Root Canal Therapy

What is root canal therapy? 

Root canal (endodontic) therapy involves removing and cleaning out the infected nerve (pulp) tissue within a tooth’s root and filling it with a biocompatible material. 

When would I need a root canal? 

When a tooth becomes irreversibly decayed, fractured, or traumatized into its nerve (pulp), a root canal is often indicated to preserve the natural tooth and prevent removal (extraction). 

What does a root canal involve? 

First, local anesthetic will be administered to the tooth and surrounding gum. A rubber sheet will be placed over the tooth to keep it free of contaminants and prevent accidental ingestion of dental materials, irrigants, and/or small instruments. Next, a small opening (access) will be made into the tooth to allow visualization of the nerve and tooth roots. The infected tissue is removed with thin files and the surrounding tooth is disinfected of bacteria. A biocompatible filling material (gutta percha) is then placed into the root space along with a sealing paste. Finally, a tooth-colored resin filling is applied to cover the initial opening and prevent bacterial leakage. 

Do I need a dental crown after a root canal? 

This depends upon several factors including tooth location and the amount of intact tooth remaining. After a root canal is completed, the tooth becomes more prone to fracture due to a loss of structural integrity. In general, teeth towards the back of the mouth (molars and premolars) experience the highest chewing forces and often require crowns. Teeth towards the front, such as incisors and canines, are subject to significantly less chewing force and do not always necessitate crowns. 

I have an existing crown and need a root canal. Does this mean I will also need a new crown? 

Not necessarily - often times, if there is minimal to no decay, a root canal can be performed through an existing crown. A small hole is made through the crown to access the roots, which are subsequently cleaned out. A resin filling is placed to seal off the initial opening. However, if there is significant decay beneath the crown, it will likely need to be removed to completely clean out the tooth. In this case, a new crown will be needed. 

What can I expect after root canal therapy? 

After a root canal is completed, you may notice slight tenderness and sensitivity for a few days. This can be usually managed with over-the-counter pain medications. It is a good idea to avoid chewing on the tooth, particularly hard and/or crunchy foods. Once the tooth has healed, continue brushing and flossing daily to keep the area clean. Although the nerve has been removed, the tooth itself can still develop decay. 

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