What is a root canal?

Once upon a time, if you had a tooth with a diseased nerve, you would probably lose that tooth. Today, endodontic treatment can safely and comfortably save a tooth that otherwise would have to be removed. In fact, root canal therapy is successful about 95% of the time. Remember, a healthy, restored tooth is always better than an artificial one!

Why can’t you just remove the tooth?
The choice is yours, but there are many disadvantages to losing a tooth. When a tooth is removed and not replaced, the teeth next to the empty space begin to shift from their normal position. This may cause teeth to become crooked or crowded, which decreases chewing and biting efficiency. Crowded or crooked teeth may be more prone to dental disease because they are harder to keep clean than properly aligned teeth. As a result, other teeth may be lost if the missing tooth is not replaced.

A replacement tooth (an implant or a bridge) is usually more expensive than endodontic treatment and involves more extensive dental procedures on adjacent teeth.

Inside each tooth is the pulp, which provides nutrients and nerves to the tooth. It runs like a thread down through the root, but when it is diseased or injured, the pulp tissue dies. The most common cause of pulp death is tooth fracture, trauma or a deep cavity that exposes the pulp to saliva. The bacteria found in saliva can cause an infection inside the tooth. Left untreated, an infection eventually causes the pulp to die. Pus can build up at the root tip, forming an abscess than can destroy the supporting bone that surrounds the tooth. If you do not have it treated, the whole tooth gets infected and you could lose it.

Here is how your tooth is saved through treatment:
First, the tooth is isolated from the saliva with a rubber dam (a sheet of rubber placed around the tooth). An opening is then made through the crown of the tooth into the pulp chamber. You may be given a local anesthetic prior to this step so that you will be more comfortable during treatment.

The pulp is then carefully removed from both the pulp chamber and root canal or canals. The root canal is cleaned, enlarged and shaped to a form that can be properly filled. Often the canal can be filled during this visit. However, if it still seems too infected our dentists will wait. Medication may be placed in the pulp chamber and root canal between appointments to help eliminate bacteria and prevent infection.

A temporary filling will be placed in an opening in the crown of the tooth to protect the pulp chamber and root canal between visits.

If the pulp was severely infected, our dentists may leave the tooth open for a few days to drain. You may also be given antibiotics to help the body control infection that has spread beyond the tooth.

During the next stage of treatment, the temporary filling is removed. The pulp chamber and tooth canal are then filled and permanently sealed with a material that prevents bacteria from reentering the canal. In the final step, a gold or porcelain crown is usually placed over the tooth to restore structure, function and appearance. If an endodontist performs this step of the root canal, he or she will usually recommend that you return to your dentist for this final step.

The type of material used for the crown will depend on where the tooth is located in your mouth, the color of the tooth and the amount of natural tooth remaining. A front tooth, for instance, most likely will be restored with porcelain or a porcelain-fused-to-metal crown for aesthetic purposes. When a back tooth has been badly fractured or decayed, a gold or porcelain-fused-to-metal crown may be used. Dr. Vincas Sidrys or Dr. Matthew Garcia will discuss these options with you.

Your endodontically treated and restored tooth could last a lifetime, if you continue to care for your teeth and gums. As long as the root of an endodontically treated tooth is properly nourished by the surrounding tissues, your tooth will remain healthy.

Most of the time, a root canal is a relatively simple procedure with little or no discomfort and involving one to three visits. Most importantly, it can save your tooth and your smile! Please call Willowdaile Cosmetic and Family at 919-479-5800 if you have any questions about having a root canal in Durham, North Carolina.