A root canal is a treatment used to save a damaged, injured or infected tooth. In the past, dentists had to pull a tooth once the root became infected. But the root canal procedure prevents that.
Sometimes called endodontic therapy, a root canal can be performed by your regular dentist, or he may refer you to a specialist (an endodontist). Depending on the complexity of the problem tooth, it may require up to three visits to completely perform a root canal and capping procedure.
When a Root Canal Is Needed
A root canal becomes necessary when the pulp inside the tooth becomes infected or damaged. The pulp material is normally protected by a layer of dentin inside the tooth, which is further protected by the tooth’s exterior enamel. If a cavity reaches deep enough, or if the layers are degraded by tooth decay, it can expose the pulp to the bacteria in the mouth. A tooth that’s damaged by a crack or another type of injury can also expose the pulp.
Bacteria can lead to the pulp becoming infected. It can cause further problems because the pulp extends from the interior chamber of the tooth down through the roots and into the jawbone. This can ultimately lead to disease in the bone, and when it progresses to that stage, extracting the tooth is often the only option.
- Saves a tooth that would otherwise need to be pulled
- Allows the bone underneath to fully heal
- Prevents further dental complications
- Relatively painless during the procedure
An endodontic therapy treatment will vary slightly based on whether it’s performed on front or back teeth. Front teeth tend to only have two roots, while molars can have three or more roots. Each root needs to have the pulp extracted, so back teeth can be more complex to work on. Sometimes a root canal will be necessary on more than one tooth, if infection has spread through the jawbone from the original problem tooth.
Your dentist will apply a local anesthetic near the affected tooth. The tooth will need to be kept dry and clean during the pulp extraction, so a dam will be placed around it. The dentist will then make an opening in the crown (top portion) of the tooth. Using a set of tiny specialized tools, he’ll extract the pulp from the tooth, all the way down to the roots. Once the tooth is hollowed out, a temporary filling will be placed to keep saliva and food out of the hole until the next visit. If the tooth has become infected, the dentist will sometimes place medicine or antibiotics in it along with the filling for added treatment.
On the second visit, the temporary filling will be removed and the dentist will fill the root canals with a more permanent substance. This will prevent re-infection. Then the tooth is capped with another temporary filling, which will allow the root canal fillings to harden before the next visit.
The third treatment will normally complete the process. The temporary cap is removed and then replaced with a permanent filling and possibly a crown. If the tooth needs structural support, a metal or plastic rod may be inserted into the root canal. Several aftercare visits may be needed to monitor the healing of the tooth.
The cost of a root canal from a dentist can vary from $350 to $600 for a front tooth, and the back molars can range from $500 to $850. The crown that’s used to finish the procedure can average about $1,000. If multiple teeth need to have root canals at the same time, the procedure can be thousands of dollars. An endodontist who specializes in root canals will charge more.
Learn more about the costs of root canals.
A root canal allows a damaged or diseased tooth to be saved, which is always an advantage. Replacements such as dental bridges or another artificial option will never fit in the patient’s mouth quite as well as his natural tooth. Extracting the tooth rather than performing a root canal can lead to difficulty in biting or chewing, so a root canal is the option that will most often be recommended.
If the pulp in the tooth hasn’t become infected, your dentist may recommend a simple pulp capping or crown procedure. Rather than hollowing out the roots, the tooth is just capped. The other options are removing the tooth and installing a dental bridge or a dental implant. A bridge will attach the affected tooth to the teeth on either side of it, and will require crowns for each attached tooth. An implant involves an artificial tooth being attached to the bone underneath with a screw. A bridge and an implant are both much more costly than a root canal.
It's also worth weighing the advantages between a root canal and an extraction.
The biggest risk of a root canal is that the procedure can be ineffective the first time. If the dentist misses any infected material and caps the tooth, the entire procedure will need to be performed again. Your dentist might take X-rays and determine that a second root canal is not feasible. In this case, you’ll be referred to a specialist for an endodontic surgery. A root resectioning might have to be performed, in which case the root of the tooth will be accessed and the diseased portion will be shaved off. A filling then reseals the tooth.
You should be able to resume your normal activities within a day of the procedure. You’ll most likely be prescribed antibiotics during the recovery period from a root canal surgery. The tooth itself is structurally weakened at this time, so your dentist will caution you against chewing or biting with it. If a front tooth is involved, you may be on soft foods or liquids for awhile, just to be on the safe side. Over-the-counter pain medication can be taken to manage any pain or discomfort. The tooth will be sensitive for the first few days.
The good news about all the trouble that goes into a root canal procedure is that it’s likely to be a permanent fix. As long as the tooth isn’t damaged and you keep up with good dental hygiene, the repaired tooth should last the rest of your life.
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