Frequently Asked Questions About Root Canal
There are often a lot of questions surrounding root canal treatment. In order to help clear up some of the confusion, we’ve compiled a list of the most commonly asked questions about root canal procedures and answered them below:
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An endodontist is a dental specialist who has received one to two additional years of extensive training in the diagnosis of oral or facial pain and the treatment of that pain with root canal procedures and other methods that focus on treating the soft tissues inside and around the teeth.
The aim of endodontic treatments is to treat and relieve the issues that are causing your dental pain while saving the tooth rather than extracting it whenever possible. While there’s no guarantee, in many cases endodontic treatment or endodontic surgery can save a tooth that has become infected or diseased.
Endodontic treatment makes use of equipment and tools that are usually more sophisticated than what can be found in a general dentistry office, which allows for a more precise look at what is going on inside your teeth. This allows your endodontist to make a more accurate diagnosis of the cause of your pain, and also offer you treatment options that are better tailored to treating your specific situation.
The success rate of endodontic treatments is very high and when performed by an endodontic specialist, routine treatments can usually be performed in an hour or less and within one visit.
Many people hear that they might need to have a root canal and cringe automatically, without even really knowing what the procedure entails. Root canals have long been the punchline to jokes about unpleasant experiences, but this misconception is actually very outdated. Modern root canal procedures have little resemblance to the lengthy, painful process that earned them such a bad reputation in the past, when pain control techniques were not as precise as they are today. It was also much more difficult to assess the actual condition of the unseen parts of the tooth before the procedure began, which often led to situations in which more work was required than originally expected and that could mean a very long time in the dentist chair for the patient.
Thankfully, this is no longer the case. Today, making sure that patients are comfortably anesthetized during any potentially painful procedure is of the utmost importance in the dental field, and endodontics places an emphasis on understanding and achieving proper pain control techniques. Patients will have the option to choose their preferred pain control method prior to the procedure and will be kept numb throughout. You will feel vibrations and occasional pressure in the area being worked on, but you should not feel any pain during the procedure. In the unlikely event that you do feel pain, let your endodontist know immediately and your anesthesia can be adjusted as needed.
Afterward, the area around the affected tooth will be a little tender, so you may need to be cautious of your bite pressure on that side, but this should resolve after three or four days. Most patients have immediate relief following a root canal, because the procedure will have removed the infection that was causing any pain or sensitivity in your tooth.
Endodontic procedures are needed when you have a tooth that has become infected. This infection is called an abscess, and it occurs in or around the root of your tooth. Abscesses develop when the soft tissue (usually referred to as the “pulp”) inside your tooth has died and left untreated, has become inflamed and then infected. If you want a procedure that will save your tooth rather than having it extracted, which can be more costly than a root canal and result in the eventual shifting of your other teeth, then an endodontic treatment is the only form of treatment that will eliminate the infected tissue within your tooth.
Some patients inquire about the possibility of taking antibiotics to treat the infection, and while this can be helpful to some degree, it will not cure the infection entirely. Because the infected pulp is inside of your tooth, antibiotics will not eliminate the infection at the source. Endodontic treatment involves the removal of infected tissue, which is the only way to completely get rid of the cause of the infection.
Typically, patients who are referred to an endodontic specialist by their general dentist after they have been experiencing one or many of the following symptoms:
● Pain in and around the tooth
● Uncomfortable sensitivity to heat and cold
● Swelling in the face or areas around the teeth
● An aching sensation in the bone around the tooth
● Swollen gums
● Pain when chewing
It may sound unlikely, but there are often cases in which the infection developing in your tooth that will eventually lead to the necessity of a root canal may occur without you even being aware that it is happening. Some infected teeth are only becoming painful in the later stages of the infection. A chronic infection may first present itself as discomfort, but it might not exactly be painful.
Any tooth pain or discomfort, however minor it may seem at the time, should not be ignored. A tooth that is infected will eventually become painful, and treatment should not be delayed just because you are not experiencing acute pain right away. The sooner you seek treatment, the more likely your endodontist will be able to save your tooth, as well as prevent further complications that can arise from an infection that has been left untreated.
