Frequently Asked Questions
What is root canal treatment?
Root canal treatment is the removal of the nerve and blood vessels of a tooth for the purpose of trying to save the tooth from extraction. A simple analogy is removing the wick from a candle. The void where the wick was is cleaned and smoothed and then we place a rubber-type material into the cleaned out space to seal the canal.
What is the dental pulp?
The pulp is the soft tissue that contains nerves, blood vessels, and connective tissue. It lies within the tooth and extends from within the crown of the tooth (that portion of the tooth that is visible) to the tip of the root in the bone of the jaw.
What happens if the pulp gets injured?
When the pulp is diseased or injured and can’t repair itself, it dies. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside of the tooth. Left without treatment, pus builds up at the root tip, in the jawbone, forming a “pus-pocket” called an abscess. An abscess can cause damage to the bone around the teeth.
Why does the pulp need to be removed?
When the infected pulp, which is made up of blood vessels and nerves, is not removed, pain and/or swelling can result. Some elements of the infection can injure your jaw bones and the resulting bacteria may enter your bloodstream. Without treatment, your tooth may have to be removed. In severe cases, you might need to be hospitalized due to an infection throughout your body.
What does treatment involve?
Treatment often involves from one to three visits. During treatment, the diseased pulp is removed. The pulp chamber and root canal(s) of the tooth are then cleaned and filled with a rubber-type material that seals the tooth so that no germs enter the tooth.
Here’s how your tooth is saved through treatment:
First, an opening is made through the top of the tooth into the pulp chamber. The pulp is then removed. The root canal(s) is cleaned and smoothed. Medications may be put into the root canal(s) to help get rid of germs and prevent infection. If the treatment requires more than one visit, a temporary filling will be placed in the crown opening to protect the tooth between appointments or the tooth may be left open for a few days to drain. If a prescription is provided, please follow the directions as written. On the subsequent appointment, the temporary filling is removed and the pulp chamber and root canal(s) are cleaned and filled. However, if we advise you that your tooth requires a crown, you will need to return to our office for that procedure.
Root Canal Gallery
If the nerve of a tooth gets infected, it can be extremely painful. The goal of root canal treatment is to relieve pain, and restore your smile!
A root canal procedure involves removing diseased tissues (indicated by the yellow arrow), which contain the nerve and blood supply of a tooth, and replacing it with a rubber-type material. The area that is filled is called the “root canal.” The root canal of each tooth is very different. The reason this tooth needed a root canal was due to decay (indicated by the white arrow) entering the pulp.
This tooth has what is called an “accessory canal,” which is a canal that splinters off in an unexpected direction. This tooth had to be retreated due to the first root canal failing, which is evident by the dark area, which is where the arrow is pointing. Upon retreatment, the accessory canal was found and filled, and the prognosis for this tooth is good.
This is an example of a back tooth that developed a cyst (the dark area around the tip of the root). A root canal was performed and you can see some of the root canal filling material in the dark area, which represents an accessory canal. The prognosis for this tooth is good because the accessory canal was found and filled.
This is another example of an accessory canal in a back tooth. This canal, by the red arrow, was rather large. The prognosis for this tooth is also good because the accessory canal was found and filled.
This is an x-ray of an upper molar with four canals, which is not very common. What makes the treatment of this tooth more difficult is the curvy nature of its canals.
Most of the canals, where the nerve and blood vessels of the tooth reside, are narrow like the wick of a candle. Some canals are very wide, similar to this x-ray of a front tooth. This means there is less tooth structure surrounding the canal, which can indicate that the tooth is weaker.
This is an x-ray of an upper front tooth. The root on this tooth is shorter than normal. The cells of the root of the tooth are being eaten away in a process that is called external resorption. This process usually occurs very slowly over a several months or years and is usually associated with some sort of trauma to the tooth. The dotted line on the left image above indicates an infection from the left tooth. The dotted line on the right image above represents that portion of the root of the tooth that has been lost due to the resorption.
This is an x-ray of a back tooth, known as a molar, which was taken immediately after root canal treatment. The arrow is pointing to a dark area, where there is an infection.
The yellow arrow below indicates internal resorption. This occurs when the cells inside the tooth destroy the root from the inside out. This process usually happens very slowly over a matter of months or years and is usually associated with some sort of trauma to the tooth.
The treatment for internal resorption usually takes a two or more appointments. First, a medicated filling is placed and then, after a few weeks, the medicated filling is removed and the procedure is completed in the conventional way. This type of condition requires annual examination by x-ray to check on the tooth. The prognosis is fair to poor, but the only other option is to extract the tooth. The dark area around the entire root of the tooth above indicates the presence of a large infection. Conventional root canal treatment was performed and this is an x-ray of the tooth about six months later. You can see the dark infected area has disappeared and has been replaced by healthy bone structure. The prognosis for this tooth is excellent.