The information presented below is only for informational purposes. Your surgeon will talk to you about details regarding your specific procedure.
Who is a candidate for a root canal?
If your tooth is infected or there's severe damage to the pulp, a root canal will be recommended. An untreated cavity is the most common cause for this infection. The pulp inside the tooth can become inflamed from trauma or extensive restorative work. It can even be affected from a series of fillings being applied in a short period of time. This inflammation usually leads to infection and pain in the tooth is the most common and obvious symptom.
How are dental root canals performed?
Depending on the number of teeth and severity of the problem, root canals usually require one to two visits not including any follow-up visits. Your dentist or endodontist will numb the area around the affected tooth, or may offer you the option of mild sedation. The tooth is then drilled to the pulp area either through the top or the back of the tooth. The actual root canals are measured after some of the pulp has been removed. This is done so that the dentist can clean the entire canal, and so that enough of the filling material will be used to completely fill the canal. The actual measuring is done with either x-rays or electronic imaging devices.
All of the diseased pulp in the tooth is removed, and the canal is cleaned out thoroughly with an antiseptic solution. This solution will clean all of the canals within the tooth. The canals are then filled with a flexible plastic material and a temporary filling is then put on top of that. A crown or permanent filling will be done after there has been no sign of infection. Crowns are most common since the root canal procedure weakens the tooth. The crown is usually placed as soon as possible, within a month or less. You can expect two to three days of soreness after the procedure, or longer if the infection in the root canal was severe.
What can I expect during a consultation?
Your doctor will review your past dental and medical history. A dental x-ray will be taken as different x-ray angles are necessary to reveal possible problems such as decay or an abscess. Also, a series of test, such as hot, cold, biting and percussion (tapping) can be performed on several teeth. Through these tests the dentist will attempt to reproduce your symptoms that will enable him/her to make a proper diagnosis and decide if you do, or do not, need a root canal.
How does the dental pulp become damaged or infected?
The dental pulp gets contaminated by bacteria. Bacteria are a normal host present in the mouth and saliva, but when it gets inside the tooth and enters the pulp (through decay, or a fracture in the tooth, broken down old filling, or a gap between your tooth and an existing crown), then it becomes pathologic. The time frame for this to occur can vary significantly. Sometimes it is very fast and usually painful, but also, it could be a very slow process in which the patient is unaware and no pain is present until it is significantly advanced.
Is the root canal procedure painful?
With modern technology and local anesthetics, root canals are usually much faster and more painless than ever before. A similar anesthetic, as the one used in the general dentist office, will be used for a root canal. The main difference is the quantity. A deeper level of anesthesia is necessary for this procedure to be painless. In many occasions, it can be a completely pain-free procedure.
Painkillers are usually recommended for a few days after treatment, in order to control normal post-treatment discomfort.
How much time will a root canal take?
Root canals can be done in one, two or multiple appointments, depending on the tooth, how many roots there are, the current conditions of the tooth, the accessibility to area, the canals, and time available. Each visit or appointment can take from under 1 hour, to over 2 hours.
What happens when an infected dental pulp is not treated?
The infection will continue its progress, extending from the area around the dental pulp and to the surrounding tissues, such as the root, the bone, the gums etc. A progressing infection could easily involve facial spaces and the patient would then start observing swelling of the face. Such condition could become life threatening if left unattended.
Will my tooth discolor after root canal treatment?
No, with all the new materials and modern technology used during the procedure, your tooth should not discolor after the treatment. If you have a tooth that has had a root canal and it has discolored, it is best to have your dentist take a look. It may be that germs (bacteria) have penetrated underneath the old filling, and it is time for a new one.
What follow-up care is involved in a root canal procedure?
Avoid chewing on the tooth. It will most likely feel very tender and sensitive to pressure or touch. There should not be any discomfort upon drinking hot or cold fluids. Follow any instructions given by your dentist in reference to drugs such as painkillers and antibiotics. Any of these, or the combination of them, usually provide excellent results to alleviate the normal post-treatment discomfort. If your pain does not respond to the initial medicine, then you should call your dentist. Sometimes, there will be a need for stronger painkillers and/or antibiotics. Finally, once your tooth is pain free, you must get a dental reconstruction of the crown. This last item is very important and should happen as soon as possible after completion of the root canal.
Do I need to take antibiotics every time a root canal is done?
No the use of antibiotics is usually determined by the dentist on an individual basis, per case, per tooth. Usually, if there are systemic signs and symptoms such as swelling, fever, generalized sense of ill feeling, and/or lymph node tenderness, then an antibiotic will be prescribed. The common toothache even when it is associated with a minor localized infection or abscess will not automatically require an antibiotic. Since a high number of cases will respond favorably to the dental treatment, antibiotics are not prescribed on a preventive basis.
Will I feel anything after root canal treatment?
In most cases the quantity and quality of pain will subside dramatically within the first 24-48 hours. Any sensitivity to cold, hot or even breathing air "in" will be gone after the first visit. Nevertheless, you will experience mild to moderate pain that will last for several days after treatment. This pain is usually relieved by taking over the counter medications such as aspirin or ibuprofen. The most common complaint is tenderness to touch, bite, tapping or chewing on the tooth. It is recommended to refrain from any of the above until your tooth is permanently restored. You should realistically give yourself 2-4 weeks to fully recover.
Since the root canal, my tooth no longer hurts. Can I start chewing on it?
It is not recommended that you start chewing on the tooth immediately after the root canal treatment. Most times it will be very tender, but even if it is not painful to chew, you should avoid chewing on it until the crown of the tooth is properly restored (repaired).