The procedure involves removing inflamed or damaged tissue from inside a tooth and cleaning, filling and sealing the remaining space.
The pulp, or soft inner tissue of your tooth, is normally surrounded and protected by a layer of dentin. Above the gumline, the dentin is protected by a layer of enamel; below the gumline, the dentin is covered by cementum. When a deep cavity, decay or crack destroys these protective layers, the pulp is exposed to the bacteria in your mouth. This can result in inflammation, infection and, eventually, necrosis (pulp death). A severe blow to the tooth can also damage the pulp. Irritants may then escape from the end of the root and cause a diseased area (apical lesion) in the bone.
Root canal treatment removes the damaged pulp and irritants. This allows the bone surrounding the root end to repair and heal.
You could, but then adjoining teeth may shift and interfere with biting and chewing. You can have a replacement tooth implanted or attached to adjacent healthy teeth, but this can be expensive and require even more dental treatment. There is no real substitute for your own tooth, which is more efficient in chewing and biting than an artificial one would be.
The cost of root canal treatment depends on the severity of your problem, as well as the tooth location and number and shape of canals. Additionally, fees vary depending upon the educational experience of practitioner. Please ask for a cost estimate before treatment begins.
An examination, including radiographs, will be performed. A local anesthetic will be given, if necessary. A sheet of latex, called a “rubber dam,” will be placed around the tooth to isolate it and keep it clean and dry during treatment. Complete treatment consists of the following five basic steps:
Step 1. An opening is made in the crown of the tooth.
Step 2. The pulp is removed from the pulp chamber and root canals. Tiny instruments (“files”) are used to clean the root canals and shape them to a form that will ensure they will be well sealed. A temporary filling is placed in the opening to seal the opening and protect the tooth between visits.
Step 3. The root canals are filled and sealed with a material that prevents bacteria from re-entering. The opening in the crown of the tooth is sealed with a temporary filling. Radiographs (x-rays) are made before, during and after treatment.
Step 4. At future appointments, which may be in another department, the temporary filling will be replaced with a permanent filling and/or crown.
Step 5. The root canal, permanent filling, and/or crown are evaluated for healing at periodic intervals called recall appointments.
Although the pulp is removed, your tooth remains alive, nourished by surrounding bond and gum tissues. With a permanent restoration, regular brushing and flossing, proper diet and periodic dental checkups, your tooth has an excellent chance for success.
You will be contacted in the future to return for a recall appointment, when the tooth will be radiographed and examined to be sure healing has occurred. There is no charge for this service. A postcard will be sent to remind you to make this appointment.
Three groups of practitioners provide root canal treatment at the College: 1) dental students under the supervision of faculty; 2) dentists receiving advanced specialty training (residents); and 3) faculty, who are endodontic specialists. The residents and faculty generally treat more difficult cases.
Most patients experience a little soreness after the appointment. This may be due to the injection, the necessity of keeping the mouth open for a long time, or the treatment. Your temporary filling will be hard enough to bite on within approximately a half-hour, but avoid biting or chewing on the treated tooth if it hurts.
Over-the-counter analgesics like acetaminophen, aspirin or ibuprofen usually relieve the discomfort. Should pain last more than a few days, or if severe pain or swelling occur, call your treating department. After hours you may call your student or doctor, or call (319) 356-1616 ( University Hospital ) and ask for the endodontic resident on call. Remember, if your tooth hurt before you came in for treatment, it may take a while to heal.
When your root canal treatment is complete, a temporary filling is placed. The tooth needs to be permanently restored to prevent contamination or fracture. The Endodontic Department specializes in endodontic procedures, so you will need to return to your general dentist or restorative department for a permanent restoration. It is important to return promptly because the temporary filling can loosen and leak, possibly causing the root canal treatment to fail, which would necessitate re-treatment.