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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.
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.
Common causes of root canals include:
Signs that a patient may need endodontic treatment include:
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.
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 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.
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.
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.
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.
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.
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.
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:
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:
Posterior Root Canal
Anterior Root Canal
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.
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Restoration of Root Canal-Treated Teeth: an Adhesive Dentistry Perspective. Springer International PU, 2018.
“Root Canal Treatment.” American Association of Endodontists, www.aae.org/patients/root-canal-treatment/.
“Root Canal Explained.” American Association of Endodontists, www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/root-canal-explained/.
Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.