DR. JAMES KATIB ORAL IMPLANTOLOGY FRANKFURT UNIVERSITY - DENTIST MANCHESTER NH
Root canal therapy is a treatment used to repair and save a tooth that is badly decayed or infected.
Our teeth are meant to last a lifetime. Sometimes, however, damage occurs to a tooth (often from a deep cavity or an injury that causes a tooth to crack) and the inside of the tooth becomes infected. This infection damages the pulp of the tooth – the network of blood vessels and nerves inside. Left untreated, the damaged pulp can cause infection that will damage the bone around the tooth and cause swelling and pain. If the damaged tooth becomes infected, your dentist, or a dental specialist called an Endodontist, may have to perform an endodontic treatment (often called Root Canal Therapy) to save it. Endodontic treatment involves opening the tooth, removing the damaged pulp, cleaning, shaping, filling and sealing the tooth. Depending upon how much infection there is in the injured tooth, your may be put on medicine before your dentist or Endodontist can begin to work. Your dentist or Endodontist will start by getting the tooth ready.
The Root Canal Procedure
The root canal procedure requires one or more office visits and can be performed by a dentist or endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice of which type of dentist to use depends to some degree on the difficulty of the root canal procedure needed in your particular tooth and the general dentist’s comfort level in working on your tooth. Your dentist will discuss who might be best suited to perform the work in your particular case. The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. Your dentist or endodontist will then use local anesthesia to numb the area near the tooth. Actually, anesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetize the area to make the patient more relaxed and at ease. Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth. An access hole will then be drilled into the tooth. The pulp, along with bacteria, the decayed nerve tissue, and related debris, is removed from the tooth. The cleaning-out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.
What Should One Expect After Root Canal Therapy?
The root canal procedure should relieve the pain you feel. Until your root canal procedure is completely finished — that is, the permanent filling is in place and a crown, if needed, is in place — it’s wise to minimize chewing on the tooth under repair. This step will help avoid recontaminating the tooth’s interior and also may prevent a fragile tooth from breaking before the tooth can be fully restored. For the first few days following the completion of treatment, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort usually can be controlled with over-the-counter pain medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Most patients can return to their normal activities the next day. As far as oral health care is concerned, brush and floss as you regularly would, and see your dentist at normally scheduled intervals. Because the final step of the root canal procedure is application of a restoration such as a crown or a filling, it will not be obvious to onlookers that a root canal was performed. Root canal treatment is highly successful; the procedure has more than a 95% success rate. Many teeth fixed with root canal therapy can last a lifetime.
Complications of a Root Canal
Despite your dentist’s best efforts to clean and seal a tooth, new infections might emerge. Among the likely reasons for this include:
- More than the normally anticipated number of root canals in a tooth (leaving one of them uncleaned).
- An undetected crack in the root of a tooth.
- A defective or inadequate dental restoration that has allowed bacteria to get past the restoration into the inner aspects of the tooth and recontaminate the area.
- A breakdown of the inner sealing material over time, allowing bacteria to recontaminate the inner aspects of the tooth.
Sometimes re-treatment can be successful. Other times, endodontic surgery must be tried in order to save the tooth. The most common endodontic surgical procedure is an apicoectomy, or root-end resection. This procedure relieves the inflammation or infection in the bony area around the end of your tooth. In this procedure, the gum tissue is opened, the infected tissue is removed, and sometimes the very end of the root is removed. A small filling may be placed to seal the root canal.
How long does a Dental Crown last?
A dental crown usually lasts for 10-15 years, but they have been known to last for more than 25 years. The longevity of a crown depends on the health of the tooth beneath the crown and the root of your tooth. No matter how good the crown is, if the foundations it is sitting on are in poor condition, then the crown may not last. It is like building a house on sand, you can’t expect it to last. You need to take good care of your crown to help it last as long as possible. Brushing and flossing just as you do with your natural teeth will keep your crown and it’s surrounding gums healthy. Grinding or clenching your teeth can also lessen the life span of a crown.
Root Canal Post Operative Instruction
Do not chew directly on the tooth. Wait until treatment is complete and a crown is placed on the tooth. The tooth may be sensitive to biting pressure until the procedure is complete. Also, the tooth is now more prone to fracture as a small hole was made in the tooth in order to access the nerve tissue.
please take them as prescribed until you finish off the entire bottle. This helps to control infection.
It is not uncommon for a tooth to be uncomfortable or exhibit a dull ache immediately after receiving root canal therapy. This may take a few days and maybe as long as several weeks to subside. This occurs because of conditions which existed before treatment was started, such as inflammation of the nerves around the tooth and/or an increase in blood volume in the area which is part of the healing process. We recommend you take something for pain relief within one hour of leaving our office, preferably before the anesthesia we administered wears off. Ibuprofen (Advil, Motrin, etc.) works well. Two to four 200mg tablets may be taken every 4 hours for the next 3 to 4 days to control discomfort in the area. If you are allergic to ibuprofen, acetaminophen (Tylenol or Excedrin) is a substitute but is not an anti-inflammatory pain reliever. Aspirin and aspirin containing products are NOT advisable.
If you experience swelling and/or worsening pain between root canal treatment appointments, please call the office. You may need further treatment.
A temporary filling has been placed in the tooth where treatment was rendered. This is only meant to last a short time. From chewing, the temporary filling will become compressed and “pushed down” into the access hole and may feel as if it has “fallen out”. It most likely has not.
No two teeth are alike and therefore no two root canal treatments are alike. Just because root canal treatment you had in the past may or may not have been eventful doesn’t mean something is wrong if this tooth reacts differently.
When root canal treatment is complete, a crown and build-up restoration is necessary to prevent contamination and fracture of the tooth which can result in failure of the root canal therapy, need for gum surgery or potentional loss of the tooth. Current guidelines issued by the American Association of Endodontists (root canal specialists) recommend placement of the crown within 30 days of treatment. Delay in obtaining the final restoration (usually a crown) may result in possible loss of the tooth.