Root Canal Therapy

A root canal is a little tunnel or passageway that extends from a central chamber of your tooth, through the root and out the end of the root tip. Here the nerves and blood vessels that fill these passageways attach to the nerves and blood vessel coming from your heart and brain. All teeth have root canals, anywhere from one to four or more per tooth.

Anything that damages the nerve and blood vessels (the dental pulp) in the center chamber of your tooth, the pulp chamber, can cause pain and or infection to develop. Two common causes of infection in the tooth are bacteria, which can enter through a cavity and deep decay, and trauma (a blow) to the tooth. Both of these can cause the tooth to die.

When pulp becomes traumatized, diseased or infected there often is pain and sensitivity. As the problem progresses to the pulp in the root canals there can be the development of pus and the formation of an abscess often with severe pain and swelling.

Root canal therapy is a remarkable treatment with a high rate of success. Root canal therapy involves opening the tooth to gain access to the canals which pass through the center of the roots. When the canals can be accessed, they can be cleaned, disinfected and enlarged enough to fill. The purpose of cleaning and filling the root canal is to seal the tip of the root and eliminate the source of infection thus halting its spread. Before root canal therapy was available the only option was tooth extraction. But now we can save many teeth, most for a life time.

Root canal therapy usually involves only one visit. During the visit a small opening is made in the tooth so the canals can be opened, cleaned, disinfected and filled to seal the root tip ends of the canals.

During a root canal treatment the tooth is numbed with a local anesthetic. There should be little or no feeling during the process. If there is any swelling or tenderness around the tooth you may experience minor discomfort. In very few cases there can be considerable discomfort until the tooth is opened and anesthetic placed inside the tooth.

My advice is to take Advil or Tylenol while your tooth is still numb from the treatment to ease the transition while the anesthetic wears off. Continue the medication for a day or so if needed. If a stronger medication is prescribed for you, take it as needed but according to instructions on the bottle. If you have unusual problems such as excessive pain or swelling please call the office. 989-792-6621

Antibiotics should be taken until they are gone, but as instructed on the bottle. This should be done even though the tooth feels fine.

Do Root Canal Treatments always work?

No! A root canal treatment is not a "black and white cure". It is a therapy much like physical therapy treatment. Though it is not a cure, it does have a high success rate. Sometimes the infection never clears up and the tooth either has to be retreated, have a retrofill placed (a retrofill is a filling placed in the end of the root tip after it has been surgically exposed during a minor procedure), or extracted. The failure of root canal therapy can result from causes that are not under our control (such as the anatomy of the tooth, breakage of endodontic instruments in the root, or the patient's own immune system).

After the artery, vein and nerve are removed the tooth is technically 'dead'. The reason your tooth may be sore is that the area around the tooth (bone and gums) may be inflamed and infected. After root canal therapy, treated teeth often need a strong restoration to reinforce the tooth to reduce the tendency for it to break. Some will also need a post (which helps to retain a crown build-up which is needed where large amounts of tooth is missing). The 'build-up' or 'core', is the process of building the tooth up to size and shape and closing the access opening for the root canal therapy so that it will hold a crown or other restoration. The final restoration is then placed on the tooth to hold everything together and protect your tooth from the heavy biting forces in your mouth which can exceed 55,000 psi. The build-up and crown are separate procedures from the root canal therapy.

After the root canal therapy, build-up, and the final restoration, the tooth should be fine and you should use it as you would any ordinary tooth.