Root Canals

Dentists today believe that the best teeth are your own, and they make sure you do not lose any of them. Successful root canal treatment lets you keep your tooth. The only other option is to have your tooth removed.

Keeping your tooth helps to prevent your other teeth from drifting out of line and causing jaw problems or gum disease. Saving a natural tooth avoids having to replace it with either a bridge or an implant.

What is Root Canal Treatment?

Also called endodontics, root canal treatment is the process of removing the infected, injured or dead pulp from a tooth.

Teeth are made up of three hard layers:

  1. Enamel
  2. Dentine
  3. Cementum

There is a space inside the hard layers of each tooth. It is called the root canal system and it is filled with soft dental pulp made up of nerves and blood vessels that help the tooth grow and develop.

Once a tooth is fully-grown, it can survive without a pulp. If the pulp of a tooth becomes infected, a root canal (or endodontic treatment) is needed. When this treatment is performed, the pulp is removed.

During your regular check-up, your dentist checks for infection and damage to teeth, even though you may not notice any signs of tooth trouble. If trouble is spotted and you need a root canal, your dentist may do it, or refer you to a dental specialist with at least two years of extra university training in this area. Root canal specialists are called endodontists.

If your child's baby (or primary) tooth is damaged, your dentist may refer you to a pediatric dentist. If you notice a problem with a tooth, do not wait until it hurts. Call your dentist as soon as you injure a tooth or notice a cavity or loose filling. If you get attention quickly, there is a better chance that damage can be prevented and the tooth saved.

When Root Canal Treatment is Needed?

The pulp inside a tooth can be damaged by cracks in the tooth, deep cavities or accidents. Germs (or bacteria) can get into the tooth and lead to infected tooth pulp. This situation may cause pain and/or swelling. Sometimes, the pulp becomes infected or dies, but does not cause any pain.

Your dentist may notice:

  • changes in the colour of the tooth,
  • changes in your gums, or
  • changes picked up by a dental x-ray.

Sometimes, if a great deal of dental work is needed, your dentist can tell from your exam and x-rays that the pulp of a tooth is not likely to survive. In all these cases, root canal treatment can ease or prevent symptoms, and save the tooth.

How it is done?

  • Step 1. A member of the dental team will place a rubber dam around the tooth. This dam protects the tooth from germs in your saliva while the work is being done.
  • Step 2. Your dentist or endodontist may give you "freezing" (or anesthetic). In some cases, anesthetic is not needed.
  • Step 3. Your dentist or endodontist will make a small opening in the tooth to reach the root canal system and the damaged pulp.
  • Step 4. Your dentist will take out the pulp by cleaning and enlarging the root canal system with very fine dental tools (or instruments).
  • Step 5. Then he or she will fill and seal the root canal with a rubber-like material (called guttapercha) after it has been cleaned.
  • Step 6 Your dentist or endodontist will seal the opening of the tooth with either a temporary or permanent filling.

Things to Consider:

Root canal treatment may be completed in one appointment, or it may take two or more visits. It depends on the complexity of the root canal system and on the degree of pulp damage. Sometimes, if the infection has spread from the tooth to the bone (or abscess), the infection may have to be drained before the root can be filled.

After root canal treatment, your tooth may be tender for one or two weeks. Bad pain or swelling are not common. If the pain is severe, call your dentist or endodontist. After a root canal, your tooth has to be fixed (or restored) to look, feel and work as much like a natural tooth as possible. Your dentist may use a filling or a crown to restore your tooth. It depends on the strength of the part of the tooth that's left. A back tooth will likely need a crown, because chewing puts a great deal of force on back teeth. If not enough of the tooth is left, your dentist may use a post to help hold the crown on. A tooth that has become dark may be bleached, crowned or covered with a veneer.You can still get a cavity or gum disease after a root canal. It does not protect your tooth from other types of damage.

Root Canal Re-treatment and Root Canal Surgery:

Most of the time, a root canal is a success, but in some cases, a second root canal is needed. This procedure is called re-treatment. The root canal filling material is taken out, and the canal is re-cleaned, reshaped and refilled. A dentist or an endodontist may perform root canal surgery when a regular root canal cannot be done, or when it has not worked.

Surgery is done to:

  • check the end of the root for cracks (or fractures);
  • remove parts of the root that could not be cleaned during regular root canal treatment;
  • clear up an infection that did not heal after regular treatment.

All dentists learn to do root canal treatment in dental school, but because re-treatment and surgery are more complex, your dentist may refer you to an endodontist.

Most of the time, a tooth that has had a root canal can be saved, but there are cases where all efforts to save a tooth fail and the tooth must be pulled (or extracted).