Endodontics

Root canal treatment is used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.

"Root canal" is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth's nerve lies within the root canal.

The nerve of a tooth is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory – to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

Why Does the Pulp Need to Be Removed?

When nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth. In addition to an abscess, an infection in the root canal of a tooth can cause:

What Damages a Tooth's Nerve and Pulp in the First Place?

Nerve and pulp can become irritated, inflamed and infected due to deep decay, repeated dental procedures on a tooth and/or large fillings, a crack or chip in the tooth, or trauma to the face.

What Are the Signs that a Root Canal Is Needed?

Sometimes no symptoms are present; however, signs to look for include:

What Happens During the Procedure?

Dr. Meyer will perform root canals on most teeth and most patients. However, a referral to an Endodontist may be recommended depending on the degree of difficulty and Dr. Meyer’s interdisplinary recommendations. An Endodontist is a dentist who specialized in the causes, diagnosis, prevention and treatment of diseases and injuries to the nerve of a tooth.

The first step in the procedure is to take an x-ray to see the shape of the root canals and determine if there are any signs of infection. Dr. Meyer or an Endodontist will then use local anesthesia to numb the area near the tooth.

Next, to keep the area dry and free of saliva during treatment, Dr. Meyer will place a rubber dam (a sheet of rubber) around the tooth.

An access hole will then be placed into the tooth. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files. A series of these files of increasing diameter are each subsequently 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 used periodically to flush away the debris.

Once the tooth is thoroughly cleaned, it is sealed. Dr. Meyer will wait 2-3 weeks before sealing the tooth. The Endodontist may choose to seal the tooth the same day it is cleaned out. If the root canal 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. At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth's root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.

The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown and post or a tooth colored filling needs to be placed on the tooth to protect it, and to prevent further breaking and restore it to full function.


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