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Root Canal Therapy – What You Need to Know

A root canal treatment is a dental procedure to remove the nerve and clean the nerve canal below the tooth of bacteria to save it from having to be extracted.

A tooth’s nerve is not vitally important to a tooth after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

What is a Root Canal?

The term “Root canal” is used to describe the cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s nerve lies within the root canal.

Every tooth has a nerve and blood supply going to it from its roots in the jaw bone. In certain situations, the nerve of a tooth can become infected and develop painful abscesses .Without treatment, the tissue surrounding the tooth will become infected and abscesses may form and cause swelling of the surrounding gum and tissues.

Why Does Tooth Pulp Need to Be Removed?

When a tooth’s nerve tissue or pulp is damaged, it deteriorates and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled bulb that forms at the end of the root. In addition to an abscess, an infection in the root canal of a tooth can cause:

  • Swelling that may spread to other areas of the face, neck, or head  
  • Bone loss around the tip of the root
  •  Drainage problems extending outward from the root. A hole can occur through the side of the tooth allowing the bacteria to leak into the gums or through the cheek into the skin.

These oral infections are caused by common oral bacteria in the saliva that enter the root canals and affect the tooth’s nerve system. Once the bacteria hit the nerve, they can quickly travel down it and into the bone. Once this occurs, an abscess can form below the tooth.

Common Causes of Tooth Infections:

  • Tooth decay (caused by bacteria) in the tooth penetrates deep enough to hit the nerve. This is the most common cause.
  • Infection of the surrounding gum and bone – leading to infection of the nerve.
  • A broken tooth leading to an exposed nerve for example through a physical trauma such as a sports injury or car accident. The tooth itself can be sore to touch and chew, or even just sensitive to stimuli such as sweet, hot or cold foods and drinks.

One of the more common signs of an infected tooth is a persistent pain, which may be dull or throbbing, that seems to be getting worse. Many patients complain of a pain that stops them from sleeping or wakes them up at night.

When a tooth is infected, or has the potential of being infected, root canal treatment may be the only way to save the tooth and prevent a tooth extraction. Sometimes, after a tooth has had a root canal treatment it will require a form of tooth preservation, such as a cap or crown, to strengthen and protect the tooth.

What Happens During a Root Canal?

A root canal requires one or more surgery visits and can be performed by a dentist or endodontist.

The first step before the procedure begins 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.

In many cases a patient is already in pain so the procedure may be slightly uncomfortable due to the hypersensitive state of the nerve affected by the bacteria. Your dentist or endodontist will then use local anaesthesia to numb the area near the tooth. While anaesthesia is safe even for pregnant women, you should inform the dentist if you are pregnant or trying to get pregnant or if you are taking medication for some other reason.

Anaesthesia may not be necessary, if 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 purpose for this procedure is to systematically remove all bacteria from the canal system as well as shape the canals so that they can be properly filled to prevent any further re-infection.

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.

After treating and filling the canals, it is important to seal them to prevent re-infection by bacteria. The material used to seal the canals is a modified rubber-based material called “Gutta Percha”.

Once the canals are sealed, it is important to restore that tooth so that there will be no further exposure of the root canal system to bacteria or saliva (which contains the bacteria).

The final step may involve additional restoration measures because a tooth that needs a root canal is often one that had a large filling or extensive decay or other weakness. This may be a crown, crown and post, or other restoration which needs to be placed on the tooth to protect it and prevent it from breaking. This will restore the tooth to its full function. Your dentist will discuss the need for any additional dental work with you.

What Should You Expect After the Root Canal?

For the first few days following the completion of a root canal, the tooth may feel sensitive due to natural tissue inflammation, especially if there was pain or infection before the procedure. This sensitivity or discomfort can usually be controlled with over-the-counter pain medications such as ibuprofen. Most patients can return to their normal activities the next day.

If your root canal procedure is conducted over two visits, and the permanent filling is not in place and/or the crown, it is wise to minimize chewing on the tooth which is under repair. This will help you avoid recontamination of the interior of the tooth and also may prevent a fragile tooth from breaking before it can be fully restored.

Two Common Issues of a root canal to a tooth

Once the nerve is removed the lack of blood supply to the tooth can cause the tooth to discolour. Secondly, and for the same reason, the tooth can become weak and can fracture or break relatively easily.

Because of these two common side effects, it is usually recommended that a Crown be placed over the tooth as a final restoration. A crown (or cap) is used to hold it together and improve the tooth’s aesthetics.

Call 02 9299 5504  to book an appointment for wisdom teeth removal, family dental or root canal treatment at our York St dental clinic. You can also contact us online for more information.

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