When a tooth has become painful, it often means that the pulp within your tooth and the surrounding soft tissue have become infected. This occurs when something has allowed bacteria to reach the pulp, or root canal, in your tooth. There are several ways this can occur – most commonly it happens when a tooth has begun to decay when a cavity has developed and gone untreated when a tooth has been fractured or cracked, or as a result of periodontal disease. This bacteria will cause the pulp in your tooth to become inflamed and eventually infected.
The treatment for this condition is usually a root canal, which is an endodontic procedure in which your specialist will remove the pulp in your tooth that has become diseased. When that is done, the inside of your tooth will be sterilized, and then the canals will be filled with a rubbery substance called Gutta-percha, which will conform to the spaces left in your canals. Your tooth will then be filled with cotton and a temporary filling, both of which will be removed by your general dentist when you see him to have the permanent crown placed on your tooth
A root canal treatment will eliminate the infected tissue within your tooth, seal the places where the infection occurred and prevent the possibility of further infections while allowing your tooth to continue functioning as normal. A crown should be placed on your tooth within a week or two of your root canal by your general dentist, and this will provide further protection to the tooth, preventing it from cracking and becoming infected again.
This can differ depending on which tooth will need treatment, but the typical cost ranges from around $700 to $1500. You’ll need to speak to your insurance company about what your coverage will provide, but with most root canals, copays generally range from somewhere between 20-50%. There may also be alternative payment plans that we can offer you.
It’s also worth noting that this fee refers only to the endodontic procedure, but does not include the cost of the crown that will need to be placed on your tooth by your general dentist within a week or two following your root canal.
A tooth can almost always be treated with an endodontic treatment procedure. However, there are some cases in which conditions may have occurred that have made the root canals within your tooth inaccessible, making it impossible to save the tooth.
This can also be the case with a tooth that has been seriously fractured and cannot be restored. There are also many cases in which a routine endodontic treatment may not be enough, but endodontic surgery can still save the tooth.
One such option is an apicoectomy. This is a surgical procedure that is sometimes needed when a routine root canal treatment has been performed, but the bone surrounding the affected tooth has not been able to heal from the infection. It may also be needed when your endodontist is not able to access and completely clean out all of the infected tissue at the end of the root during a routine root canal. Leaving any infected tissue in the root means that your tooth will not heal properly and will continue to cause you pain. An apicoectomy is sometimes the only way to remove the tip of the root in order to remove all infection, which will allow your tooth to heal.
Apicoectomies are performed by accessing the root of your tooth from under your gums rather than from the top of your tooth. The tip, or apex, of the root, will be removed, the root canal will be cleaned out, and then the root will be sealed.
You will need to avoid eating for an hour after your procedure and continue to be mindful and cautious of the treated tooth for the week following treatment. It is very uncommon for patients to have complications following a routine endodontic procedure. You will need to schedule an appointment with your general dentist to have a crown placed on the treated tooth. This should be done within two weeks after your root canal.
If the infection in your tooth was severe, your root canal may be performed over the course of two visits to your endodontist. During your first visit, an antibiotic paste will be placed inside your tooth to directly treat the infected area before your tooth can be resealed during your second visit.
The actual root canal procedure takes between 20 to 60 minutes, start to finish. Patients come into the office and go home the same day. In fact, morning appointments are out by lunchtime, and afternoon appointments are out by dinnertime.
On occasion, a tooth that has been treated with a root canal does need to retreat. This can happen for a few different reasons. It’s possible to miss a canal during treatment, which means that infection can reoccur because not all of the diseased pulp was able to removed. Infections can also develop again if the crown placed on your tooth after your first procedure was not placed properly and has allowed bacteria back into the tooth. Fortunately, root canals that are performed by an endodontic specialist rather than a general dentist have a higher success rate.
