Root Canal Treatment: Insights from Endodontists

What is a root canal?

A root canal is a dental procedure designed to relieve pain and save a tooth that has become infected or inflamed. The treatment involves removing the infected or inflamed pulp from inside the tooth.

After removing the pulp, the dentist or endodontist cleans and disinfects the inside of the tooth, then fills and seals it with a rubber-like material called gutta-percha.

The final step often involves placing a crown on the tooth to protect it and restore its function. Root canal treatment is a highly effective way to preserve a tooth that might otherwise need to be extracted.

What happens during root canal treatment?

During root canal treatment, several key steps are followed to treat the inflamed or infected pulp of a tooth:

Diagnosis and X-ray: The dentist or endodontist examines the tooth and takes an X-ray to determine the extent of the infection.
Anesthesia: The area around the tooth is numbed with local anesthesia to ensure comfort during the procedure.
Pulpectomy: An opening is made in the crown of the tooth to access the pulp chamber. The infected or inflamed pulp is removed carefully.
Cleaning and Shaping: The root canal(s) inside the tooth are cleaned and shaped to prepare them for filling. Special tools are used to remove the debris and diseased tissue.
Filling the Canal: After cleaning and disinfecting, the canals are filled with a biocompatible material, usually the rubber-like material called gutta-percha, which is then sealed with an adhesive cement. This step helps prevent bacteria from re-entering the root canals.
Restoration: The opening in the tooth is sealed with a temporary filling. Eventually, a permanent restoration, like a crown, is placed on the tooth to protect it and restore its full function.

The entire process might take one or more visits to the dentist, depending on the condition of the tooth and the complexity of the procedure. After treatment, the tooth may feel sensitive for a few days, but this discomfort can usually be managed with over-the-counter pain medications.

How do you know if you need a root canal?

Here are some signs that you might need a root canal:

Severe Tooth Pain: Pain in the tooth when you chew or apply pressure, or a lingering pain in response to temperature changes, can indicate the need for a root canal.
Prolonged Sensitivity: If your tooth remains sensitive to hot or cold temperatures long after the source of heat or cold has been removed, it might be a sign of nerve damage or infection requiring root canal treatment.
Discoloration: A tooth that becomes darkly discolored may suggest underlying damage to the internal tissue, often due to decay or trauma.
Swelling and Tenderness: Swelling of the gums near the affected tooth can indicate an infection that might extend beyond the tooth itself.
A Persistent or Recurring Pimple on the Gums: Sometimes called a sinus tract, this can indicate the presence of an abscess.
Trauma or Decay: If a tooth has been chipped or cracked and exposes the pulp or if deep decay has reached the pulp, a root canal might be necessary to save the tooth and prevent further damage or infection.

If you experience any of these symptoms, see your dentist.

What are the signs of needing a root canal?

If you experience severe toothache that worsens when you chew or react sharply to hot or cold temperatures, it might indicate the need for a root canal.

Swollen, tender gums around a tooth or a tooth that has changed color to a dark gray or black are also common signs.

Sometimes, a persistent or recurring pimple on the gums, often accompanied by drainage, can suggest an abscess which is a clear indicator for this treatment.

Extended sensitivity to temperature changes or a history of trauma to the tooth exposing the pulp could necessitate a root canal.

How much does a root canal cost?

The cost of a root canal can vary widely depending on several factors, including the complexity of the problem, the location of the tooth, and regional differences in dental fees. Typically, root canals on the front teeth tend to be less expensive than those on molars because molars are more difficult to treat due to their multiple roots.

On average, the cost for a root canal procedure might range as follows:

Front Tooth: $300 to $1,500
Bicuspid: $400 to $1,800
Molar: $500 to $2,000

These costs reflect the root canal treatment itself and do not include the cost of the final restoration, like a crown, which can add several hundred dollars to the total fee.

How does endodontic treatment save the tooth?

