Root canal is a procedure in dentistry that is used to repair and save damaged, decayed or infected tooth.The procedure can be performed by an endodontist or by a general dentist. Naturally, the tooth is made up of three different layers which consists enamel, dentin and pulp. The pulp is softer innermost layer of the tooth that contains the living part of the tooth. The pulp contains blood vessels, nerves and connective tissue which are essential for the growth and well-being of a tooth.
However, the tooth nerve and tissues can become irritated, inflamed, damaged and infected. Certain dental problems such as deep cavities, cracked or broken tooth due to trauma, gum diseases, and repeated dental procedures on a tooth, can actually damage the tooth nerves and tissues. You should also know that when a damaged tooth’s nerve and tissues are left untreated, they are likely to become infected or cause an abscess.
As the infection and damages spreads, the patient will experience persistent excruciating pain and discomforts around the affected tooth. In most cases like this, extraction or root canal treatment is usually recommended. Root canal involves the removal of inflamed or infected pulp, the pulp cavity is then refilled to protect the area from further damages.
How the root canal procedure is done
Like I said earlier, a root canal treatment, also known as endodontic treatment, can either be performed by a general dentist or an endodontist. The treatment is necessary when the pulp chamber, which contains the canals within the tooth, becomes infected or inflamed. In dentistry, there is a general accepted procedure for carrying out root canal treatment. Before the procedure, the dentist or endodontist is likely to explain most of the things that you should expect during and after the restoration.
The entire procedure may take up to 2 or 3 sessions to be completed depending on the condition of the tooth. Each sitting may last between 30 – 90 minutes. (1) So, below is a step-by-step guide on how to perform a root canal treatment.
1. Radiographic examination: the first step in the procedure is to take a series of X-rays of the affected tooth. A radiographic examination is very important because it provides a detailed picture of the root canal and the extent of the damages within the tooth. X-ray is also used to see to if there is any sign of infection in the surrounding bone.
2. Numb the area: during the procedure, the dentist will try as much as possible to ensure that you are comfortable throughout the process. The dentists will anesthetize the area by administering a local anesthetic to numb the tooth, making the procedure painless. The local anaesthetic acts as a painkilling medication that numbs the tooth and the surrounding tissues.
3. Drills an opening: after numbing the area, the dentist will keep the area dry, free from saliva and other substances with the use of a dental dam. A dental dam which is usually a sheet of rubber is placed around the tooth in order to isolate the area. The dam also protects you by preventing the swallowing or breathing in of any chemical that the dentist will use. (2) Next, the dentist will drill a tiny opening on the tooth’s surface, in order to have access to the pulp chamber.
4. Removing the pulp: at this point, the dentist already has access to the soft tissue at the centre of the tooth. With the use of special files, the infected, diseased and dead pulp, along with bacteria and other debris are cleaned out from the tooth. At this stage of the procedure, it’s very important that the inflamed or infected pulp are cleaned out thoroughly. The dentist may still use sodium hypochlorite to dissolve and flush away any debris or nerves that are still remaining inside the tooth.
5. Filling the root canal: once the tooth is thoroughly cleaned, the canals are then shaped with fine instruments so that they can be filled. At this point, the dentist is likely to enlarge and shapen the canals, creating enough space for a filling which will be used to replace the pulp. Before inserting a temporal filling, the dentist may need to disinfect the canal to kill any remaining bacteria. Sometimes, if there is an infection or swelling, your dentist may put an antibiotic inside the tooth and wait for about a week before sealing the tooth permanently.
6. Sealing the tooth: on the next appointment, the dentist will have to fill inside the tooth and the exterior access hole that was created at the beginning of treatment. But before then, the temporary filling and medication within the tooth is removed. After the temporal filling and the medication must have been removed, a rubber compound known as gutta percha is used to fill the canal. The exterior access hole is sealed using a suitable permanent sealant.
In some cases after filling the root canal procedure, the filled tooth may appear darken. When such a problem occurs, the dentist can treat the discolouration by whitening the tooth using chemical or by placing a tooth-colored crown over the tooth.
7. Dental crown: crowning a tooth after the root canal procedure might be necessary if the treated tooth is likely to fracture or discolored. Crowns can be made from different materials depending on your choice and the purpose of the crown. Before a crown can be placed over your tooth, the size of the tooth will be reduced in order to create space for the crown.
The accurate measurement of the shapen tooth is taken to ensure the crown to be produced will fit perfectly. It takes about a week for a dental crown to be moulded and fully ready for installation. You can check here to see – the cost of crowns, the installation procedures, before and after pictures.
What to expect after the procedure
It’s common to experience pain and sensitivity within the first few days following the completion of an endodontic treatment, such as a root canal. In most cases, the pain and discomforts are caused by natural tissue inflammation around the treated tooth. Luckily, the sensitivity or pain is usually controlled with over-the-counter pain medication such as Ibuprofen. However, the pain can be persistent and severe if any bacteria remains even after the procedure, the infection might get worse. It is advisable to consult an endodontist for further evaluation and treatment.
In most cases, the tooth might crack leaving the area exposed for bacteria and infection. It’s also possible that the seal could erode and create an opening for bacteria to enter and infect the tooth again. Well, if the pain is caused by infection, the dentist might repeat the procedure or recommend suitable antibiotics. You can read this post to see – what causes pain after root canal treatment.
Normally, the pain after a root canal treatment should not exceed seven days. If the pain is too intense within some few days after the procedure, it’s always advisable to see your dentist.