Root Canal Therapy 

When the nerve or the pulp of the tooth becomes damaged, diseased or injured it loses the ability to repair itself.  It will begin to deteriorate much like an infected cut.  Once the bacteria penetrates the root canal space it proceeds to destroy the nerve.

Sometimes the tooth may be sensitive to sweet, cold, heat or the pressure of chewing.  Other cases, there is no warning and the pain and pressure can be intolerable as an abscess forms in the tooth and expresses itself into the surrounding bone.  Fillings do not correct the problem, the only treatment that can eliminate this discomfort is the removal of the cause – the inflamed or infected nerve.

A root canal is started by creating a small opening in the tooth to gain access to the space that holds the nerve.  The diseased nerve tissue is removed by instruments called files and irrigation is used to remove tissue, debris and bacterial contamination.  Once the canals have been cleaned the dentist will place a filling material inside the tooth to help prevent any further contamination.  Occasionally due to a large infection, the tooth can not be cleaned sufficiently in just one appointment.  In this instance medication is placed in the tooth for a period of time to help remove any infection.  Once the infection is gone the root canal can be finished.

The next step is to restore the tooth.  If a large portion of the tooth has been destroyed by a cavity or fracture, a post may be placed to anchor the filling material used to rebuild the tooth.   The dentist recommends a crown be placed on teeth that have been endodontically treated.  After root canal therapy your tooth may become brittle and is at an increased risk of fracture, especially if much of the tooth has been destroyed by a cavity.  The crown improves the appearance and function of the natural crown it is replacing.  Every attempt will be made to communicate both the risks and potential complications as treatment progresses.  However, despite our best efforts there can be unexpected complications.

Questions & Answers

Do root canals hurt?
For some teeth, profound local anaesthesia may be difficult to achieve.  This is due to the presence of the infection which hinders the effectiveness of the anesthetic.  The process of doing a root canal should rarely hurt when addressed before the infection has caused visible swelling and exudate (pus).

There is always a period of post operative discomfort.  The degree and type of pain you experience after a root canal depends on a number of factors.  They include your unique reactions to dental trauma, the amount of pain you had prior to treatment, and the amount of manipulation necessary to work on the teeth.  The dentist may recommend something for pain and antibiotics may be required and should be taken as directed.   The tooth is expected to be sore to chew on for several days to a week.  Remember that pain radiates.  It is not unusual during the healing phase to feel sensations not related to the area of the tooth or even to feel pain when there was none prior to treatment.

Will antibiotics cure a root canal infection?
Absolutely not!  Antibiotics are indicated when there is swelling, temperature, or other systemic signs of infection.  Antibiotics may be useful to diminish symptoms such as a biting pain before the root canal can be started, and may help prevent some types of post treatment pain involved with having the root canal performed.  Antibiotics cannot cure a root canal infection because the source of infection is inside the tooth where there is no blood supply.  Therefore there is no mechanism to deliver the antibiotics.  The cure is the complete cleaning, shaping and obturation of the contaminated root canal space.