Many teeth that would have been lost in the past, can now be saved with modern dental treatment. When the soft tissue (mostly nerves and blood vessels) inside a tooth becomes damaged, it often has to be removed. We call this procedure a root canal treatment. There is a tremendous amount of misinformation about root canal treatment. The following should answer many of your questions, but please don’t hesitate to ask your dentist if you still have questions after reviewing the notes below.
Why do I need root canal treatment?
Most commonly, the tooth is inflamed inside, a condition we call a pulpitis. Usually the patient has severe cold sensitivity or a toothache. This can be caused by a cavity, a deep filling or crown, or by trauma. If we test the tooth and determine that it will not get better by itself, we have to take the damaged tissue out.
We also see cases where the tissue inside has died and started to rot, leading to an infection or abscess. Again, we have to remove the dead tissue so your body can heal.
Other less common scenarios include doing root canal therapy to provide a space for a restorative post or to shorten a tooth, or when the pulp is eating away the inside of the tooth.
What is the procedure?
It’s like a long, boring filling visit. We have to freeze the area, and make a hole through the top of the tooth to get at the soft tissue. Then we clean and rinse out the tooth and roots, and fill the empty space with a molten rubber material.
Does it hurt? I’ve heard people say this.
No, again it’s like having a filling done. We, as dentists, find it really frustrating to hear all the jokes and wild stories about root canal treatment. Perhaps people remember the pain before they had root canal treatment, if they left things too long before getting it done. If the area underneath the tooth was infected or inflamed, the tooth may be sensitive to pressure or biting for a few days after treatment; this is natural and part of your body healing.
Do I need a crown on a tooth after it has had root canal treatment?
Often this is the case. The reason is threefold: often the tooth became sensitive and needed root canal treatment because it has a very large filling. We have to further weaken the tooth making the hole in it to clean it out. And once a tooth has no blood supply, it dries out over time which can make it more brittle.
What is an endodontist?
A dental specialist with advanced training in root canal therapy is called an endodontist. Sometimes we will refer you to an endodontist if you have an unusually challenging case.
Are there alternatives to root canal therapy?
Yes, we can remove the tooth and replace it with an implant retained crown or fixed bridgework. Your dentist will help you decide which option is most practical in your specific case.