When a tooth's nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. Abscesses generally cause quite a bit of pain.
An infection in the root canal of a tooth can cause swelling that may spread to other areas of the face, neck, or head. It can also cause bone loss around the tip of the root, drainage problems extending outward from the root, and a hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.
Symptoms of an infection include:
- Severe toothache pain upon chewing or application of pressure
- Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
- Discoloration (a darkening) of the tooth
- Swelling and tenderness in the nearby gums
- A persistent or recurring pimple on the gums
A Root Canal Procedure
A root canal requires one or more office visits and can be performed by a dentist or 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. Dependant on the degree of the difficulty of the root canal procedure needed in your particular tooth, our dentists will perform the procedure or recommend an endodontist.
An X-ray is required to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Local anesthesia to used to numb the area near the tooth, although it may not be necessary since the nerve is dead. However, most dentists still anesthetize the area to make the patient more relaxed and at ease.
Next, to keep the area dry and free of saliva during treatment, a rubber dam (a sheet of rubber) is placed around the 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 root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it is sealed. Some dentists like to wait a week before sealing the tooth. For instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose 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 in the exterior hole in the tooth to keep out contaminants (like saliva and food) between appointments.
At the next appointment, a sealer paste and a rubber compound called gutta percha is placed into the tooth's root canal to fill the interior of the tooth. To fill the exterior access hole created at the beginning of treatment, a filling is placed.
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. Our dentist will discuss the need for any additional dental work with you.
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.