A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.
We will take every measure to ensure that your procedure is in no way uncomfortable or painful. If treatment is needed, we will inject a small amount of anesthesia to gently numb a concentrated area of your mouth. For most patients, the feeling of numbness usually subsides after 2-3 hours.
The roots of your tooth are not removed. The inside of the roots are cleaned and the rest of the root is left to support the tooth.
Your tooth will no longer be sensitive to hot or cold, but it will still have feeling due to the bone and ligament that hold your tooth in the jaw.
Teeth are often uncomfortable after a root canal, and discomfort usually peaks about two days after treatment. It is common for the tooth to still be a little uncomfortable for a week or so. It is important that the tooth is getting better over time.
Your jaw may be sore and your lip may be numb, but you should be in good shape to continue your regular schedule.
In most cases, you will be referred back to your general dentist who will assure the tooth has an adequate permanent restoration. Most back teeth will require a crown if there is not already one in place. In this office, a permanent filling is often placed (instead of a temporary) to assure the tooth is adequately sealed. We will assure that you are informed of the next step in your dental treatment. If you have received a temporary in our office, and your root canal is completed, I recommend getting the permanent filling within three weeks.
I do not recommend chewing on the tooth until it has received a permanent restoration. The risk of tooth fracture is very high in root canal treated teeth that have not been permanently restored.
If you already have a crown, most of the time the root canal will be done through a small opening in the top. Your dentist will need to repair the opening after your root canal is completed. A new crown may be indicated if there are imperfections that do not lead to predictable dental health. Crowns with porcelain (tooth colored crowns) are susceptible to fracture of the porcelain (happens less than 5% of the time). If the porcelain fractures in a way that the crown is no longer functional or esthetic, then replacing the crown may be necessary.
Many patients ask if they can come to me for all of their dental work. The answer is that I specialize in root canal therapy and limit my practice to that area of dentistry. Out of respect for your dentist, who has referred you to us, we will return you to their care. If you do not have a dentist, then we can help you find an appropriate match.
Maintaining your natural teeth is one of our priorities, but if we feel that root canal treatment is not predictable then a dental implant may be indicated. Implants are great for replacing missing teeth, and will be recommended if it is believed that they will be a better long-term investment in your health. The use of the dental operating microscope helps in predicting the outcome of treatment.
Use of a microscope adds superior lighting and magnification while treating your tooth. From the time I started my endodontic training, I have considered the microscope a necessary adjunct in providing top-quality care.
I acknowledge that you want to spend as little time in the dental chair as possible. The idea in dentistry that faster is better is false (in most cases). You would never tell your cardiologist to do your bypass as fast as possible. Rather, you would say “Please do your best.” If your root canal is taking longer than expected, it is because we care about the quality of care you are receiving, and we are trying to treat the entire anatomy present in your tooth. I re-treat many root canals that were done by a fast-paced practitioner oblivious to the nuances that make root canal therapy successful.
If you have not had your tooth permanently restored in a timely manner, the canal system may have become re-infected with bacteria. In this case a re-treatment may restore your tooth to health. In most cases you will need to pay for the cost of re-treatment, so getting the tooth restored early is a wise use of resources. The rate of fracture for an unrestored root canal treated tooth is very high. If the tooth has cracked then it may not be restorable, and you will lose what you have invested.
If you are unable to afford the restorative phase of treatment at this time, please discuss this with your dentist. At a minimum, the tooth should get a permanent filling and receive a temporary crown or be removed from occlusion (shaved down so you can’t bite down on it)
Yes, for most root canal treatments, we recommend that patients return to the office one year after the procedure is finished.