The Basics of Root Canal Treatment

female patient and her dentist preparing for treatment

When a tooth is so damaged through decay or cracking that future infection is a certainty, root canal treatment becomes necessary. The most common endodontic procedure is known as a pulpectomy, where the dental pulp is removed to prevent further infection. In this treatment, the dentist will drill into the pulp chamber (if that’s still necessary), and the infected pulp is removed. After that, the nerves will be drilled out of the canals themselves and then filled in the canals with inert material. This procedure is also known as root canal therapy.

What is a root canal and how is it done?

The therapy doesn’t necessarily start with the surgery itself. In some cases, gum blisters may have developed, and it may be necessary to drain the abscess by cutting at the gums and letting the pus leak out. Antibiotic treatment will then be prescribed. This will make it easier for the anesthetic to work for the actual surgery itself. The attending dentist will also have to check if the patient is having tooth-grinding concerns, as that can also trigger pain attacks.

A pulpectomy combined with root canal treatment may also be performed, where all the pulp will be removed and a temporary filling and dressing will be applied, until the pain and infection lessens enough for proper surgery. A similar treatment, pulpotomy, leaves the nerves in the canals. This treatment eliminates most if not all of the pain. As the nerves and blood supply are removed from the tooth, it will be necessary to fit a crown for it.

A root canal is a dental procedure that removes infected or inflamed pulp from inside a tooth, followed by sealing the canal to prevent further infection. Here’s a breakdown of the steps involved:

Before the procedure:

  • Diagnosis and X-rays: Your dentist will examine your tooth and take X-rays to determine the extent of the infection and plan the procedure.
  • Anesthesia: Local anesthesia is typically used to numb the area around the tooth. In some cases, general anesthesia may be necessary.
  • Isolation: A rubber dam is placed around the tooth to isolate it from the rest of your mouth and prevent swallowing of instruments or debris.

During the procedure:

  1. Access and drilling: Your dentist will create an opening in the top of the tooth to access the pulp chamber. They will then use specialised rotating instruments to remove the infected pulp from the root canals.
  2. Cleaning and shaping: The canals are cleaned and irrigated with disinfecting solutions to remove any remaining bacteria or debris. They are then shaped to allow for proper filling.
  3. Filling the canals: Biocompatible material like gutta-percha is used to fill the cleaned and shaped canals to prevent further infection.
  4. Sealing the tooth: A temporary or permanent filling is placed over the access opening to seal the tooth.

After the procedure:

  • Pain and discomfort: Some pain and sensitivity are common after a root canal, but it can be managed with over-the-counter pain medication. Your dentist may prescribe antibiotics if there’s a risk of infection.
  • Follow-up appointment: A follow-up appointment is usually scheduled within a week to monitor the healing and potentially place a permanent crown on the tooth to restore its strength and function.

Important Notes:

  • Root canals are generally safe and effective procedures. However, complications like infection, damage to surrounding teeth or nerves, and fractures can occur in rare cases.
  • Discuss any concerns or potential risks with your dentist before the procedure.
  • Maintaining good oral hygiene after a root canal is crucial to prevent future infections.

Remember, this is a general overview and specific details may vary depending on your individual case. Always consult your dentist for personalised information and guidance regarding your root canal procedure.

A dental crown covers the grinding edge of the tooth, and seals the treated tooth. However, unlike natural teeth, a tooth that has had its blood supply and nerves removed is actually more susceptible to decay, given that the patient cannot fail the pain anymore. Also, the tooth structure isn’t hydrated by blood anymore, making it more prone to damage. Regular visits to the dentist for X-rays will ensure if the root canal surgery is successful, or if further treatments are needed.

How Painful Is It After A Root Canal?

When done properly, a root canal treatment is said to be painless. The pain reported by people who have undergone root canal treatment is mainly caused by the tooth infection and not by the procedure per se. Patients will experience sensitivity and discomfort around the treated tooth for five days at most. there are medications that the surgeon will provide you during the procedure and after the treatment for home use.

The pain experienced after a root canal can vary greatly from person to person, and even from tooth to tooth for the same person. Here’s a breakdown of what to expect:

Immediately after:

  • Most people experience mild to moderate discomfort or soreness for a few days. This is due to inflammation and sensitivity in the area.
  • Some people may have minimal to no pain at all. This is especially true if the tooth was already numb before the procedure due to an existing infection.
  • Aching, throbbing, or pressure sensation is common. This can be mistaken for pain, but it’s usually just the tooth healing and adjusting.

Within the first week:

  • The discomfort typically peaks within 24-48 hours and gradually subsides over the next few days.
  • Pain medication prescribed by your dentist can effectively manage any discomfort. Over-the-counter pain relievers like ibuprofen or acetaminophen can also be helpful.
  • Applying ice packs to the affected cheek can reduce swelling and pain.

Factors influencing pain:

  • Severity of the infection: Teeth with more severe infections may experience more pain after the procedure.
  • Individual pain tolerance: Some people are naturally more sensitive to pain than others.
  • Complexity of the procedure: More complex root canals on multiple roots may cause more discomfort.
  • Personal anxiety or fear: Anxiety and stress can amplify the perception of pain.

Tips for managing pain:

  • Follow your dentist’s instructions for medication and care.
  • Take it easy for the first few days to allow your body to focus on healing.
  • Spoil your taste buds with delicious and easy-on-the-teeth options like soups, purees, and steamed vegetables.
  • Keep it gentle! Brush and floss around the treated tooth carefully.
  • Contact your dentist if you experience severe pain, swelling, or fever.

Why is a root canal done in two visits?
Patients with complicated cases including those with curved roots or serious infection will need the procedure to be done in two stages to ensure that the necessary steps are made to prevent reinfection. Patients undergo crown installation a few weeks after root canal treatment to seal the tooth properly.

  1. Infection Control: The process typically starts with cleaning and disinfecting the infected tooth. In cases of severe infection, it may be necessary to address it over multiple visits to ensure complete elimination.
  2. Managing Inflammation: By conducting the treatment in stages, it allows time for the tissues to heal and any inflammation to subside before completing the procedure. This reduces discomfort and promotes better healing.
  3. Complexity of the Procedure: Some root canals can be intricate, particularly if the tooth has multiple canals or if the infection is extensive. Breaking down the treatment into multiple visits allows the dentist to focus on different aspects of the procedure thoroughly.
  4. Temporary Fillings: After the initial visit, the dentist might place a temporary filling or medication to alleviate symptoms and protect the tooth until the next appointment, ensuring the tooth remains functional between visits.
  5. Customised Treatment: Conducting a root canal in two or more visits allows for a more tailored approach, ensuring that each step of the process is performed meticulously and with precision, reducing the risk of complications and ensuring a successful outcome.
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