do not require any anesthetic but it will make it more comfortable.

Cleaning Of Tooth Canals. Tiny instruments are used to slowly clean out and debride bacteria, decayed nerve tissues, and bacteria from inside the tooth’s canals. Sterile water, peroxide, or sodium hypochlorite are used periodically to flush away the debris and kill any bacteria present.

Filling of Canals. Each canal is filled to the end of the tooth with a rubbery compound called gutta percha and permanently sealed. The process essentially is like a cork to prevent bacteria and fluid from re-entering the tooth, and keep it sterile. Many dentists prefer to wait a week or so before sealing the tooth. This will give the inflammation that has developed a chance to decrease back to normal levels. Others 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.

Following treatment, your tooth may feel sensitive for a few days to a week. This is especially true if there was pain or dental infection before the procedure. This discomfort can be relieved with over the counter or prescription pain medications or an antibiotic may be necessary if an infection was present. Follow directions given to you very carefully and feel free to ask your dentist questions if an issue comes up.

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 immediately.

Restoration of Tooth. Generally but not always a tooth that needs a root canal often is one that already has a large dental restoration or extensive tooth decay. Even when tooth decay was not a factor, the tooth treated with a root canal is weaker than a “live” tooth. Therefore, a crown, crown and post, or other extensive dental 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 a completed dental restoration, you will not be able to notice any difference in its function or form or feel. You and your dentist will discuss this need further and make an informed decision together the best course of action for your dental care.

Is A Root Canal Painful Conclusion

A dental root canal is extremely successful with a more than a 95% rate of success. Many teeth with a completed root canal can last a lifetime with no issues.

Most root canals are completed to relieve the pain of toothaches caused by pulpal inflammation or dental infection. With modern advancements in techniques, dental materials, and anesthetics, most patients state that they do not feel any pain once the procedure is underway. Root canal procedures have an undue reputation of being painful. Usually most patients report that the procedure itself is no more painful than having a routine dental restoration placed. The misconception has developed because the majority of the pain stems from the dental infection and pulpal inflammation that has developed. This can be tricky to get good anesthesia but a good dentist will be able to make you comfortable during the procedure.

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



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If you have a damaged (from tooth decay or even periodontal disease) or traumatized tooth, extraction is not the only option as there is a chance that you can save your natural tooth. Whenever possible, it is always better to save your teeth rather than lose them, as missing teeth have negative effects on confidence, ability to chew, general health and the alignment of the remaining teeth. Here are the alternative procedures to tooth extraction if you would like to keep a beautiful, natural smile.

Save Your Teeth with Root Canal Procedures

Root canal treatment is the most popular alternative to teeth extraction. Endodontic treatment or a root canal treats the living parts found inside the teeth known as the pulp. The pulp consists of the soft tissue inside the teeth made up of nerves, blood vessels and connective tissues that nourish the root during the development stage. When the teeth develop fully, it is possible to remove the pulp without affecting the teeth since the supporting tissues provide nourishment.

Tooth decay, repeat dental procedures, cracks, chips, trauma caused by accidents and faulty crowns can trigger infections and inflammation of the pulp. Root canal therapy treats the damaged pulp preventing major pain and abscess. Root canal treatment involves the non-surgical removal of the infected or inflamed pulp. The resulting hollow is cleaned, disinfected, shaped, filled and sealed to prevent further infections. A tooth restoration procedure using a crown or filling follows to restore the tooth to its normal function and structure. After root canal treatment, teeth can last for a lifetime without requiring another root canal treatment or dental procedure.

Save Your Teeth with Endodontic Surgery

Another alternative to losing teeth through extraction is to undergo endodontic surgery. One of the most popular surgeries is apicoectomy or root-end resection done when the inflammation or infection continues spreading to the bony tissue even after root canal treatment. An endodontist removes the infected area and sometimes part of the root and then seals the area. This is a safe procedure made comfortable by the use of local anesthesia. There are no serious complications and the bone heals within a few months.

Another sophisticated endodontic surgery procedure to save the teeth is intentional replantation. This involves the removal of the infected teeth for treatment outside the mouth. After treatment, an endodontist plants the tooth back in its socket and it resumes normal operation without the infection. Other surgery options to save the teeth include separating the tooth into two halves, or surgery to fix or remove an injured root.