The endodontist numbs the affected area. After some protective procedures for the tooth, an opening is created in the top, and the tooth’s pulp is removed from the tooth itself and the canals. The number of canals depends on the type of tooth and its location. The canals are carefully cleaned and disinfected. Shaping of the canals then begins, to ensure all infected tissue is gone and there is sufficient room to fill the root canals. During the time, X-rays are taken to verify proper shaping and cleaning of the root canals.
Some root canals are done in one visit, while others require two sessions. For a primary appointment, the endodontist places medication in the root canal to kill bacteria and then places a temporary filling on the tooth. Prescribing antibiotics is the norm, with the next appointment scheduled in about a week.
For one session root canals, the endodontist fills the root canal with natural latex known as gutta percha. A sealing solution is then applied, and a temporary filling is put in place. The same procedure is done for two session root canals, although the original temporary filling requires removal.
A dentist will put in a permanent crown to prevent future breakage. A post placed in a canal can serve as an anchor for the permanent filling.
Many patients are in pain from the infected tooth itself, so the root canal offers relief. While root canals were painful decades ago – hence the jokes about unpleasant things people would rather do than have a root canal – that’s not the case today. Good anesthesia and proper surgical techniques mean that most patients feel no more pain during a root canal than they would during any dental procedure. While patients may feel some pain in the days following the root canal, it is usually manageable with over-the-counter pain relievers. If you experience a lot of pain weeks or months after a root canal, that signals a problem, possibly another infection. Contact your dentist immediately if this occurs.
While you can eat after a root canal, it is important to avoid chewing with the affected tooth. Without restoration by a dentist, the tooth is fragile and may easily break. Eat soft foods and avoid harder crunchier items. It is not a good idea to consume nuts, popcorn or anything requiring vigorous chewing or tending to get stuck in teeth.
Temporary fillings are designed to last between six to eight weeks. It is important to return to the dentist as scheduled to have permanent sealing and a crown put on the tooth. Failure to do so not only endangers your tooth but your overall health. A temporary filling left in too long can result in tooth infection, gum disease and the loss of the tooth. You also cannot eat normally with a temporary filling.
After the root canal, the affected tooth may remain sensitive for several days. Over-the-counter non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen or naproxen are sufficient for pain relief after a root canal. The medications are marketed under the trade names such as Advil, Motrin or Aleve, as well as generically. If the patient experiences severe pain – which is unusual – the endodontist can prescribe stronger medications for short-term use. You may also try rinsing your mouth with a salt water solution several times daily to reduce any swelling. Put one teaspoon of salt in an 8-ounce glass of warm water and stir well before using.
Many patients require only one or two visits for a root canal. The first appointment cleans out and shapes the tooth’s root canal, and the second appointment focuses on tooth filling and sealing. If two appointments are scheduled, they are generally a week apart. Much depends on whether or not the tooth still has live pulp. If the tooth is dead – necrotic – or harbors an infection, two appointments are the best choice. Although the two appointment system does require an additional visit, any infections or other issues appearing in that time frame are addressed by the practitioner. The next step, performed by a general dentist, is preparation for a crown.
The root canal is the removal of infected tissue within the tooth and its canals. Within several weeks of the root canal, the tooth undergoes a buildup to replace its interior. An impression is made of the tooth to design the crown.
Without a crown, the affected tooth is likely to break. If that happens, an extraction and bridge are needed. A temporary crown is cemented in place while the permanent crown is under creation in a laboratory. The temporary crown is generally in use for about two weeks. The permanent crown is made of metal or porcelain, and permanent cement is used to keep it in place. While crowns are not inexpensive, they are designed to last for decades.
The build up – which must take place within several weeks after the root canal – basically rebuilds the interior of the affected tooth with a composite material. This may include adding a post to the canal to provide more security for the buildup. The buildup itself isn’t strong enough for regular chewing, so a crown is needed to protect a rebuilt tooth. A crown also serves an aesthetic purpose – a buildup doesn’t look like a normal tooth.
