Root Canal Treatment for Adults

What is a Root Canal?

Decay, disease, and injury can threaten the health and structure of teeth, ultimately ruining smiles. However, with advancements in treatment and technology, teeth have a better chance of being saved. For example, root canals (endodontic treatment) remove the infected dental pulp in the roots of severely decayed teeth. This treatment also relieves dental pain associated with the infection. Then the tooth is restored with a dental crown to prevent future damage, such as a fracture.

"Root canals are one of the most common dental procedures, with more than 15 million performed every year."

American Association of Endodontics

Instead of reverting to prosthetics, endodontic treatment treats the internal structure of the tooth. The crown that covers your tooth after endodontic treatment also restores the look, function, and feel of your natural teeth.

What is Dental Pulp?

The pulp chamber of a tooth contains nerves, connective tissue, and blood vessels. The dental pulp within the chamber has a gel-like texture that consists of 75 percent water and 25 percent organic materials.

In short, pulp provides sensory innervation (stimulation) through a tooth’s nerve. Although, when the dental pulp becomes infected, the teeth become extremely sensitive to hot or cold substances. An infected pulp can also cause the nerve to die, which often causes no pain at all. So, this is why your dentist removes the infected pulp during the procedure.

What Causes a Root Canal?

Common causes of root canals include:

• Severe Tooth Decay — when a tooth becomes heavily decayed from an untreated cavity and poor oral hygiene.
• Tooth Chips or Cracks — caused by injuries, excessive teeth grinding (bruxism), or damaged tooth enamel.
• Infection of the Gums Surrounding the Infected Tooth — when the gums become infected, it is more likely that the bacteria will travel to a tooth’s root.
• Previous Dental Trauma or Injury — after a permanent tooth is dislodged or moved sideways from a traumatic injury, the nerve within may die, and endodontic treatment is used to restore the tooth.
• Large Cavity Fillings — teeth with large cavities and fillings are more prone to infection.

When to Seek Treatment

Signs that a patient may need endodontic treatment include:

• Severe Toothaches — if a toothache occurs after chewing or when pressure is applied.
• Tooth Sensitivity — if hot or cold substances cause severe tooth sensitivity.
• Gum Swelling — if gums surrounding the infected tooth are tender or swollen.
• Abscess or Fistula Formation — if there is a small white pimple-like swelling near the roots of a tooth.
• Tooth and Gum Discoloration — when a tooth, gums, or both become darker and other symptoms (above) are present.

Who Performs Root Canals?

Endodontists

Endodontics is a specialized area of dentistry that focuses on treating injury or disease affecting the dental pulp. Endodontists are the primary providers of root canals. In fact, they perform about 25 root canals per day. These experts require advanced training in endodontic treatment and use state-of-the-art technologies, such as digital imaging and microscopes, to treat patients safely and quickly.

General Dentists

Many general dentists also perform root canals. Although, they do not typically receive advanced training in endodontic treatment since their services are broader. These dentists only perform about two root canals per day, while endodontists perform 25 per day.

Root Canal Procedure: Step-By-Step

Root canals are typically completed within one to three visits to an endodontist, with each appointment lasting around 90 minutes each. In a multi-visit procedure, the first appointment consists of radiographs of the infected tooth, tooth numbing, and infected pulp extraction. The endodontist places a medicated paste into the roots between visits. During the second appointment, your dentist cleans, shapes, and seals the root canal. In the third appointment, they restore your tooth with a crown.

Numb the Tooth

The first step of endodontic treatment is to numb the tooth. This ensures a patient won’t feel anything during the procedure. In addition, your dentist uses a small shield to keep the infected tooth clean, dry, and isolated.

Access the Dental Pulp

After the tooth is numbed, the endodontist makes an opening through the biting surface of the tooth and into the pulp chamber. This allows them to access the dental pulp easily and quickly.

Remove the Dental Pulp

Removing dental pulp is the most important step in the process. An endodontist will carefully remove all soft tissue from within the roots and then clean and shape the root canals using small instruments. Then they place a medicated irrigation fluid into the root canal to disinfect it and rinse out debris.

Fill the Root Canal

The root canal is sealed at the end of the root and the opening toward the access in the biting surface after being professionally shaped and cleaned. A temporary filling is placed to close the access opening.

Tooth Restoration

After the treatment is complete, a patient will visit their general or family dentist to have the tooth properly restored. Common restorative treatments include a dental crown, which helps protect the tooth after endodontic therapy. The restored tooth will return to its natural function, shape, and look.

Aftercare

If the tooth is unrestored, do not chew or bite with it. Only a crown protects an endo-treated tooth from fracture. A filling does not. Thus, a patient can chew normally within a few days.

Endodontists recommend following good oral hygiene practices, such as brushing, flossing, fluoride, and teeth cleanings, after receiving endodontic treatment.

Other aftercare practices include:

• Pain Management — depending on a patient’s needs, over-the-counter medications and ibuprofen are recommended for the first few days following treatment.
• Food Restrictions — as mentioned above, chewing food with an unrestored tooth can lead to a serious fracture. It’s also crucial to avoid sticky or hard food and only eat soft food until the tooth heals.
• Recovery Time — recovery is typically quick after the tooth restoration is placed. Patients may experience mild pain for a few days after treatment.

Treatment Cost

Endodontic treatment is sometimes an alternative to tooth extractions. Instead of removing the infected tooth, an endodontist removes the infected soft tissue within the tooth, allowing the dentist to restore the tooth to normal function.

This procedure is also more expensive than tooth extractions. The cost for treatment varies depending on which tooth requires treatment:

Insurance Coverage

Coverage varies depending on a patient’s dental insurance plan. Root canal therapy is medically necessary, so insurance usually covers most of the treatment cost.