Saving the tooth
Root Canal Therapy
Clearing infection from inside the tooth so the tooth itself can be kept rather than pulled.
Why a tooth needs one
Inside every tooth is a chamber containing nerve and blood vessels, called the pulp. Deep decay, a crack, or repeated heavy treatment on the same tooth can let bacteria reach it. Once the pulp is infected or dying it does not recover, and because the chamber is sealed inside a hard tooth, pressure builds and the pain can be severe. Left alone the infection spreads out of the root tip into the bone and forms an abscess.
Root canal therapy removes the infected pulp, disinfects and shapes the canals inside the roots, and fills them so bacteria cannot recolonise. The tooth stays in place and stays functional. The alternative is extraction, which solves the infection but leaves a gap that then has to be dealt with, usually at greater cost and effort than the root canal.
At the appointment
The tooth is X rayed and tested, then numbed with local anaesthetic. A rubber sheet is normally placed to isolate the tooth and keep saliva out of the canals. An opening is made through the top of the tooth, the pulp is removed, and the canals are cleaned and measured along their whole length. Between visits the tooth may be dressed with a medication and sealed with a temporary filling.
The procedure has a reputation for pain that mostly belongs to the infection rather than the treatment. A tooth that needs a root canal often hurts a great deal beforehand, and the treatment is what stops it. With the tooth properly numb the appointment itself is uncomfortable rather than painful, and the main complaint afterwards is usually a sore jaw from holding the mouth open.
Visits, Recovery and When to Call
Visits and timing
Commonly one or two appointments, each often an hour or more, because canals are narrow, curved and vary in number between teeth. A molar has more canals than a front tooth and takes longer. A separate later appointment is usually needed for the permanent restoration.
Afterwards
Tenderness when biting for several days is normal, since the ligament around the root has been irritated. Over the counter painkillers usually cover it. Avoid chewing hard food on that tooth until the permanent restoration is in place, because a hollowed out tooth fractures easily.
Call sooner if
Swelling develops, pain increases rather than settling after two or three days, the temporary filling comes out, or you get fever alongside the pain. Swelling that reaches the eye, the floor of the mouth or the neck, or that makes breathing or swallowing difficult, needs emergency medical care, not a dental appointment.
The tooth still needs covering
A root treated back tooth has had its centre hollowed out and is more brittle than an intact one, so it is usually restored with a crown rather than a plain filling. Skipping that step is the most common reason a technically successful root canal ends with the tooth fracturing and coming out anyway.
Keep reading
Questions About Root Canal Therapy?
Describe the problem on the phone. That conversation is usually enough to work out the first appointment. Mandarin, Taiwanese, English and Japanese are spoken.