Root canal treatment (RCT) is done to conserve the tooth, which cannot be repaired with a restoration as it is badly decayed and infected. When an infection reaches the tooth pulp (the part that gives blood and nerve supply to the tooth), it causes pain and sensitivity.
In a root canal treatment, the infected pulp is removed, and the canal is cleaned with a disinfectant and then sealed with the sealing material. A root canal is a space inside the tooth that contains the tooth pulp.
Infection from the pulp may spread to the surrounding tissues causing inflammation and sometimes abscesses may also get formed in the periphery of the tooth. The removal of the nerve and the blood supply of the tooth will not affect the function of the tooth.
RCT will help in saving the tooth structure, relieving the pain, swelling, and infection that is harming other surrounding structures.
When the pulp, the interior part of the tooth, becomes wounded, infected, or inflamed, a root canal treatment is required. The visible part of the tooth can be conserved even when the pulp is removed. The structure of the tooth can be preserved by removing the injured or infected pulp.
The damage to the pulp can be because of the following reasons: a tooth decay/ dental caries/ cavity approaches the pulp chamber that is in deep decay, multiple dental procedures were performed on the same tooth, trauma to the tooth with or without a fracture of the tooth, attrition, or abrasion of one or multiple teeth.
If the pulp of the tooth is involved, mild to severe pain can be felt, sensitivity to hot and cold, and swelling, in severe cases there can be pus discharge. X-rays will be done to confirm the diagnosis after a physical examination of the infected tooth by your dentist.
A pulp vitality test can be used as a supplementary diagnostic aid if there is a history of trauma or any other associated pathology.
A general dental practitioner may refer you to an endodontist (a specialist in RCT), if RCT is indicated in your case.
$150 to $480
-Tooth extraction is not needed.
-You get to preserve the infected tooth.
-No loss of bone mass around the infected tooth area.
-It is medically impossible to clean a root canal to perfection, despite all the preventive actions, post-operative infection might still happen.
-Some patients experience discomfort with the root canal treatment procedure, during which they have to sit with the mouth open for a few hours.
Root canal treatments are generally performed in a dental clinic. During your appointment, a dental assistant will guide you to the clinical area, help you to settle on a dental chair, and then place a drape around your neck to maintain hygiene.
The major steps of a root canal treatment are:
Step 1 - Anesthesia: To avoid the pain from the prick of an injection needle, a topical anesthetic solution is sprayed on the gums. Once the area is numb, a local anesthetic solution will be injected around the affected tooth to anesthetize the gum. You may feel a sharp prick of the injection needle or a burning sensation because of an ingredient in the anesthetic solution, but this will subside quickly. If you have never been exposed to anesthetic solution before, then a patch test can be done to check for allergic reaction. Although you’ll be awake during the procedure, you will not feel any pain because of the anesthesia.
Step 2 - Removing the pulp: After achieving the effect of anesthesia that is when your tooth is numb, a deep hole will be made on the top of the tooth using a micro-drill. You will not feel pain or sensitivity but a little tactile sensation. When the the pulp chamber in the cavity is exposed, it is cleaned with needle like instruments called files. Your endodontist will take multiple x-ray scans to ensure that all the canals are cleaned .
Step 3 - Antibiotics: To prevent reinfection, your dentist will disinfect the canal with a disinfectant before sealing it with a sealer and filling material. Gutta-percha is used as a filling material, which will fill the space in the root canal. Sometimes it’s also referred to as artificial nerves, although it is now non-functional. Your dentist may prescribe you oral antibiotics in case the tooth or surrounding tissues become infected.
Step 4 - Temporary filling: After the completion of RCT, the access opening is filled with a temporary filling material before the permanent filling to keep a check on any immediate post-op complications. The opening is closed with this sealant in most cases to prevent any further damage by saliva or food particles.
There isn’t much preparation required from your side for a root canal treatment. Depending on the type of anesthesia, you might be asked to not eat just before your appointment. It is advised to be accompanied by someone when you come for your appointment as the treatments can be stressful.
You are expected to give proper medical history like information related to diabetes, hypertension, allergies, etc. and also details of the medications you are on. In most cases, it takes approximately an hour to complete the procedure.
You may feel some soreness and inflammation in the region surrounding the tooth (gums), for this medication like acetaminophen (Tylenol) or ibuprofen (Advil) might be prescribed. If the pain doesn’t relive after a few days of treatment, call your dentist.
Normally, you can resume your routine within a day after the procedure. Post-treatment, avoid eating from the treated tooth till you get permanent filling done or a crown placed on the tooth.
You will be recalled to the dental office after a few days of the RCT procedure and a few diagnostic x-ray scans will be taken to ensure that there is no infection or lesion. The temporary filling will also be replaced with a tooth-colored permanent filling or preparation and the size of the tooth will be taken if you opt for a crown.
A dental crown or a cap is an artificial tooth with a tooth structure identical to your natural existing dentition. It is advised to get a crown after RCT specifically when most of the natural tooth structure is lost due to decay.
Crowns can be made with metals like silver, and gold or with a tooth-colored material like porcelain and zirconia. It may take some weeks to get used to this new crown.
We understand you may want to change your plans due to the coronavirus (COVID-19) and its health implications.
Despite every effort of your dentist, there are chances of reinfection. Common causes of reinfection are the inability to detect an accessory canal or crack in the root of the tooth, faulty/aging dental restoration allowing microleakage, and bacteria is able to recontaminate the site of the root canal treatment.
When is a root canal needed?
Root canal treatment in required when the tooth decay spreads deep to the pulpal level causing inflammation and pain in the affected tooth. This can also occur due to trauma where even with no decay and loss of tooth structure, the dental pulp can be damaged.
The pulp is the soft inner part of the tooth which provides blood and nerve supply to the tooth. You may feel sensitivity to hot and cold initially because of exposure of superficial nerves which gradually increases with the deepening of decay. To save the tooth, it is required to remove injured or inflamed pulp and also to avoid further spread of the infection.
Other causes of pulpal injury include repetitive dental treatments on the same tooth. Your dentist will advise x-ray scans to confirm the diagnosis and to plan the treatment accordingly. Pain is the most common symptom of irreversible pulpitis, a condition when RCT is needed.
Why do I need root canal treatment?
The infected pulp is removed in root canal treatment, and if it is not done then the tooth will further decay resulting in further loss of the natural tooth along with severe infections in your mouth. The source of infection has to be removed to prevent the spread of infection. Removal of the pulp as part of RCT doesn’t affect the integrity of your tooth. Your tooth will be non-vital but functional.
Will I have pain and discomfort after the procedure?
You might feel mild pain and inflammation after treatment. Your dentist will prescribe pain killers after the treatment. In prolonged cases of infection, it may take a few days for the pain to subside. It is advised to not chew from the side of the treatment until all steps of the treatment are completed, which also includes a permanent restoration or a crown placement.
How do you know if you need a root canal?
RCT is indicated for a fractured tooth, deep tooth decay, sensitivity to heat, pus discharge around the tooth, pain while eating, faulty restoration, increase in pain while laying down, discoloration of the tooth, sensitivity to hot and cold even after the removal of stimulus. If you injure your teeth due to an accident, please make an appointment with your dentist for further diagnosis and treatment.