Root Canal

Our Woodlands patients many times will hear the term ‘root canal’, and think of a painful procedure at the dentist. Most people will want to stay away from having to have this particular procedure done at all. Yet most people – unless they’ve had it done themselves and sometimes not even then – don’t exactly understand what a root canal really is, what it does, or who performs it. We hope this page and its information helps to give you a little more insight about the procedure so that, if you do need to have one (or more than one) at any stage, you’ll be much more prepared.

What Is The Difference Between Endodontics and Root Canal?

Although the term ‘root canal’ is used interchangeably with ‘endodontic work’, the fact is that technically the two are different things. When people talk about needing to have a root canal carried out, they really mean they need to have an endodontic procedure. A root canal is actually part of the tooth, not a dental technique. The root canal is the area within the tooth where the nerve tissue, cells, and blood vessels are located. Yet over the years, the name for this part of the tooth has become synonymous with endodontic therapy, so much so that it is probably the term used more often.

When is endodontic treatment necessary

If the pump within the tooth becomes infected and inflamed, it will be excruciating, and it could even start to kill the tooth and the teeth surrounding the affected one. There are several reasons why an infection like this would start. They include:

  • Deep tooth decay
  • Having to have many dental procedures that focus on one tooth
  • A chip or crack in the tooth that allows bacteria to find its way inside
  • Any kind of dental trauma such as a sporting injury or car accident

Even if there is no visible damage to the tooth, the pulp can still become infected. If the infection or inflammation of the pulp is not treated quickly, it will leave the patient in a lot of pain, and in some cases, an abscess can form.

Signs That Root Canal Treatment Could Be Required

The most obvious and significant sign to watch out for that could indicate that endodontic treatment is needed is a sudden toothache that doesn’t fade away. As well as this, exceptional sensitivity to cold or heat could also indicate a problem in this area. If the tooth has tender to the touch or it hurts when you are chewing, if there is swelling in the gum and/or lymph nodes, and if the tooth becomes discolored, it’s wise to speak to a dental specialist regarding endodontic care.

Of course, there are some cases where there are no symptoms at all. When this has happened, the only way to tell if there is an endodontic issue is during a routine dental check-up or, unfortunately, when the tooth dies.

How Root Canal Treatment Saves The Tooth

The dentist or endodontic expert can save the tooth if the infection is spotted soon enough before too much damage has been done. To do this, they will remove the infected pulp, after which they will clean out the root canal to ensure that no debris is left (anything left behind could cause the infection to return). The gap within the tooth will be filled and sealed.

Once this has been done, a crown – or similar dental product or treatment – will be added to the tooth. This is done to strengthen the affected tooth and to ensure you can use it properly. Once the restoration is complete, you should have no further issues with the tooth.

The Root Canal Procedure

Depending on the complexity of the specific procedure you need to undergo, your root canal treatment may need to be carried out over more than one visit, although it is possible to complete the work in one visit. So that you know what will happen, the procedure should go as follows:

The Root Canal Specialists will examine your tooth, and they will take an x-ray so the endodontist can see the extent of the issue. At this point, you will be given a local anesthetic.

  • When your tooth is numb, a rubber dam (a protective sheet) will be placed over it. This isolates the tooth and protects those around it.
  • Next, the dental specialist will use a tool to open the crown of the tooth. This enables them to reach the infected pulp in order to remove it. The Endodontist will use very small tools and a steady hand to ensure that no damage is done and that all the pulp is removed. They will then shape the space to allow room for the filling.
  • Once the space is made and cleaned, the dental specialist will fill your tooth. They will fill it with ‘gutta-percha’ which is mixed with cement. This mixture ensures that the gap in your tooth is completely sealed and prevents additional infection.
  • Usually, a temporary filling is placed on top of the tooth to cover the opening in the crown. This will be removed at a later date when the permanent crown is installed.

Root Canal Procedure

Does A Root Canal Cause Pain?

Something that patients often worry about when it comes to undergoing a root canal or endodontic procedure is that it will be painful; it certainly has a reputation for this. The truth is that the tooth already needs a root canal so patient is already in pain before they even arrive and having the root canal procedure actually gets them out of pain.

Plus, with modern technology and advancements in medical and dental care, the pain of a root canal is usually described as discomfort more than anything else. This procedure was much more painful in the past, but today it is a lot easier to deal with. And remember, endodontic treatment will only be recommended if it is absolutely necessary. It will save the tooth and make you much more comfortable.

For a few days after the treatment, you may feel that the tooth is sensitive, and this pain can be relieved with standard over-the-counter medication. If the pain continues for longer or is much more intense and your medication isn’t working, go back to your dentist immediately.

Can All Teeth Have Root Canal Treatment?

The majority of all teeth can undergo endodontic treatment without any problems. Sometimes, however, the root canals cannot be easily accessed, or the root is damaged. Sometimes there isn’t good enough bone support for the work to be carried out. In these cases, it will, unfortunately, be necessary to remove the tooth.

This is rare, however. Most teeth can be saved thanks to innovations in dental care and equipment. Even those teeth that the patient might have lost just a few years ago can now be saved, although they may require more in-depth surgery than the standard root canal procedure.

Will The Tooth Need Any Special Care Once Root Canal Treatment Has Been Carried Out?

