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Root Canals

Teeth have hollow channels inside the tooth crown and roots that contain the tooth's pulp tissue. These are called pulp chambers and root canals respectively.

The pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.

When the pulp is diseased or injured and can't repair itself, it dies. The most common causes of pulp death is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tip, in the jawbone, forming a pus-pocket called an abscess. An abscess can cause damage to the bone around the teeth.

If the infected pulp is not removed, pain and swelling can result. Certain by-products of the infection can cause inflammation which in turn may injure your jawbones. Without treatment, your tooth may have to be removed.

Treatment 

Your dentist uses root canal treatment to treat problems of the tooth's soft core (the dental pulp). Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment has given dentists a safe way of saving teeth.  Most root canal treatments are 90 – 95% successful as long as the integrity of the tooth has not been compromised because of decay, a crack or missing tooth components.

Treatment often takes one to three visits. During treatment, your general dentist or endodontist (a dentist who specializes in problems of the pulp) removes the diseased pulp in the chamber and root canal(s) of the tooth, then cleans and shapes and seals them at the tip of the root and in the crown of the tooth with a filling.

Here's how your tooth is saved through treatment:

  1. An opening is made through the crown of the tooth into the pulp chamber.
  2. The pulp is then removed. The root canal(s) cleaning and shaping is started.
  3. If due to time constraints or the presence of an infection another appointment is required, your dentist will place a temporary filling and instruct you to be careful not to chew anything hard or sticky on that side between appointments.  Sometimes your dentist may not place a temporary filling if the infection is still draining.  In this case they may leave it open and have you return within 48 hours to close up the tooth and place the temporary filling until the next appointment. You might also be given medicine to help control infection that may have spread beyond the tooth.
  4. At a subsequent appointment, the temporary filling is removed and the pulp chamber and root canal(s) are cleaned, shaped and filled.
  5. In the final step, a gold or porcelain crown is usually placed over the tooth. If an endodontist performs the treatment, he or she will recommend that you return to your family dentist for this final step.
  6. Your restored tooth may last a lifetime, if you continue to care for your teeth and gums. However, regular check-ups are necessary to ensure ongoing health.  The most common cause of loss of root canalled teeth is decay below a crown margin, making flossing critical to crown/tooth health.  In addition, as the diseased pulp was removed and nutrition no longer maintains the suppleness of the tooth and it’s roots, fractures may occur over time with heavy occlusion or highly filled teeth.
  7. Root canal and crown therapy is a way to prolong tooth life when the nerve dies.  The alternative treatment would be tooth removal.