Dr. Krause may recommend root canal therapy when the nerve of a tooth is infected by extensive decay (cavity) or dental trauma that physically damages the nerve tissue. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space (canal) is disinfected and sealed with medicated biocompatible dental materials. A critically important followup treatment of your tooth’s therapy is creating a well fitted restoration necessary to return the tooth to proper shape, appearance and predictable long term function.
When a tooth can be saved but not the nerve Dr. Krause believes the 1st choice treatment to consider is root canal therapy. This is a conservative treatment in comparison to the alternative of removing the tooth. The nerve and associated tissue is not required to maintain the tooth once the tooth is fully developed. Many patients believe that removing a tooth solves the problem but in reality the patient’s problems are just beginning. Typically extracting (pulling) a tooth will ultimately be more costly and cause significant problems to adjacent teeth by increasing the risk of dental disease, periodontal disease, bone and gum shrinkage, tooth migration or shifting with resultant esthetic compromise and bite disorders/disease.
Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy:
- An abscess (or pimple) on the gums and/or swelling and/or tenderness.
- Sensitivity to hot and cold.
- Severe toothache pain.
- Sometimes no symptoms are present.
Reasons for root canal therapy:
- Decay that contaminates the tooth pulp (the living tissue inside the tooth).
- Infection or abscess has developed inside the tooth or the bone at the root tip.
- Injury or trauma to the tooth.
What does root canal therapy involve?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).
While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva and protect the patient. An access opening is made on top of the tooth and a series of cleaning root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed. Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.
At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.
Following root canal treatment and decay removal the tooth is significantly weaker in resistance to oral forces which is why most teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking and restore it to its full function.
You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in a long life for your tooth with root canal treatment and definitive restoration making it a worthwhile investment in optimal oral health.