When Are Root Canal Treatments Necessary?
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:
- Long-standing extreme pain and hypersensitivity that can be localized to a single tooth
- Biting pain due to cracks present in a tooth
- Pain that does not resolve following placement of a deep filling (i.e. close to the nerve)
- Throbbing pain or biting pain due to dental abscess or infection
- A draining abscess (involving pus) originating at the root of a symptomatic or non-symptomatic tooth
- Insufficient tooth structure to retain a dental crown (the root canal treatment enables access to the root interior for placement of a retentive post)
People and popular culture often stigmatize root canal therapy as an uncomfortable procedure although 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.
What is involved in a root canal procedure?
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.
Recovery Time & After Care
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.
Protecting Your Tooth After Treatment With a Dental Crown
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
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.