Root Canal Therapy

What is Endodontics?

Endodontics is the branch of dentistry that is focused on saving natural teeth. The group of people who specialize in endodontics are endodontists. The term comes from the Greek words “endo” meaning inside and “odont” meaning tooth. Therefore, an endodontist is someone who diagnoses and treats the inside of the tooth. The outer layers of the tooth are made up of mineralized tissue which is similar to bone. These layers are called enamel and dentin. The innermost layer is the pulp, and this is where your nerves, blood vessels and connective tissue are found. All dentists are trained in endodontics, however, some teeth can be especially difficult to diagnose or treat. For this reason, many dentists choose to refer their patients to an endodontist.

Why is root canal therapy necessary?

Root canal therapy is necessary when the pulp becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay due to bacteria, multiple dental procedures on the tooth, or a crack in the tooth. In addition, trauma 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, and/or lead to an abscess.

Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. Sometimes there are no symptoms at all.

How is a root canal performed?

Root canal therapy can be performed in one or two visits, depending on the source of the problem and the complexity of the tooth. In rare cases, three appointments are needed. The first step is to examine, test, and x-ray the tooth. The area is then numbed with local anesthetic to reduce or eliminate pain. Next, a latex rubber dam is placed to isolate the tooth from the rest of the oral cavity, creating a barrier to prevent bacteria and saliva from entering the tooth during treatment. We then use a hand-piece to create a small hole in the top of the tooth to the space where the pulp chamber and canals are located. Instruments called files are then used to remove all the tissue from the canal spaces, and to prepare the canal for a root filling material.

 

After the space is cleaned and shaped, we fill the root canals with a bio-compatible material which is placed with an adhesive cement to seal the canals to the best of our ability. The goal is to create a barrier so that tissue and fluid cannot enter through the tip of the root.

 

After the canals have been filled, a temporary filling is placed in the crown of the tooth over a small piece of cotton. It is important to have this temporary filling replaced by a permanent one with your general dentist. The temporary filling material will wear down and is only meant to be in place for a maximum of three weeks.

How is a tooth restored following a root canal?

Under normal circumstances, a core filling and crown will be required following root canal therapy. However, in some cases when there is a lack of tooth structure to support the crown your tooth may need a post to hold the core filling in place. This provides a solid foundation for the crown and fills in all the space that was created to perform the root canal. The most important thing to do after a root canal is get a crown placed with your dentist. It helps protect the tooth from developing root fractures and prevents leakage back into the canals. This is the last step in restoring your tooth to full function.