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Root Canal

What is a Root Canal?

Root canal treatment is the removal of the tooth’s pulp, a small, thread-like tissue in the center of the tooth. Once the damaged, diseased or dead pulp is removed, the remaining space is cleaned, shaped and filled. This procedure seals off the root canal. Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment saves many teeth that would otherwise be lost. The most common causes of pulp damage or death are:

  • 1. A cracked tooth
  • 2. A deep cavity

Why Would You Need Root Canal Treatment?

Root canal treatment is needed for two main reasons: infection or irreversible damage to the pulp. An untreated cavity is a common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it opens into the root canal system, allowing bacteria to infect the pulp. Infections inside teeth don’t respond to antibiotic treatment. The inflammation caused by the infection restricts the tooth’s blood supply, so antibiotics in the bloodstream can’t reach the infection very well. The reduced blood supply also limits the pulp’s ability to heal itself.


The pulp also can become damaged from trauma, a fracture or extensive restorative work, such as several fillings placed over a period of time. Sometimes, a common dental procedure can cause the pulp to become inflamed. For example, preparing a tooth for a crown sometimes leads to the need for root canal treatment.


In many cases, when the pulp is inflamed, but not infected, it will heal and return to normal. Your dentist may want to monitor the tooth to see if this happens before doing root canal treatment. Sometimes, though, the pulp remains inflamed, which can cause pain and may lead to infection. Once the pulp becomes infected, the infection can affect the bone around the tooth, causing an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty canals with an inert material. If root canal treatment is not done, the tooth may have to be extracted. It is better to keep your natural teeth if at all possible. If a tooth is missing, neighboring teeth can drift out of line and can be overstressed. Keeping your natural teeth also helps you to avoid more expensive and extensive treatments, such as implants or bridges. If an infected or injured tooth that needs root canal treatment is ignored, not only can you lose the tooth, but also the infection can spread to other parts of your body.


What is a Root Canal?

Root canal treatment consists of several steps that take place over several office visits, depending on the situation. These steps are: First, an opening is made through the back of a front tooth or the crown of a molar or pre-molar. After the diseased pulp is removed (a pulpectomy), the pulp chamber and root canals are cleaned, enlarged and shaped in preparation for being filled. If more than one visit is needed, a temporary filling is placed in the crown opening to protect the tooth between dental visits. The temporary filling is removed and the pulp chamber and root canal permanently filled. A tapered, rubbery material called gutta-percha is inserted into each of the canals and is often sealed into place with cement. Sometimes a metal or plastic rod is placed in the canal for structural support. In the final step, a crown is usually placed over the tooth to restore its natural shape and appearance. If the tooth is very broken down, a post may be required to build it up prior to placing a crown.


Root Canal Treatment from Start to Finish:

1. A Deep Infection

Root canal treatment is needed when the tooth’s root becomes infected or inflamed through injury or advanced decay.

2. A Route to the Root

The tooth is anesthetized. An opening is made through the crown of the tooth to the pulp chamber.

3. Removing the Infected/Inflamed Tissue

Special files are used to clean the infection and unhealthy pulp out of the canals. Irrigation is used to help clean the main canal (called lateral canals).

4. Filling the Canals

The canals are filled with a permanent material, often gutta-percha. This helps to keep the canals free of infection or contamination.

5. Rebuilding the Tooth

A temporary filling material is placed on top of the gutta-percha to seal the opening until the tooth is ready to be prepared for a crown. A crown, sometimes called a cap, is made to look like a natural tooth, and is placed on top.

6. Extra Support

In some cases, a post is placed to give the crown extra support

7. The Crowning Touch

The crown is cemented into place.

How Long Will the Restored Tooth Last?

Your treated and restored tooth/teeth can last a lifetime with proper care. Because tooth decay can still occur in treated teeth, good oral hygiene and regular dental exams are necessary to prevent further problems.

As there is no longer a pulp keeping the tooth alive, root-treated teeth can become brittle and are more prone to fracture. This is an important consideration when deciding whether to crown or fill a tooth after root canal treatment.

To determine the success or failure of root canal treatment, the most relied-upon method is to compare new X-rays with those taken prior to treatment. This comparison will show whether bone continues to be lost or is being regenerated. Tooth pulp damaged by a deep cavity. The pulp is removed and the root canals cleaned before filling. The chamber is filled and sealed.

The Second Time Around: Possible Retreatment or Surgery

A root canal can fail for several reasons. If your dentist failed to remove all of the infection from a canal or did not clean out all of the canals, the tooth can become infected again. Or, if there is leakage around an old filling or crown, bacteria can get in and reinfect a root canal.

Although the procedure itself is the same, a repeat root canal treatment tends to be more involved and time consuming than the original one because your dentist must remove the restorative material before he or she can do the second root canal. That’s why retreatment generally costs more than the first root canal. Another reason that a retreatment may take longer is that failed root canal treatments often involve infections that are difficult to destroy.

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