Root Canals

What is a root canal? Why do I need one?

Your teeth are meant to last a lifetime. Years ago, diseased or injured teeth were often pulled. But today, even if the pulp inside one of your teeth is injured or infected, the tooth often can be saved through root canal (endodontic) treatment.

How does the pulp get injured or infected?

Infected or Injured Pulp
There are a few ways that the pulp can be affected, but they are very similar to other injury causes. One way is very deep decay, or cavity that infects deep into the pulp and causes it to become irritated and sometimes infected, this process can be very painful. Another way is if the tooth has suffered fro m trauma, like a blunt hit, maybe a sports accident or a hard bite of candy or food. Due to the blunt force to the tooth you are essentially bruising the pulp which will cause it to die slowly over time, which may not always be painful. The pulp is the life of the tooth, which also provides the tooth with nutrients that keep it alive and healthy so in some cases the tooth may turn dark or gray in color. 

How do you treat the pulp or infection?

Treating Infected or Injured Pulp
Now that we know the pulp in infected or damaged, it needs to be removed. As you can see in the picture to the left, the pulp fills a large space in the crown portion of the tooth and also in the canals of the roots, hence the name “Root Canal”.  During the procedure, a small hole is made in the top of the tooth in order to access the canals and all cavity is removed. We then use a series of small files to slowly remove the pulp from each canal, it is very critical to the life of  a root canal that all of the pulp is removed. Once everything is removed, the space that was occupied by the pulp in the canals now needs to be filled and sealed to ensure that bacteria does not transfer from the crown of the tooth to the end of the root as well as the other way around. This another very critical part of the root canal process. Each canal needs to be sealed from one end to the other, any shortness can allow for re-infection and future pain. Several x-rays are usually taken during this process to ensure accuracy. A special material called Guttapercha fills each canal, while another resin material much like composite fills the void made in the crown portion of the tooth, this is called build up.

What happens after the root canal?

X-Ray of a Root Canal
The large white area in the photo the left is a temporary filling that is filling the large hole that was originally cavity and any other structure that needed to be removed to access the canals of the tooth. As you can see, this is a very large portion of the tooth, easily more than 60% of the original tooth structure. The tooth is very weak at this point and the chances of it breaking  or fracturing are very high. It is because of this reason that the tooth will require a further restoration in order to stabilize and protect the tooth. This type of restoration will either be a porcelain onlay or a full coverage crown and this restoration can also be prepped at the same appointment as the root canal in most cases. 

What will happen if I do not do the Root Canal?

Consequence of Not Having a Root Canal
You will end up losing the tooth. Once the pulp is damaged, regardless of what caused it, it is only a matter of time before infection starts to develop if it hasn’t already. Infection starts growing at the apex or end of the tooth and can continue to grow until the infection releases itself in whats called a facial abcess or fistula. This is a small blister on the gum area around the tooth that is filled with infection and sometimes will need to be drained prior to the root canal treatment. As long as the infection is present, it is constantly eating away at the bone structure holding the tooth in place. Eventually the infection will have damaged so much of the surrounding bone that the tooth will become loose and will need to be removed. The photo above shows what will happen when a tooth has gone missing for too long and the teeth around it begin shifting. So as you can see a root canal may not be the most exciting thing to do, but will save you from pain, other tooth problems and  definitely more money in the future.