Endodontic treatment, commonly known as a root canal, saves the tooth by removing infected or inflamed tissue from its interior. This process halts the spread of infection and preserves the tooth’s structure, allowing it to continue functioning in the mouth. Here’s how it works:

Removing Infection: The primary step in a root canal is to access the inside of the tooth and meticulously remove the infected or inflamed pulp. This pulp contains blood vessels, nerves, and connective tissue, which can harbor bacteria once the tooth is compromised.
Cleaning and Shaping: After removing the pulp, the dentist cleans and shapes the inner chamber and canals of the tooth. This step is crucial to ensure that all debris and bacteria are removed to prevent further infection.
Filling and Sealing: The cleaned and shaped canals are then filled with a biocompatible material, typically gutta-percha. This rubber-like material seals the canals to prevent bacteria from re-entering. The tooth is then sealed with a temporary or permanent filling to protect the inner work.
Restoration: Finally, the tooth is restored with a crown or other restoration to return it to full function. This step not only protects the underlying dental work but also restores the tooth’s appearance and functionality, allowing it to function like any other tooth in chewing and biting.

By treating and preserving the natural tooth, endodontic treatment helps maintain the tooth’s integrity and alignment within the jaw, supporting overall oral health and preventing the teeth from shifting, which can cause additional dental issues.

What are the potential benefits of root canals?

Root canal treatment effectively eliminates pain caused by tooth infections and preserves the natural tooth, avoiding extraction. This procedure helps maintain proper chewing function, protects other teeth from excessive wear or strain, and upholds the aesthetics of one’s smile.

What are the risks or complications of root canals?

Root canal treatments are generally safe, but they carry some risks. Complications can include incomplete removal of the infection, leading to re-infection, or a crack in the tooth that goes undetected, which might also harbor bacteria.

The tooth can become brittle and more susceptible to fracture post-treatment. In some cases, the sealant material can fail over time, allowing bacteria to re-enter the tooth and cause new infections.

Will I feel pain during or after the root canal?

During a root canal, you’re unlikely to feel pain because the area is numbed with local anesthesia.

After the procedure, some tenderness and sensitivity around the treated tooth are common but usually manageable with over-the-counter pain relievers. This discomfort typically subsides within a few days as the inflammation decreases.

Will the tooth need any special care or additional treatment after endodontic treatment?

After a root canal, the tooth generally requires a permanent restoration, like a crown, to protect and stabilize it.

This restoration helps ensure the tooth can handle the forces of chewing. It’s also important to maintain good oral hygiene, including regular brushing, flossing, and dental check-ups, to prevent new infections and ensure the longevity of the treated tooth.

Can all teeth be treated endodontically?

Most teeth can be treated endodontically, but some cases may be too complex due to severe damage, extensive decay, or anatomic challenges such as limited root canal accessibility or severely curved roots. In such instances, alternative treatments like tooth extraction may be necessary.

What to expect after a root canal?

After a root canal, expect some tenderness in the area for a few days, which is normal and can be managed with over-the-counter pain medications.

It’s common for the treated tooth to feel slightly different from your other teeth the first few days after treatment. Avoid chewing on the affected side until the tooth is fully restored with a crown or filling to prevent any damage

Does a root canal kill the tooth?

A root canal does not kill the tooth; it removes the infected or inflamed pulp inside, which contains the tooth’s nerves and blood supply. This procedure eliminates pain and infection, but the tooth itself remains intact. Although the tooth is no longer vital because it lacks a blood supply, it can still function normally within the mouth once properly restored.

Do you need a crown after a root canal?

Yes, after a root canal, a crown is often necessary to restore and protect the tooth, particularly if it’s a molar or premolar. The crown provides strength and prevents the now more brittle tooth from fracturing, ensuring it can handle the pressure from chewing.

Can a root canal fail?

Yes, a root canal can fail, typically due to the incomplete removal of the infection, re-infection, or a missed canal that harbors bacteria.

Other reasons include a breakdown of the inner sealant over time or a crack in the tooth that allows bacteria to re-enter. If a root canal fails, additional treatments such as retreatment, apicoectomy, or even tooth extraction may be necessary.

What happens if you don’t get a root canal?

If you don’t get a root canal for a tooth that requires one, the infection in the tooth’s pulp can worsen, leading to increased pain, swelling, and the formation of an abscess.

