Why do I need a Root Canal?

Why do I need a Root Canal?
Knowing what to expect

Oh no! You’ve heard those dreaded words – You need a root canal. While Drs. Hochberg and Diora understand that everyone prefers to avoid dental treatment due to concerns that it will hurt, for many patients root canal therapy actually alleviates the pain caused by infection. So, why the apprehension when treatment is needed? In the ‘olden days’, root canals, and other dental procedures as well, were associated with discomfort. However, with today’s techniques, along with anesthetics and medications, a root canal is similar to having a filling. And the best news is that a root canal oftentimes allows us to save a tooth that otherwise would have been extracted.

When is a root canal needed?

A bit of understanding of tooth structure is important before we can answer this question. The center of a tooth is soft and contains the pulp, housing the tooth’s nerves, along with the associated connective tissue and the blood supply.  Problems arise when this inner sanctum is breached through dental disease or accidental damage. Once the pulp chamber is compromised, bacteria can enter the chamber causing extensive bacterial growth, which, in many instances, leads to infection. This infection can be present anywhere in the pulp chamber. When it occurs at the tip of the root and causes a pus-filled pocket to form, it’s called an abscess. The old cartoons showing a person with a swollen face and in discomfort are oftentimes those where there is an abscess or the infection has broken through into the bone or the face; hence the swelling.  Like all infections, left untreated, not only is the tooth subject to further damage, but also one’s overall health can be impacted.

Before the advent of modern dentistry and advance technology to treat these types of infections the only solution was to remove the tooth. And, while there are some instances where the tooth cannot be saved, many times it can. Dr. Hochberg or Dr. Diora will take an x-ray of the tooth. This provides an inside look showing the doctor the number of canals as well as the shape and direction of the canals. They’ll look to see if there is an abscess or if the infection has spread outside of the tooth structure and they will discuss their findings with you.

If a root canal is proposed – it’s okay. While there are some cases where our dentists may refer to an endodontist, a specialist in root canals, oftentimes they are able to provide the care needed should the tooth appear restorable.If you’ve had a filling before, this will be a similar procedure. You will receive numbing anesthesia, and should you request it, either nitrous oxide or medications are available to help you relax. Your dentist will access the tooth’s center in order to remove the diseased pulp tissue with special instrumentation called root canal files. The files serve to shape the canals to the very tip of the root, taking out the bacteria and the center soft tissue structure, leaving voided canals.Whether the next steps, filling the voids then sealing the tooth, are done in one visit or more, depends on the original nature of the problem. In some instances the tooth can be sealed at the time of treatment. A paste and gutta-percha (a compound from a rubber tree) fills empty pulp chamber, occupying the voids in the canals as well. To complete the procedure, a tooth-colored composite restoration, just like one that is provided if there is decay and the cavity is filled, is used to seal the area where the hole was drilled into the tooth. In other instances, the pulp chamber is filled with a temporary filling or, if need be, a medicated (sedative) filling, allowing the tooth time to recover from the infection and swelling to subside. During this time we suggest that you chew on the other side, reducing the risk of recontamination of the tooth, until you return in a few weeks to complete the procedure. In either instance, you may experience a bit of discomfort, and can take Advil during this time. Even though the tooth no longer has nerves, there is trauma that the infection caused to surrounding structures.

Once the tooth’s center is filled and the tooth is sealed, Drs. Hochberg and Diora will advise you as to whether the tooth is strong enough as is or if further care is needed. Inasmuch as the damage reached the tooth’s center, many times either the existing disease process or the accidental injury has already weakened the tooth’s structure. If this is the case, your dentist will recommend a final restoration – a crown, with or without a post & core, in order to provide the strength needed for the tooth to withstand the forces of biting and chewing.

Remember, our goal is to remove infection and prevent further damage, while working to keep the tooth in place. All our teeth are important. To maintain overall oral health and avoid shifting teeth, bone loss and a compromised smile, when a tooth is lost – we need to replace it. While not every patient is aware that a tooth is in jeopardy and it’s only determined during routine dental screening x-rays, there are some symptoms that should not be ignored. If you notice any of the following:

• Pain when chewing or pressing on the tooth
• A change in the color of a tooth
• A pimple on the gum tissue
• Swelling and tenderness
• A noticeable sensitivity to hot or cold food and liquids

Give us a call at Colony Square Dental Associates and let us take a look. We’re available to help you maintain and restore your teeth … And if you need a root canal, don’t worry, we’ll do our utmost to keep you smiling!