Root canal therapy is a treatment used to repair and save a tooth that is badly decayed or infected.
A root canal procedure is performed when the nerve of the tooth becomes infected or the pulp becomes damaged. During a root canal procedure, the nerve and pulp are removed, and the inside of the tooth is cleaned and sealed.
Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed. The discomfort experienced in the period leading up to seeking dental care is truly painful, not the root canal procedure itself.
What Is Dental Pulp?
The pulp or pulp chamber is the soft area within the center of the tooth. The tooth's nerve lies within root canals, which lie within the roots or "legs" of the tooth. The root canals travel from the tip of the tooth's root into the pulp chamber, which also contains blood vessels and connective tissue that nourish the tooth.
A tooth's nerve is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory -- to provide the sensation of heat or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.
Why Does the Pulp Need to Be Removed?
When 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 a tooth’s root. In addition to an abscess, an infection in the root canal of a tooth can cause:
- Swelling that may spread to other areas of the face, neck, or head
- Bone loss around the tip of the root
- Drainage problems extending outward from the root. A hole can occur through the side of the tooth, with drainage into the gums or through the cheek into the skin.
Signs That Root Canal Therapy Is Needed?
- Severe toothache pain upon chewing or application of pressure
- Prolonged sensitivity (pain) to hot or cold temperatures (after the heat or cold has been removed)
- Discoloration (darkening) of the tooth
- Swelling and tenderness in nearby gums
- A persistent or recurring pimple on the gums
Sometimes no symptoms are present.
The Root Canal Procedure
The root canal procedure 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. The choice of which type of dentist to use depends to some degree on the difficulty of the root canal procedure needed in your particular tooth and the general dentist's comfort level in working on your tooth. Your dentist will discuss who might be best suited to perform the work in your particular case.
The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. Your dentist or endodontist will then use local anesthesia to numb the area near the tooth. Actually, anesthesia may not be necessary, since the nerve is dead, but 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, your dentist will place a rubber dam (a sheet of rubber) 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 hypocrite is used periodically to flush away the debris.