Endodontics is the dental specialty that deals with the nerves of the teeth. When a tooth becomes infected, it is usually related to the nerves in the root of the tooth. The infected nerves and blood supply need to be removed. If left untreated, an infection can turn into an abscess, which is a much more serious problem that includes bone destruction in the jaw, pain, and sometimes swelling of the gums or face.
The area around the tooth is numbed with a local anesthetic to start the procedure. The dentist will then place a barrier to isolate the tooth from the oral cavity to prevent contamination from saliva and other oral fluids. An opening into the tooth's pulp chamber will be prepared to access the root canal. The infected tissue within the root canal will be removed and the canal cleaned. Our office utilizes rotary endodontics, which is a way of performing the root canal utilizing a specific electrical handpiece and special files. These tools often make the process faster and allows the dentist to perform the process with greater ease, accuracy, and comfort for the patient. After the infection has been removed, the space is filled with a sealer and filling, called gutta percha. It is highly recommended that a tooth that has undergone root canal therapy be fitted with a crown for protection. This will improve the appearance and functionality of the tooth as well as increase the success of the procedure and the longevity of the tooth.
"Root canal" has become a scary term for dental patients to hear, but the benefits of the procedure and advances in dental technology have made it much less "scary." Local anesthetics and proper pain medication allow the procedure to be performed with little to no pain in most cases. There may be some soreness following the procedure, but that is normal for most dental procedures. Over the counter painkillers are usually enough to relieve any pain afterwards, but your dentist may prescribe a stronger pain medication if needed. The procedure will relieve you from pain caused by the infection allowing you to enjoy all the foods you love without any pain from heat, cold, or biting too hard. If you are experiencing dental pain, consult your dentist today!
With proper care, most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth. Root canals performed by endodontists (root canal specialists) have a 95% success rate. In some cases, however, a tooth that has received endodontic treatment fails to heal. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment.
Why do I need retreatment?
As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:
- Narrow or curved canals were not treated during the initial procedure.
- Complicated canal anatomy went undetected in the first procedure.
- The placement of the crown or other restoration was delayed following the endodontic treatment.
- The restoration did not prevent salivary contamination to the inside of the tooth.
In other cases, a new problem can jeopardize a tooth that was successfully treated.
New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth. A loose, cracked or broken crown or filling can expose the tooth to a new infection. A tooth sustains a fracture. Retreatment is performed in two visits and involves the following:
- At the initial visit the endodontist will examine the tooth, take x-rays and discuss your treatment options. If you and your endodontist choose retreatment, the retreatment will be scheduled at that time for a future date.
- At the retreatment appointment the endodontist will administer local anesthetic to numb the tooth. After the tooth is numb, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials (crown, post and core material) must be disassembled and removed to permit access to the root canals.
- After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth using a microscope, searching for any additional canals or unusual anatomy that requires treatment.
- After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. Post space may also be prepared at this time.
- After your endodontist completes retreatment, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to full function.
- If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery.