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Root Canal Therapy
Root canal therapy is a treatment used to repair and save a tooth that is badly decayed or infected. Root canal therapy is performed when the pulp, which is composed of nerves and blood vessels in the tooth, becomes infected or damaged. During root canal therapy, the pulp is removed, and the inside of the tooth is cleaned and sealed. People fear root canals because they assume they are painful, however, most people report that the procedure itself is no more painful than having a filling placed. The discomfort experienced in the period leading up to seeking dental care is truly painful, not the procedure itself.
If you need a root canal and it’s left untreated, there is a risk of getting an infection or having a tooth abscess manifest. A tooth abscess is a bacterial infection in the inner part of the tooth where pus has formed and can result in moderate to severe pain. It can spread down to the root and cause inflammation and swelling. Once inflammation occurs, it will force the pus into a tight space (known as the abscess) at the tip of the root where the swelling exists. The symptoms can lead to pulp death, bone loss, and a full loss of the tooth itself. Additional symptoms that indicate the need for root canal therapy include holes in the tooth, gum swelling, discoloration (darkening) of the tooth, or prolonged sensitivity.
Root canal therapy can be performed by a dentist or an endodontist. An endodontist is a dentist that specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the tooth's dental pulp. Depending on the severity of the root canal procedure needed, the dentist may suggest an endodontist. The first step of the procedure is taking an X-ray to asses the shape of the root canals and check to see if there are any signs of infection in the surrounding bone. The dentist may or may not administer anesthesia to numb the area by the tooth. Anesthesia may not be needed, but most dentists will administer it to make sure the patient is relaxed and at ease.
Next, the dentist will place a sheet of rubber called a rubber dam, to keep the area dry and free of saliva during the procedure. An access hole will be drilled into the tooth and the pulp, along with bacteria and debris, is removed from the tooth. After this step, the cleaning-out process occurs which is when root canal files are placed into the access hole and worked down the full length of the tooth, to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is occasionally used to flush out the debris.
Once the tooth is thoroughly cleaned, the next step is sealing. Some dentists will wait a week before sealing the tooth and some dentists will seal the tooth the same day after cleaning. If for instance, there is an infection, the dentist may wait a week before sealing the tooth and put medication inside the tooth to clear it up. If root canal therapy is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep contaminants out between appointments. The interior of the tooth will be filled with a sealer paste and a rubber compound called gutta-percha during the next appointment. To fill the exterior access hole, a filling is placed. The final step may include further restoration of the tooth. Root canal therapy often involved a large filling or extensive decay or other weakness. The dentist will discuss the need for any additional dental work with you.