Root canal treatment: Your questions answered

Source: Web exclusive, October 2011

You may have heard of root canal treatment, but do you know what it is and why you might need it? This dental treatment becomes necessary when the soft pulp of your tooth ‘ the tissue at the core that contains the nerves and blood vessels ‘ becomes infected. It sounds nasty, but the good news is that most root canal treatments save the tooth and last a lifetime.

How does the problem start?

Normally, our dental pulp is protected by outer tooth material. But if it is exposed to the real world ‘ if you break a tooth to the nerve, or you have serious tooth decay or deep dental work ‘ the pulp is vulnerable to attack. ‘All of a sudden, saliva and bacteria can get to the nerve and will infect it,’ says Dr. Bruce Ward, a North Vancouver dentist. ‘The nerve is a really delicate tissue.’ The pulp tissue dies, and if the infection isn’t stopped in its tracks, it can spread, damaging bone and causing you to lose your tooth.

Why not just yank the tooth out?

Pulling the tooth may sound like a quick fix, but keeping your natural tooth is hands down the best option. Losing a tooth can lead to problems with your jaw and the alignment of the rest of your teeth. Replacing it with an artificial tooth may cause aggro of its own, like interfering with a well-balanced diet (people often avoid certain foods). And if that’s not enough to convince you, root canal treatment is usually a bargain compared to the cost of extracting your tooth and getting a bridge or an implant.

How will I know that I need root canal treatment?

A common symptom of a dental pulp problem is pain. ‘If you’ve got pain that keeps you awake at night, or starts up when you take cold or hot liquid and continues for more than a few minutes, or if you can’t chew on the tooth, those are all indications that the nerve is possibly dying,’ says Dr. Ward. You may also have swelling. If the damage is from an accident that completely severed the nerve or blood vessels ‘ a hockey puck to the mouth will do it, for instance ‘ then the tooth might turn dark. Or your dentist may notice the problem during an exam or on an x-ray.

How will it be done?

Treatment may be done by your own dentist or an endodontist who specializes in treating dental pulp. He or she will prepare your mouth with anesthetic and a rubber shield to keep the bacteria in your saliva away from the tooth. A hole is then made through your tooth to get at the pulp chamber and root canal system. There are one to four (or more) canals in the roots of a tooth, depending on its location in your mouth. Through the hole, the dentist or endodontist removes the dead or infected tissue and cleans out the chamber and canals. This is done by hand or with a motorized instrument.

After that’s done, the canal is entirely filled in with a harmless natural filling material. Depending on the condition of the tooth, you may need to go back for dental restoration, such as a crown.

Yikes’ will it hurt?

If you’re panicking about pain, you can put it out of your mind. A root canal makes you feel better, not worse. ‘Usually the symptoms are relieved on the first appointment,’ says Dr. Ward. It may feel a little like getting a filling, which is pretty painless with today’s technology. There may be a bit of discomfort for a few days afterwards, but that can be relieved by an off-the-shelf anti-inflammatory medicine.

What should I watch for afterwards?

If your tooth hurts or swells badly, or if you still can’t chew on it, call your dental professional. Those are signs that something still needs attention, whether it’s a deep crack in the tooth, an additional canal that needs treatment, or a canal that needs retreatment.

Odds are, though, that everything will feel fine. If you do your best to look after your teeth and gums, there’s no reason why your treated tooth won’t last as long as the rest of your mouth.

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