Endodontic surgery is beneficial in the following situations:

  • For diagnosis and treatment of root infections, minor fractures and tiny canals that do not show on the x-rays; yet there are symptoms of infection.
  • For cleaning, treatment and sealing of too narrow canals that root canal treatment instruments cannot penetrate to reach the roots.
  • For treatment of teeth that fail to heal after a root canal treatment or develop infections after a root canal procedure.
  • For treatment of damaged roots and supporting bone structure of the teeth.

Other Ways to Save Your Damaged or Dying Teeth

Medication

Some people take painkillers to eliminate toothache and other symptoms instead of undergoing a tooth extraction immediately. However, this does not deal with the root problem but only eliminates the symptoms. It is possible to treat some infections using antibiotics, however. Still, it’s best to consult your dentist to find out the best solution for your specific needs.

Early Periodontal Disease Treatment

For people with mild gum disease, tooth loss is inevitable if the mild gum disease goes untreated and develops into chronic periodontal inflammation. Early diagnosis and treatment of gum disease is the best way to prevent tooth loss associated with periodontal disease.

Apart from endodontic procedures, maintaining proper dental hygiene is the best way to save your teeth from extraction or any other restorative dental procedure. Proper dental care involves brushing teeth properly at least twice a day, flossing daily, following a healthy diet and visiting the dentist regularly. This prevents damage to the teeth in the first place, thereby eliminating the need to undergo root canal treatment or teeth extraction. This is also the best way to ensure your teeth stay healthy for a long time and delay tooth loss.

If it is too late or impossible to save the teeth and extraction is inevitable, replacing the extracted teeth with dental implants and other structures is the best way to avoid the negative effects of physically visible tooth loss.

Conclusion

It is important to see your dentist regularly for routine dental care and examinations. This will help prevent the issues listed above. Maintaining good dental health will lead to a lifetime of smiles.



Tooth issues can occur no matter what age you are. From the littlest child to the oldest adult, having good education when tooth issues arise is paramount. Have you ever wondered what parts make up your teeth? Why they are so strong?

Anatomy Of A Tooth

The anatomy of a tooth is actually quite simple. A tooth is made up of various layers that work together to give us our beautiful smiles. Every tooth is made up of multiple parts. These parts are as follows:

-Crown. This is the part of the tooth that you see when smiling. The crown is covered in a white colored material called enamel. Enamel is the hardest substance found in the human body. Even though enamel is very strong, it can easily be broken down by the acids produced by oral bacteria and the acids found is many popular drinks like soda.

-Dentin. Dentin is the layer right beneath the enamel.  Although not as hard as enamel, it’s hardness rating is comparable to that of bone.  Another great quality of dentin is it’s flexibility.  For example, if you bite down on a very hard food, the dentin is able to flex a little bit and can keep your tooth from cracking like it might if teeth were just made of enamel.

-Pulp. This is the inner most layer of the tooth.  The pulp provides bloodflow and nutrition to the tooth. The pulp also allows for the nerves to enter the tooth. Without proper bloodflow and innervation of the nerves a tooth will die. The pulp of a tooth is removed during root canal therapy. This procedure allows your dentist to save the tooth for form and function. Once the pulp is removed from a tooth it becomes more brittle with an increased risk of breaking. This is why dentists often recommend placing a dental crown over a tooth that has received root canal therapy.

-Root. This part of the tooth is hidden under the gum tissues. This can be visible when the gums recede as can happen during periodontal disease. The root is what anchors the tooth inside the bone allowing for support during chewing of food. One other portion of the root is called cementum. The cementum is a thin layer that anchors the tooth to the bone thru the periodontal ligament.

Periodontal Ligament (PDL). The main function of the periodontal ligament is to attach the teeth to the bone.  The peridontal ligament also sends sensory information to the brain.  For example, if you are eating some popcorn and bite down hard on a popcorn kernel, your jaw suddenly opens to alleviate the pressure.  The periodontal ligament sends that pressure signal to your brain, causing that reflex. The tooth doesn’t feel the pressure since the tooth is only capable of sending pain messages to your brain.