This can result in further damage to the bone around the tooth and potentially spread the infection to other areas of the body. Ignoring the need for a root canal can ultimately lead to tooth loss and more severe health complications.

Do root canals cause cancer?

No, root canals do not cause cancer. This misconception stems from outdated and debunked research from the early 20th century.

Modern scientific studies and reviews by reputable health organizations, including the American Association of Endodontists, have found no link between root canal treatment and cancer. Root canal procedures are safe and effective treatments for saving teeth and eliminating infection.

Can I brush my teeth after a root canal?

Yes, you can brush your teeth after a root canal, but be gentle around the treated area, especially if there’s any soreness or swelling. Avoid chewing on the side of the treated tooth until it has been fully restored with a permanent filling or crown to protect it.

Will a tooth turn black after a root canal?

A tooth may darken after a root canal, but this isn’t always the case. Discoloration can occur if the pulp tissue inside the tooth becomes necrotic or if there was significant trauma before the treatment.

If discoloration occurs, it can be treated with internal bleaching or covered with a crown or veneer to improve the aesthetic appearance.

How many visits does a root canal take?

A root canal typically requires one to two visits to complete. The number of visits can depend on the complexity of the root canal and the extent of the infection. Some cases may require additional visits to ensure the infection is fully cleared or if the tooth has a complex root system that needs more extensive treatment.

Can you smoke after a root canal?

Avoid smoking immediately after a root canal, as smoking can hinder the healing process. Smoking reduces blood flow, which can delay healing and increase the risk of complications like infection. Read more: Can You Smoke After A Root Canal? Hear From Dental Experts

Can I drive after a root canal?

Yes, you can drive after a root canal if you have had a local anesthetic only. This type of anesthesia numbs the treated area but doesn’t impair your ability to drive.

However, if you received sedation or general anesthesia during the procedure, you will need someone else to drive you home as these can impair your coordination and judgment temporarily.

What kind of dentist does root canals?

This dental treatment is typically performed by endodontists, who are dentists specialized in treating dental pulp issues. Endodontists receive additional training beyond dental school that focuses on diagnosing tooth pain and performing root canal treatment and other procedures related to the interior of the tooth. General dentists also perform root canals, especially simpler cases, but they often refer more complex cases to an endodontist.

When is it too late to get a root canal?

It’s considered too late to get a root canal when the tooth is too severely decayed or damaged to be saved, or if the infection has severely compromised the bone and surrounding tissues.

If the structural integrity of the tooth is lost or if the infection poses a broader health risk, extraction might be necessary instead of a root canal. Timely consultation with a dentist is crucial to determine the best course of action for preserving oral health.

Can you eat before a root canal?

Yes, you can eat before a root canal procedure. It’s generally recommended to have a light meal a few hours beforehand, especially since the local anesthetic used during the procedure might numb your mouth for several hours afterwards, making eating difficult immediately following the treatment. Avoid overly hot or cold foods right after the procedure, to prevent discomfort.

Is it better to have a root canal or extraction?

Root canal therapy is often preferred over extraction as it preserves the natural tooth structure. It involves removing infected tissue from inside the tooth, filling it, and sealing it. This maintains chewing function and prevents adjacent teeth from shifting. Extraction, while quicker and sometimes cheaper, can lead to bone loss and functional issues, necessitating replacements like implants or bridges.

Can you be put to sleep for a root canal?

Yes, you can be sedated for a root canal if you experience anxiety about dental procedures or if the situation requires it. While most root canals are performed under local anesthesia, which numbs the treatment area, sedation options like oral sedatives, nitrous oxide (laughing gas), or even intravenous (IV) sedation can be used to help patients relax or sleep through the procedure.

Can you drink alcohol after a root canal?

It’s advisable to avoid alcohol immediately after a root canal as it can interfere with the healing process. Alcohol can increase bleeding, swelling, and the risk of infection, and it may also interact negatively with any pain medications prescribed by your dentist. You’ll need to wait until the treated area has healed significantly, typically a few days, before consuming alcohol.