A trip to the dentist can sometimes result in the discovery of a dental problem that requires an endodontic treatment, commonly called a root canal.
Infection of the interior, the pulp of the tooth, can cause pain in the tooth or jaw, swelling, and sensitivity to temperature and is often an indication of needing a root canal. Deep cavities, injury to the tooth such as cracks or chips, or previous fillings that over time have weakened the tooth are frequent causes of pulp infection. A root canal can keep the affected tooth from having to be pulled.
The Endodontic Treatment
In the past, general dentists routinely performed root canals but more and more patients are referred to an endodontic specialist for the procedure. A root canal is the removal of the infected or inflamed pulp from the interior of the diseased tooth. The procedure is accomplished by opening the top portion of the tooth, the crown, and then removing the pulp, clearing the canals that run the length of the root, and then filling and sealing the cleaned canals.
A substance called gutta-percha, a tree sap that has a rubbery consistency, is used to fill the channels. Finally, a temporary seal of dental cement is placed over the opening in the crown to keep bacteria out of the newly cleaned canals.
Managing Root Canal Therapy Pain
Dental practitioners are very concerned about keeping the pain their patients experience to a minimum throughout the visit. Dentists, oral surgeons, and endodontists receive specialized training in pain management and the effective use of anesthesia. Pain during root canal therapy should be minimal, if any. However, as pain tolerance varies from person to person, patients should let the doctor know immediately if they are uncomfortable. Additional anesthesia can be delivered as well as a relaxant such as nitrous oxide gas.
After the treatment is complete, soreness for the next few days is normal. Over-the-counter pain medication may be enough to manage the residual soreness or a patient may receive a prescription for a stronger medication such as hydrocodone. However, if the pain is severe or accompanied by a fever, an infection may have set in and antibiotics will be needed to clear the infection.
Completing the Dental Restoration
The final step to completing the dental restoration is covering the tooth with a crown. A dentist will remove the temporary seal placed during the root canal therapy and fill the tooth. The tooth will be covered with a temporary crown and then with a permanent porcelain or gold crown that has been shaped from a mold made at the dentist's office. These steps usually take two visits over a period of several weeks.