Last week on the blog, we discussed the how’s and why’s of tooth decay and the benefits of early prevention. But sometimes – often for circumstances outside of a patient’s control – decay, disease or injury can threaten a smile beyond the capacity of a simple filling. This leaves patients to face the decision of root canal therapy or extraction.
We understand your apprehension – root canals can seem scary. But extractions are a permanent decision that will still require a replacement option down the road. We hope that by explaining what a root canal does and what you can expect during a procedure, we can ease some of your concerns surrounding treatment.
What are the root canals?
Let’s start with the basics of tooth anatomy. Teeth are made up of four basic parts; three of them are hard and the innermost part is soft.
The outermost layer of your tooth that you see is called the enamel. Inside that is a layer called the dentin, another hard tissue that gives the tooth structure. Below the gum line, a thin, protective layer called cementum covers the roots of the teeth.
The innermost section of the tooth is the pulp chamber. Contained within the pulp’s soft tissue are all the nerves and blood vessels that support that tooth. The pulp stretches from the center of the tooth into the roots and jawbone.
Depending on which tooth is being treated, it can have between one to four individual roots, with more roots supporting the molars at the back of the mouth.
When do you need a root canal?
Root canals, aka endodontic treatment, is needed when the pulp experiences inflammation, infection or trauma. This can be caused by deep decay, repeated dental procedures on the same tooth, or damage to the tooth’s pulp – even if no visible chips or cracks are present in the enamel.
If an infection or inflammation in the pulp is left untreated, it can cause pain and create an abscess.
Some of the telltale signs that a tooth may be in need of a root canal include:
- Severe pain while chewing or biting down
- Pimples on the gums
- Chips or cracks in the enamel
- Lingering sensitivity to hot, cold or sweet, even after the sensation has been removed
- Swollen or tender gums
- And/or deep decay or darkening of the gums
How does endodontic treatment work?
Because adult teeth do not require the pulp to thrive, root canal therapy saves the tooth by carefully cleaning out and shaping the insides of the root canals and then sealing the space. Typically, a root canal and the restoration of the crown is done in two to three visits.
First, the dentist does an exam and x-rays to determine the depth of your tooth’s roots. Then, the area around your tooth is numbed to keep you from any pain during the procedure. A protective shield is placed around the tooth to protect it from the bacteria in your saliva during the procedure.
Then, the dentist removes any existing decay in the crown of the tooth, exposing the tops of the root canal channels. Throughout the process the tooth is flushed out, cleaned and dried to keep it as clean as possible and eliminate any infection-causing bacteria. Using a very small instrument, the dentist cleans out the pulp of the tooth and shapes the canals.
Once the canals are cleaned and shaped, your dentist will use a special biocompatible material – such as the rubber-like material, gutta-percha – to fill in and support the canals. Lastly, a temporary filling will be put in place to protect the root canals until a final crown or other restoration is placed on the tooth, restoring it to full function.
Occasionally, the tooth may lack sufficient support for a crown, in which cases a small post may be placed inside the tooth, before the final crown is seated, to help support it.
If your case is particularly challenging, you may be referred out to an endodontist – a dentist who specializes in root canals – for the procedure.
What will I feel during or after the procedure?
Thanks to advances in both techniques and anesthetics, patients should not experience pain during a root canal procedure and most patients even report that they are comfortable.
While the procedure itself is not painful, the anxiety surrounding a root canal appointment is understandable. With nearly 15% of Americans avoiding dental appointments altogether due to a fear of the dentist, we want you to understand your options for comfort at our offices.
At an appointment with Dental Depot, patients are welcome to select from a number of items to help make their visit more comfortable, including warm blankets, neck pillows and even Nitrous Oxide (N2O, aka laughing gas). Nitrous may even be covered by your dental insurance provider, so be sure to ask your team when planning your appointment.
In the days following your root canal procedure, you may experience mild sensitivity in or around that tooth. This sensitivity is normal, especially if there was pain or infection before your procedure. Most discomfort can be treated with over-the-counter or prescription medications, so be sure to follow your dentist’s after-care instructions.
Are root canals dangerous?
“Information you may find on the Internet or elsewhere, claiming that if you receive a root canal treatment you’re more likely to become ill or contract a disease in the future simply isn’t true. This false claim was based on long-debunked and poorly designed research conducted nearly a century ago, long before modern medicine understood the causes of many diseases. There is no valid, scientific evidence linking root canal treatment to disease elsewhere in the body.”
It has been proven that healthy teeth make a healthy body. Unchecked infections in the mouth can spread to the rest of your body.
Is it really better to have a root canal over an extraction?
Ultimately, the only thing that will ever look and feel natural in your mouth is your original tooth. Root canals give patients the opportunity to maintain and protect their natural teeth for a lifetime. While extracting a tooth may seem more cost-efficient in the short-term, it comes at the cost of the functionality and aesthetics of your smile.
Eventually, the tooth will need to be replaced with a permanent bridge, a removable partial denture or most ideally, a dental implant. These alternatives are not only more expensive, they require more treatment time and additional procedures to prepare the supporting and adjacent teeth.
A root canal gives an opportunity to save the natural tooth, and should always be considered the first course of treatment.
If you’ve already suffered tooth loss, don’t lose hope, there are replacement options that can help restore your smile. Learn more about tooth replacement options, such as dental implants, here.