Root canal treatment involves removal of the soft tissue nerve and blood supply from the interior of a tooth. They are indicated as a solution to a number of problems including:
People and popular culture often stigmatize root canal therapy as an uncomfortable procedure however, this is incorrect. In fact, the completion of a root canal treatment often relieves intense pain and brings comfort to the patient. If you are experiencing anxiety in advance of your root canal treatment, please let us know as we can arrange for you to receive dental sedation during the procedure. Please refer to our “Dental Sedation” page accessible from our “Dental Services” menu.
During your appointment, we will provide anesthesia with a surgical grade, high strength, local anesthetic. This anesthetic solution is twice as strong as the anesthetic used for dental filling procedures. The only thing the patient will notice in response to the use of this anesthetic is a stronger or more profound sense of numbness around the tooth to be treated.
Once completely numb, your tooth will be isolated from contaminants by use of a rubber dental dam. Access for treatment is made through a small hole on the biting surface of the tooth. The soft tissue dental pulp (including nerve and blood supply networks) is then removed. This enables removal of bacteria and contaminants from the inside of the root.
Once complete numbness has been achieved, the tooth will be isolated from saliva and contaminants by use of a rubber dental dam or barrier. Access for treatment is achieved through a small hole created on the biting surface of the tooth.
The soft tissue dental pulp (including nerve and blood supply networks) is then removed. This enables removal of bacteria and contaminants front the inside of the root. Antimicrobial solutions are used frequently to irrigate and sanitize the root canal system. Once thoroughly sterilized, the canals are dried and filled with a biocompatible filling material. A tooth-coloured restoration is placed over the root filling to restore the biting surface of the tooth.
Following treatment, you will be advised to avoid chewing hard and brittle foods that have the potential to damage your tooth. Root canal treatment increases brittleness and reduces fracture toughness of your tooth. For this reason, a post-operative crown is recommended to minimize the risk of future tooth fracture. Dr. Hornby typically follows up following treatment to ensure full healing prior and suitability for placement of a dental crown.
If you have been taking an antibiotic to minimize the risk of a dental abscess becoming a systemic infection, you will be advised to finish the full course of your medication.
Your Kitchener Dentist will often complete a root canal treatment to rid your tooth of harmful bacteria causing infection. These infections can cause rapid bone loss around your tooth's root. This results in loss of support and a tooth that becomes increasingly loose over time.
For this reason, earlier intervention can minimize bone loss before your tooth becomes too loose to salvage.
Even in cases where a dental abscess and bone loss exist without pain, it is better to intervene with root canal treatment that to put it off until pain arises.
In some cases, your Dentist will recommend root canal treatment and crown placement for a cracked tooth. In these cases, delaying treatment can result in further cracking and deterioration of your tooth.
Ultimately, timely treatment can dramatically increase the likelihood of long-term success.
Root Canal Treatment, like any other Dental or Medical procedure, carries risks with it. These risks should be disclosed to you by your Family Dentist as part of a proper informed consent discussion prior to treatment. When Root Canal Treatment is thorough there is little post-operative risk to the patient. The main post-operative risk would be a recurrent infection or abscess associated with the treated tooth.
Contrary to some recent pop-science documentaries, Root Canal Treatments have never been scientifically linked to cancer and other systemic illnesses.
Yes. Root canal treatment removes nerve tissue and blood supply to your tooth to resolve infection and eliminate pain. Once this is complete, there is no longer "living" tissue inside your tooth.
Despite this, the periodontal ligament (PDL) that surrounds the outer surface of your tooth root(s) remains intact following treatment. This PDL contains millions of nerve fibres and so chewing on a root canal treated tooth will feel no different compared to a non-treated tooth.
The amount of time your Dentist takes to perform root canal treatment depends on the tooth and the number of roots (and therefore canals) it has.
A front tooth (incisor or canine) has a single root. Root canal treatment on these teeth can take 30 - 60 minutes.
A premolar tooth can have 1 (lower premolars) or 2 (upper premolar) roots. For upper premolars with 2 roots the treatment will typically take 45 - 80 minutes.
Molars have 3 or 4 canals. To perform root canal treatment on these teeth usually takes about 1.5 - 2 hours.
Root canal treatments can remove infected tissue from the canal space inside your tooth to resolve infection. In some cases, the infection may be more severe including swelling and drainage of pus. In these instances, your Kitchener Dentist may recommend initial treatment to clear bacteria and establish drainage and then follow up with a separate appointment to assess healing and complete treatment.
Generally, your Family Dentist can treat a straight forward case involving no infection or mild infection/abscess in a single appointment. However, in cases of more severe infection they may recommend a 2-stage approach.
Typically, the 2-stage treatment costs the same amount as a 1-stage approach.
During recovery from a root canal treatment, patients may feel totally normal or they may experience a throbbing ache or pressure sensitivity in the treated tooth. The sensitivity commonly subsides within 2-3 days. In cases of more severe pre-treatment infection, it may take 1-2 weeks before the treated tooth feels normal again. We typically advise our patients to test the treated tooth each day with light pressure. If post-operative discomfort exists, chew away from the treated tooth, revisiting it daily to assess for healing. If you grind and/or clench your teeth, make sure to wear your protective nightguard to minimize the likelihood of cracking or fracturing the treated tooth. It is important that patients not chew hard foods on their root-canal-treated tooth until it is reinforced with a crown.
Root canal treatment will result in removal of the dental pulp (containing your tooth's nerve) and this makes your tooth more brittle. So, while this has no effect on the strength of your tooth enamel and dentin, it can leave your tooth more susceptible to cracks and fractures.
Sometimes, a fracture can be repaired with a dental filling or dental crown. In the case of a catastrophic fracture, your tooth would be unrepairable and require dental extraction.
So, what can be done to protect your tooth after root canal treatment?
While it is possible for a tooth to discolour after treatment, it rarely occurs. The discolouration is caused by disruption of the blood vessels within your tooth during treatment. This small amount of blood can oxidize over time and stain your tooth purple, grey or black.
Discolouration is very rare and thoroughly cleaning the inside of your tooth during treatment will ensure removal of all dental pulp and residual blood.
Tooth whitening can typically reverse any staining that occurs post-treatment.
After root canal treatment, it is recommended to have a crown or “cap” placed to protect your treated tooth. Treatment eliminates nerve problems and related pain and dental abscesses when present. However, the treatment results in your tooth being more brittle and fracture-prone. The most common reason for failure of a root canal treated tooth is leakage due to cracking in the absence of a crown. These teeth can also split and require extraction. For this reason, it is important to protect and reinforce your root-canal-treated tooth with a gold, metal, or porcelain crown.
Root canal re-treatment is necessary when a previously root-canal-treated tooth experiences a relapse in pain (most commonly due to abscess or infection). This is most commonly necessary in teeth where the canals were not fully cleaned or filled during the initial treatment. Typically, re-treatment is completed by and Endodontist or root canal treatment specialist. Referral to an Endodontist can be arranged by your Family Dentist
The American Academy of Endodontics offers a great resource page on all things "Root Canal Treatment" here.