Root Canal Therapy:

What Is It and Why Do I Need It?

Your dentist may have suggested to you that Root Canal Therapy( otherwise known as Endodontics ) was needed for a particulartooth. They may have briefly discussed some of the facts concerningthe procedures involved in root canal therapy but perhaps youwould like some more information.

Years ago, a badly infected tooth, or one that just had significantdecay, was doomed to be extracted. Today the majority of theseteeth can be salvaged through a procedures utilized by both theGeneral Dentist and the root canal specialist, the Endodontist.

Extraction is truly our last resort!

Some indications of the need for root canal treatment may be:

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

Root canal treatment consists of :

• The removal of the infected or irritated nerve tissue (Fig.2)that lies within the root of the tooth. It is this infected pulptissue that causes an eventual abscess.

1. The first step in a root canal is to obtain access to thenerve. This is accomplished by establishing a small access openingin the top of the tooth. It will be done under a local anesthetic.( Fig. 3 )
   
   
2. The length of the root canals is determined and the infected pulp is removed.
   
   
3. At the same visit, the canal where the nerve is located willbe reshaped and prepared to accept a special root canal fillingmaterial. This filling procedure will probably not occur untilyour next visit. The number of visits necessary to complete yourroot canal will depend upon several factors including the numberof nerves in the tooth, the infected state of the nerve and thecomplexity of the procedure. (Fig. 4)
   
   
4. The final step in your root canal will be the sealing of theroot canal with a sterile, plastic material, called gutta perchaThis is done in order to prevent possible future infection.( Fig.5)
   
   

The tooth will then possibly need a post and core and a crown in order to re-establish normal form and function. This decisionwill be based upon several additional factors. (Fig. 6)

If treated early, root canal therapy need not be uncomfortable. With the use of local anesthetics, the entire procedure can betotally painless.

Another " Old Wive's Tale " is that by removingthe nerve the tooth becomes " dead ". This is not true.The tooth is very much alive and functioning because it receivesa source of blood supply and nerve supply from the surroundingtissues that hold it in place in your jaw bone. The tooth willhave no sense of feeling to hot, cold or sweets but will be responsiveto biting pressures etc. With the proper restoration the toothshould last as long as your other teeth and can even be used asan anchor tooth for a partial denture or cemented bridge. Thesuccess rates for root canal therapy have been reported to beas high as 95%.

Sometimes when there has been long standing infection or abscess,there may be some soreness associated with the first or secondroot canal visit. If this should turn out to be true you willbe given specific instructions to follow to minimize the discomfort.When an infection is present, it may be necessary to take an antibiotic.If pain should be present, analgesics may need to be prescribed.In either case, be sure to call your dental office if either of theseproblems should arise.

POSTOPERATIVE INSTRUCTIONS

1. Postoperative discomfort is sometimes experienced after atreatment visit. This is due to irritation of the bone surroundingthe tooth and may range from a mild discomfort in the area toan occasional episode of considerable pain. This discomfort will usually maximize in approximately 48-72 hours and then subside.Please avoid chewing on the treated tooth for a few days.
   
   
2. If a throbbing sensation occurs please keep your head elevatedas much as possible and place extra pillows under your head whenlying down. Avoid as much as possible any strenuous activity aswell.
   
   
3. If your tooth has been left open to aid in drainage of aninfection, please place cotton in your tooth as directed. Donot leave the cotton in the tooth between meals.
   
   
4. If swelling of the gum is present or should appear after atreatment visit, please rinse the area every 1-2 hours with asolution of warm salt water prepared by adding a teaspoon of saltto an 8 oz. glass of warm water.
   
   
5. If swelling of the face is present or should appear, applyan ice pack to the area for 5 minutes every 1/2 hour.
   
   
6. If antibiotic medication has been prescribed please take itas indicated until you have finished ALL of the medication. Ifyou encounter any difficulty in breathing or a skin rash, or gastricdisturbance should occur, please discontinue the medication andcall the office.
   
   

• If medication for pain has been prescribed , please take itas indicated. It is important to bear in mind that narcotic medicationssuch as Codeine, Vicodin, Percodan and Demerol may make you drowsy. Therefore, caution should be exercised in operating any potentially dangerous machinery or an automobile.
  
  

If any additional questions should arise after your visit, pleasedo not hesitate to call your dentist.