So your dentist has suggested you need a root canal treatment. And since the news broke it’s been playing on your mind.
Few treatments strike fear in a patient the way ‘root canal’ does. (Tooth extraction is another biggie.) But the anxiety people feel in the run-up to this pretty standard procedure often stems from a lack of understanding. So we’ve created this guide to give you the information you need about root canals and alleviate some of that fear.
In this guide we’ll explain:
- what root canals are
- what the treatment involves
- why you may need a root canal
- how the process is performed – step by step.
We’ll also talk about root canals and pain. As dentists, we know a major reason people fear certain treatments is they’re worried about how uncomfortable it will feel.
By the end of this guide you’ll have an impressive amount of endodontic treatment knowledge. (That’s posh, dentist lingo for ‘root canal’.) And hopefully your upcoming treatment will seem far less intimidating.
What is a root canal and why do you need this treatment?
A root canal contains the pulp, tissue and blood vessels found inside the tooth. It sits below the tooth’s crown, enamel and dentin.
Dentists suggest endodontic treatment when the pulp inside the root canals become infected (usually from bacteria getting inside the tooth). Infection may be a result of:
- tooth decay
- severe gum disease (considered a combined periodontal and endodontic infection)
- a broken filling
- a chipped or cracked tooth
- weaker teeth due to ageing.
The best way to save the tooth and stop the spread of infectious bacteria is to remove the infection with root canal treatment.
Signs you might need root canal treatment
When a tooth becomes infected, you may notice one or more of these symptoms.
- Toothache, and increased pain when eating, drinking or biting down on anything.
- Tooth sensitivity to hot and cold temperatures, and the sensitivity sticking around even after the sensation has gone.
- A darkening of the tooth and possibly the gum surrounding it, which suggests decay.
- The tooth being loose and wobbly.
- Swollen and tender gums around the infected tooth.
- Pus oozing out close to the infected tooth.
These symptoms aren’t exclusive to an infected tooth. You may be experiencing another oral health challenge, such as gum disease. To confirm the cause of your tooth or gum pain you’ll need to see your dentist. They’ll diagnose the problem and let you know whether you need root canal treatment.
Tooth decay and infection needs to be diagnosed by a dentist. Root canal treatment may be the best way to get rid of the infection and save the tooth.
What if root canal treatment is recommended but you don’t want to go through with it?
As is the case when you see your GP, when your dentist identifies an oral health challenge they should discuss all available treatment options with you. In the case of an infected tooth, only a handful of options are available.
Root canal treatment is one option.
Tooth extraction is another, and may be more realistic if the tooth is beyond saving.
The final option is to do nothing.
But putting off root canal treatment or doing nothing increases the risk of the infection spreading. It may start affecting other teeth, your gums and even your jaw. In severe cases, the infection from your tooth can spread to other parts of your body, especially if there’s swelling. This can lead to serious illness and the need for antibiotics.
However, that happens only in extreme cases. And chances are you’ll never face that worst-case scenario because you’re seeing your dentist for regular checkups. That puts you in a strong position to avoid any sort of infection. And if there is one we’ll catch it early so it doesn’t become a major issue.
The 5 steps of a root canal procedure
Step 1: Pre-procedure planning
If you come in complaining of toothache, or your dentist identifies signs of a tooth infection during your regular check-up, they’ll take some x-rays to get an understanding of the shape of your tooth and the root canals. They’ll also test the responsiveness of the nerve within the tooth.
You’ll then be asked to make an appointment for endodontic treatment.
Extra tip: On the day of your root canal, make sure you have something to eat and drink before coming in. It might be a while before you get to eat again. And having a full tummy will help reduce the risk of dizziness or feeling faint.
Step 2: Getting you comfortable
On the day of the procedure, the dentist will first numb the area with local anaesthetic. They’ll also work with you to come up with a non-verbal signal you can use if you need a break.
Step 3: Isolating the tooth
A small rubber dental dam is placed over the infected tooth to isolate it from the rest of your mouth while still allowing you to breathe normally.
This helps keep the area as sterile as possible, and minimises the risk of bacteria from your saliva getting into the tooth and worsening the infection. It also stops the irrigants used to clean the tooth from getting into the mouth. (Take our word for it when we say they taste horrendous.)
Step 4: Drilling and cleaning the root canals
Once we’ve confirmed the area is numb, we’ll drill a hole in the top of the infected tooth. We’ll then use an endodontic file in a back-and-forth motion to remove the infected pulp and tissue from the tooth’s canals.
When the file comes out clean, we know we’ve removed the infected pulp. We can then disinfect the canals using sodium hypochlorite and ethylenediamine tetraacetic acid (EDTA).
As well as removing bacteria, the endodontic file shapes the canal. It’s then possible to fill it with a malleable, plastic material called gutta-percha (a natural plant resin from a Malaysian tree called a percha).
Step 5: Filling and capping
The final step is to seal the tooth and repair the drilled hole with a regular filling. (We use Glass Ionomer Cement as a base, and then restore the tooth with composite resin.)
Most premolars and molars will need an onlay (a covering of the tooth’s surface) or a crown. This helps protect the rest of the tooth, and minimises the risk of another infection.
How long does root canal treatment take?
How long treatment takes can depend on the number of canals the tooth has. And the number of canals a tooth has depends on the type of tooth.
Canines usually have one, premolars may have one or two, upper molars can have up to four, and lower molars can have three or four. But there are many variations on this. It can also vary from person to person. Your dentist won’t know how many canals your tooth has until they start the root canal treatment.
In certain cases (e.g. when the infection is minor), your root canal treatment can be done in one appointment taking an hour or less.
But this treatment is normally completed over two or three appointments.
- Appointment 1 is usually an emergency appointment where the nerve is removed to prevent further discomfort.
- Appointment 2 is where the canals are cleaned and shaped.
- Appointment 3 is where the canals are filled and sealed with the gutta-percha, and a filling is placed on top.
This may sound long-winded. But it ensures you are comfortable, and don’t spend any more time in the treatment chair than you can handle.
Healing after a root canal procedure
When the anaesthetic has worn off your tooth and gums around the treatment site will feel sore and tender.
The discomfort should last only a day. However, for some patients it can feel sensitive for up to a week. Before you leave the practice your dentist will discuss pain relief options with you, and let you know how to care for your tooth as it heals.
Ideally you shouldn’t eat or drink anything for at least an hour after treatment. This minimises the risk of accidentally biting your lip or cheek as the anaesthetic wears off. After this time, you may find it more comfortable to eat using the side of your mouth that wasn’t treated.
Worried you need a root canal treatment?
Root canal treatment is one of the most common dental procedures in the world. From a dentist’s standpoint, this isn’t great. They’d much prefer everyone to have healthy teeth and gums and not need the treatment. But if it is on the horizon for you, take comfort in the fact you’re not alone. It’s a well-practised, well-established treatment that tens of thousands of people have done each year.
If you’re experiencing toothache or swollen gums, or can see signs of tooth decay, then don’t put off making an appointment.
Come and see us (if you’re in the Yeppoon and Rockhampton area) or your closest dentist. With a quick look, your dentist can diagnose what’s causing your discomfort and recommend treatment. And while that may be a root canal, it may not.
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