Root Canals

What is a root canal?

Root canal therapy treats disorders of the nerve of the tooth (the tooth’s soft core). Previously a tooth with a diseased nerve or injured pulp had to be extracted. Today, with root canal therapy, we believe we have a means of saving your teeth for a lifetime in our office in Ballwin, near St. Louis.

Root Canals

What is a dental pulp?

The pulp is the tooth’s soft core that contains the nerves, arteries, veins and lymph vessels of a tooth. This system provides nourishment for the cells within the teeth. The pulp lies with the dentin under the outside shell of the tooth (enamel). All teeth have only one pulp chamber, but teeth with more than one root will have more than one canal.

Why does the pulp become damaged?

When the tooth’s pulp becomes infected by decay or damaged by trauma and is unable to repair itself, the pulp dies. Once the pulp is exposed to saliva, bacteria will cause an infection inside the tooth. Left untreated, the infection eventually causes the pulp to die. Pus can build up at the root tip, forming an abscess that can destroy the supporting bone that surrounds the tooth.

Why does the pulp need to be removed?

If the damaged or diseased pulp is not removed, the tooth and surrounding tissues become infected. Pain and swelling may accompany the infection. Even in the absence of pain, certain byproducts of a diseased pulp can injure the bone that anchors your tooth in the jaw. Without root canal therapy, your tooth will eventually have to be removed.

Treatment of the involved tooth

STEP 1:

After the tooth is anesthetized, an opening is made through the crown into the pulp chamber.

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STEP 2:

The length of the root canals is determined.

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STEP 3:

Unhealthy pulp is then carefully removed from both the pulp chamber and root canals. The root canal(s) is (are) cleaned, enlarged and shaped to a form that can be properly filled.

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STEP 4:

The pulp chamber and root canal are then filled and permanently sealed with a material that prevents bacteria from re-entering the canal.

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STEP 5:

In the final step, a gold or porcelain crown is usually placed over the tooth to restore structure, function and appearance.

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Is a root canal painful?

It is not uncommon for a tooth to be uncomfortable or even exhibit a dull ache immediately after receiving root canal therapy. This pain should subside within one week. Your tooth will be sensitive to biting pressure and may even appear to feel loose. This feeling is a result of the sensitivity of nerve endings in the tissue just outside the end of the root where we cleaned, irrigated, and placed filler and sealer material. This feeling will be short lived.

We recommend you take something for pain relief within one hour of leaving our office, to get the medication into your blood system before the anesthesia we administered begins to subside. We recommend ibuprofen (Nuprin, Advil, Motrin) –800 mg (four tablets). If you have a medical condition or gastrointestinal disorder, which precludes ibuprofen, acetaminophen (Tylenol, Excedrin) is a substitute, although it does not contain anti-inflammatory properties. Aspirin and aspirin-containing products are not advisable, as they tend to increase bleeding from the area that was treated.

Whenever possible, try to chew on the opposite side of the tooth we have just treated, until you have a crown or onlay placed, or until the access area is restored. Until that time, your tooth still is weakened and could fracture.

Indications you need a root canal may include:

  1. Spontaneous pain or throbbing while biting.
  2. Sensitivity to hot and cold foods.
  3. Severe decay or an injury that creates an abscess (infection) in the bone.

Why couldn’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.

Root canal treatment can safely and comfortably save a tooth that otherwise would have to removed. In fact, root canal therapy is successful approximately 95% of the time. Remember a healthy restored tooth is always better than an artificial one.