Endodontic therapy, also known as "root canal" treatment, is necessary when the pulp of the tooth is injured and cannot naturally return to a healthy state. The pulp is the soft tissue found within the canal spaces of the tooth, and largely consists of tiny blood vessels and nerves.
There are many potential ways tooth pulp can become diseased or necrotic. Deep fillings, decay, trauma, and periodontal disease are common causes. Some people experience symptoms of pulp damage immediately, while others experience no discomfort for years.
Patients are referred to an endodontist, not only because they are in pain; but also because the tooth in question may be in jeopardy. Endodontists alleviate any discomfort and eliminate potential sources of infection to save the tooth whenever possible.
Obviously, not every tooth can be saved, but the chances of endodontic success are very good. The only alternative to root canal treatment is extraction. This is biologically costly and may be less desirable. When teeth are lost they require artificial replacement such as fixed or removable bridges or implants.
1. Do not chew on the tooth at all! On the day of treatment, it is important that you limit your diet to soups and other foods that require no chewing. Consult our Pi Dental Center cookbook, "From Soup to Nuts", for recipes and ideas. The treated tooth should experience no strain whatsoever. When eating be careful to chew on the other side of your mouth. 2. Use good judgment. Slowly, you may introduce soft foods to the treated tooth. Remember, your tooth has been traumatized and needs to heal completely before you can expect full function.
3. If your tooth feels higher than the surrounding teeth, call our office and we will schedule an adjustment. Reducing the surface areas will make your "bite" feel more comfortable.
Note: The process of inflammation can actually elevate a tooth. This is another reason to take anti-inflammatory drugs regularly.
4. If your root canal has not been completed and your temporary filling becomes dislodged or compromised in any way, please call us to schedule a time to refill the tooth.
Once your root canal has been completed, you are ready to schedule an appointment to begin your permanent restoration.
When there is either little or no tooth structure above the gum line or when the remaining tooth structure is very weak, it is necessary to place a "post" and build a "core" following root canal treatment.
During this procedure, a slender piece of metal or "post" is carefully inserted into the canal space. Once inserted, it serves as an anchor over which a shell or "core" can be placed securely. The post, covered by the core, can then provide a suitable foundation for future crown attachment.
Inserting the post is quick and painless, since no nerves remain in the canal space after root canal therapy has been performed. Treatment is completed in a matter of minutes and there is no post-treatment discomfort from this procedure.
After root canal therapy is completed, a crown is usually placed over the treated tooth as a means of ensuring its future integrity.
A tooth that has been subjected to extensive restoration and/or root canal therapy is invariably weakened in the process. The crown functions as a protective "shell," covering the tooth to help prevent it from cracking and breaking.
It is important that the patient understand the value of this protective crown. The patient may jeopardize his or her entire investment without it. We urge all patients to follow this procedure when recommended.
Even though endodontic treatment is one of the most successful and predictable procedures in modern dentistry, failures can occur. Some indications of failure include swelling, soreness, or the persistence of abscess at the root tip as identified in an x-ray. When this happens, a root canal revision procedure, also referred to as "retreatment," may be warranted.
1. Retained microorganisms (bacteria) in the root canal.
2. Breakdown or corrosion of root canal filling materials.
3. Contamination from decay or leakage from a failing restoration.
4. Inoperable canals because of calcification or unusual anatomy.
5. Sometimes tissues fail to heal for unknown reasons.
Although retreatment is technically more difficult than the original root canal, it can usually rescue a failing condition without having to consider surgery. Endodontists are especially well equipped to handle these difficult conditions because of their additional training and experience.
When considering retreatment, it is important to recognize that a revised root canal is very complex and unpredictable. For this reason, unforeseeable problems could arise during this time-consuming procedure that require a quick re-evaluation of your remaining alternatives.
It is also important to note that many patients with deteriorating root canals are considered good candidates for revision root canal treatment. Should your doctor recommend this, it is because he or she believes in the strong possibility of success. Even so, it is necessary to emphasize the delicate nature of retreatment, and the possibility that further failure could lead to endodontic surgery, if not ultimately to extraction. Fees for retreatment will vary with the complexity of the condition being treated.
Conventional root canal treatment is not always sufficient to correct every patient's condition. Occasionally, endodontic surgery is required. This is because a previous treatment has deteriorated or because anatomic considerations such as the shape of the tooth or canal space make the traditional root canal treatment especially difficult to complete.
If you experience sensitivity following any appointment, we recommend you take an anti-inflammatory drug such as Ibuprofen (e.g. Advil, Nuprin) to reduce inflammation, which will in turn reduce pain. You may also want to apply ice to the outside of your face next to the tooth, keeping the head elevated.
If you are allergic to specific medications, please be sure to inform your endodontist when discussing the correct medication to take following treatment. Stop taking medication and call our office immediately if you notice sudden rash, nausea, sudden swelling, shortness of breath, dizziness, or any other unusual symptoms.
Under no circumstances should you apply heat to the outside of your face.
Consistent medication is the key to comfort. It is essential to follow your doctor's orders by taking prescribed medications to alleviate pain and to help prevent or fight infection.
If discomfort lasts more than a few days or if you have severe pain or swelling, call our office. We will suggest medication or other steps to make you more comfortable.