For this installment of “Ask the Dentist”, Dr. Halversen answers commonly asked questions about endodontic therapy, also known as a root canal.
What exactly is a root canal?
When we do root canal therapy on a tooth, we remove the nerve and blood supply from the tooth’s pulp chamber and down the roots to where it is connected to the nerve and blood supply from the body. We do this when there is infection in these tissues. This infection usually comes from very deep decay in the tooth, or a very deep fracture or crack in the tooth.
Is it a painful procedure?
As a rule, it is NOT painful! We always make sure you are very numb before we begin treatment. Sometimes, there is so much infection in the tooth the anesthetic won’t even work to make the area numb. In that instance, we normally prescribe an antibiotic to begin fighting the infection; we then see the patient several days later when they are able to be completely numb before we proceed.
Since root canals are most often utilized to treat infection that is accompanied by a toothache, it is associated with pain. A root canal is the treatment for the toothache much like stitches are the treatment for a deep wound.
How long does it take?
This depends on which tooth is being treated and how involved the infection is. Front teeth have only one root with one canal. As you go further back in the mouth, teeth have two or three roots with two, three or four canals. The more canals that need to be treated, the more time it takes to complete treatment. Also, if the infection is quite severe, we may need several appointments to clear the infection with the help of antibiotics before we can close the area.
Do I still have a root in that tooth?
Yes! We take the nerve and blood supply away, but the root of that tooth is still there holding it in the bone. Imagine a pencil: a root canal is like taking the lead out of the pencil but the wooden outside is still there.
Do these teeth always need crowns?
Generally, yes. Most teeth that need endodontic therapy have large fillings or decay, so the tooth is badly broken down and cannot be restored with just a filling. More importantly, after a root canal, the blood supply is gone so over time the tooth becomes more brittle and can fracture easily. By placing a crown on the tooth it is kept sound and strong. Usually a post is placed down one of the treated canals to further strengthen the tooth.