A dentist may prescribe antibiotics before the root canal for pain reduction, but antibiotics cannot kill the infection within a tooth. That’s because these drugs cannot reach the source of the infection within the tooth since there is no blood supply there. Some patients may receive an antibiotic prescription after the root canal, but whether or not a patient receives post-root canal antibiotics is based on their specific medical needs.
You can eat with a temporary filling, but you must be careful. Wait until numbness from the anesthetic subsides before consuming any hot foods or beverages. Avoid chewing on the side of your mouth with the temporary filling. In general, stick to softer foods while you have the temporary filling, and don’t eat harder crunchier items. Don’t chew gum when you have a temporary filling.
It is possible for a tooth to become infected after a root canal. A tooth’s roots include branches of the primary canals. Although every endodontist strives to thoroughly clean the canals and remove all infected tissue, bits of infection may remain behind. Should re-infection occur, a second root canal or an extraction is not automatically needed. Instead, the endodontist may perform a procedure called an apicoectomy. This involves removing the root tip and infected material. After the removal, a filling is put in place. Whether an apicoectomy is appropriate instead of another root canal depends on the individual situation.
It is imperative to replace a temporary filling within the designated time after the root canal. That’s four to eight weeks. Delaying the replacement of a permanent filling may allow bacteria to enter the tooth and cause re-infection.
Temporary fillings are not designed for the long-term. At most, they are good for about four weeks after the root canal. Failing to return for a permanent filling increases the odds of re-infection, with a possible loss of the tooth or a second root canal. In a worst-case scenario, the infection goes into the bloodstream and can cause life-threatening illness.
Yes, good oral hygiene remains crucial after a root canal. However, you must take extra care when brushing your teeth. Use a soft toothbrush and do not brush too vigorously. It is also important to floss, but take care around the filling. You don’t want to catch the edge of the filling on the floss and accidentally dislodge it.
Yes, a temporary tooth filling can fall out. If this happens, call your dentist immediately. Keep the odds of losing a temporary filling low by not chewing on the side of your mouth containing the affected tooth, and avoiding harder foods. Use a soft toothbrush and take care when you floss. You want to make sure the floss doesn’t catch on the temporary filling, and you accidentally pull on it and lose it.
Most people can drive themselves home after the root canal. The anesthetic wears off soon after the procedure and the patient is fit to drive. Patients may want to relax a while in the waiting room after the surgery until they feel completely “normal.” If you have any doubts about your ability to drive yourself home, arrange for a ride with family, friends or a car service.
Patients needing a root canal usually experience severe pain from the infected tooth. However, that’s not always the case. Contact your dentist immediately if you suffer from any of the following:
A dull pain in the mouth that gets worse with time
Considerable pain when eating or drinking
A tooth that is tender to the touch
Sensitivity to hot or cold food or drink
Gum swelling in the area experiencing tooth pain
Swelling around the jaw and cheeks
What looks like a pimple on the gums – this is an abscess. Do not squeeze it.
It is possible to break a tooth and not feel much if any, pain. Always see a dentist as soon as possible if you have broken or chipped a tooth. A root canal might save it.
The cost of a root canal depends upon the affected tooth. Since more work is required in treating molars, patients pay more for these teeth. On average, a root canal costs about $1,000. That does not include follow-up procedures, including a filling or a crown. Expect to pay up to $500 for the former and up to $1,200 for the crown and build up. However, those fees are usually less expensive than having the affected tooth pulled and bridge.
After your root canal, expect to deal with mouth pain for several days. Over-the-counter pain medications are usually sufficient to deal with this discomfort, but the dentist can prescribe stronger medication if necessary. Your endodontist will give you instructions on eating and oral hygiene after your root canal. Make sure to follow these instructions, and call the office if you have any questions. If your mouth swells up significantly or you experience an allergic reaction to any medication, call the endodontist immediately.
Avoid using the affected tooth for chewing or biting until it is restored. Stay away from harder foods during this time, and don’t chew gum. While you should brush and floss, as usual, take extra care in the area of the temporary filling. The root canal itself is just one part of the process. The next, vital step is restoration. Make an appointment for this stage with your dentist within a few weeks of the root canal.
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