The reason behind having root canal treatment is to have your teeth go back to normal; pain-free and able to be used to bite or chew. The outcome of the procedure should, therefore, allow for this to happen. But it won’t happen right away; you need to ensure you don’t use the tooth (at least as far as possible) until you have returned to your dentist to have the temporary crown replaced by a permanent one.

Why is this? The answer is that until your tooth is entirely restored, it could be susceptible to damage and may fracture. Using it as little as possible – if at all – and ensuring that you make an appointment for the restorative work as soon as you can will prevent this from happening.

To help keep your tooth healthy, you should practice good oral hygiene; make sure you brush and floss your teeth at least twice a day and that you see your dentist for regular check-ups going forward, even if you don’t feel there is anything wrong.

How Long Will The Treated Tooth Last?

As long as the work has been done by a professional and you take care of your teeth just as your dentist instructs you to, there is no reason why your treated tooth shouldn’t last as long as your untreated, natural teeth.

In very rare cases, an endodontically treated tooth may need additional treatment, and this need can occur months or even many years later. When this happens, undergoing another root canal procedure will often mean your dental specialist can save the tooth. This re-treatment may be required due to tooth decay, additional trauma, an infection, or even a cracked or broken crown or filling.

Other reasons for requiring endodontic re-retreatment include:

  • Areas of the root canal that were not treated initially (perhaps because they were exceptionally narrow or curved)
  • Canal anatomy that was originally undetected
  • Too long a delay between the endodontic treatment and the permanent crown
  • Salivary contamination

What Happens During Re-Treatment?

Understandably, a patient will be anxious about having to have re-treatment for a painful tooth after they thought it was all over, but there is nothing to worry about. Your endodontic specialist will be on hand to guide you through the procedure, and if you have any questions, make sure you ask them – it’s best to know what you want to know, especially if it calms your fears.

If you do need to undergo a second procedure, you will discuss your treatment options with the endodontist. If a root canal is the best option and the patient and dental specialist both agree, then the tooth will be opened again. This will be more complex than the first time since the new crown and filling will need to be taken apart and removed as well as the tooth needing to be opened.

Once everything has been removed, the canals can be cleaned and examined under illumination and magnification to ensure that every section of the canal is seen and cleaned. Once it has been, the tooth will be sealed and filled as before, and again, a permanent crown or filling will need to be arranged as soon as possible.

It may be that the specialist was unable to reach all the canal area due to unusual anatomy, narrow canals, and similar issues. If this is the case, they will discuss the option of endodontic surgery (apicoectomy). This is a more invasive procedure, but maybe the only way to fully clean the root canals.

Is Re-Treatment The Best Choice?

Ideally, your dentist will want to save your tooth wherever possible, and ultimately this is what most patients want too. It may even be that, due to the passage of time, new technology has emerged that wasn’t available the first time you had the procedure done, meaning that with re-treatment today, there is much more chance for the procedure to be longer-lasting. Root Canal Treatment is a viable option to save your tooth for many years to come.

As with any medical procedure, there are no guarantees with endodontic treatments. The dental specialist will do their best work as hard as possible to give you the results you want.

What Are The Alternatives To Re-Treatment?

The discussion you have with your endodontist is a crucial part of any decision-making regarding your teeth and what treatment you decide to have. If, as we have discussed, endodontic treatment is not going to be possible for any reason, endodontic surgery (apicoectomy) could be the next step. This could be carried out as a lone procedure, or it might take place before standard endodontic treatment can happen. Again, your Endodontist with go through everything with you and help you make the right decision for your oral health.

Endodontic Surgery (apicoectomy)

Endodontic surgery can sometimes be the best option for locating the smallest cracks and fractures within a tooth or the hidden canals that couldn’t be picked up using an x-ray or when previous treatment was carried out. If there are calcium deposits found within root canals, surgery is usually needed at this time too. The same is true if the root surface is damaged or the surrounding bone has anomalies that make standard treatment difficult.

The most common form of endodontic surgery is called an apicoectomy, which you might hear is called a root-end resection. When this is needed, the dental specialist will open the gum close to the tooth so they can see the bone. Then they will remove any infected or inflamed tissue, and they will remove the end of the root. After this, they will fill the root to seal the canal, and stitches will close the gap. Given a few months, the bone will heal around the resected root.

Will The Procedure Hurt?

The actual procedure won’t hurt as local anesthetic will be used to numb the area. However, as the anesthetic wears off, there may be some slight discomfort, which can be dealt with using over-the-counter pain medication. As the incision heals, you may feel some swelling and discomfort, but this is normal and will soon pass. If it doesn’t, make an appointment to see your dentist immediately.

What Are The Alternatives To Endodontic Surgery?

Not everyone is happy with the idea of a more invasive – albeit entirely safe – procedure for their oral care, but in many cases, the only viable alternative to endodontic surgery would be to extract the tooth. Depending on which tooth was taken out, the resulting gap could be resolved using a removable partial denture, an implant, or a bridge. This would allow the patient to regain full use of their teeth, despite losing one, and it would prevent the adjacent teeth from shifting position and potentially causing additional problems.

In most cases, the best course of action would be endodontic care, speaking to your endodontist about your options is a good idea as you should be armed with all the facts before making any kind of healthcare decision.