-Gingiva (GumTissue). The gums form a collar or sheath around the teeth that protects the underlying bone.  When you stop brushing your teeth for an extended period of time, the gingiva become red and puffy as the body begins the inflammatory process. This is the body’s way of defending against the plaque that has built up.  If you completely stop brushing, the gingiva will eventually start to lose the war against plaque and recede from around the teeth resulting in periodontal disease that can eventually loosen your teeth.

-Bone. The bone holds the whole tooth in its place.  The bone is constantly remodeling itself. This is in response to various forces it experiences in the mouth.  For example, if you have braces on, there are forces pushing on the teeth.  The bone remodels itself to help the tooth move to the position in which it is being pushed.

Different Types Of Teeth

Every tooth in the mouth has a specific function. The teeth in your mouth are as follows:

-Incisors. These are the sharp, chisel-shaped front teeth (four upper, four lower). They are used for cutting foods.

-Canines. These are sometimes called cuspids, these teeth are shaped like points and are used for tearing foods.

-Premolars. These teeth have two pointed cusps on their biting surface and are sometimes also called bicuspids. The premolars are used for crushing and tearing.

-Molars. These teeth are used for grinding, these teeth have several cusps on the biting surface.

Conclusion

An educated patient is an informed patient who can make smart decisions regarding their dental and health care. Our teeth are quite strong but they are under constant bombardment from outside forces at all times. If you are experiencing any tooth issues see your dentist immediately to put your mind and dental health at ease.


Tooth decay is a slow, destructive process. In its earliest stages, a decayed tooth, is easily treatable. If left untreated it will lead to dental infection and tooth loss. The best defense against tooth decay is good oral hygiene along with regular dental visits. These routine dental visits will give your dentist the ability to detect tooth decay in its earliest stages.

Signs Of Tooth Decay

Pain/Discomfort. Having any kind of oral or tooth pain is not normal. It is usually a sign that something is wrong.

Tooth SensitivityThis can be due to a variety of things but it is important to note the type of sensitivity present. Is it sensitive to hot temperatures, cold temperatures, or both? Is it sensitive to sugary foods? Is it sensitive to acidic foods? If the tooth or teeth are sensitive to most or all of the questions posed than it is cause for concern.

-Persistent Bad Breath (Halitosis). Bad breath can be caused by many things like the foods we eat, periodontal disease, and systemic disease (like diabetes). Tooth decay can also present itself with a persistent malodor due to the bacteria present in tooth decay.

Tooth Decay Treatment

Treatment of tooth decay usually takes two routes. One is when it is detected early enough to see if it will reverse itself through remineralization and the other is restoring the tooth to its natural form and function.

-Remineralization. Very shallow cavities in our teeth can sometimes fix themselves with a little help. These cavities must only be in the outer layer of our teeth (enamel). Once it passes theough this layer the tooth decay will not reverse itself. The repair process is known as remineralization. Application of fluoride to the teeth can reverse the process of early tooth decay. This is usually done using a fluoride supplement or through application at a dental office. Fluoride can be harmful at high levels so it is important to follow your dentist’s advice.

-Dental Restoration. Once the tooth decay enters the underlying layers of a tooth it is time for a dental restoration to restore the form and function of the teeth. Restorations can include dental amalgam, dental bonding, and dental crowns. Dental crowns (can be porcelain or gold) are necessary when the tooth decay is extensive.

Root Canal Therapy. This treatment will be necessary if the tooth decay has entered the “nerve center” of the tooth. This allows the dentist to save the tooth preserving it for future use. Once a tooth receives a root canal it is generally recommended that a dental crown be placed.

Tooth Extraction. If a patient decides to forego root canal therapy or the decay is so extensive that it is not able to be restored, the only option is to remove the tooth (or what is left of that tooth). This is usually a last resort option.

Tooth Decay Conclusion

It is important to remember that tooth decay is preventable and even if it does arise it can be treated with minimal care. The key is early diagnosis. The only way to diagnose tooth decay early is through regular dental examinations and routine radiographs. At the first sign of tooth decay call your dentist to evaluate the situation.