Root canal therapy refers to the process by which a dentist treats the inner aspects of a tooth, specifically that area inside a tooth that is occupied by its “pulp tissue.” Most people would probably refer to a tooth’s pulp tissue as its “nerve.” While a tooth’s pulp tissue does contain nerve fibers it is also composed of arteries, veins, lymph vessels, and connective tissue.
The pulp chamber that travels down the length of the root to the tip is called a root canal. Human teeth may have one to four root canals, depending on the anatomy of the tooth. Molars may have 2 to 4 canals, premolars may have 1 to 2 canals, cuspids may have 1 to 2 canals, and finally incisors generally have 1 canal. Extra canals may branch out from the main canal, called “accessory canals.” The number of canals and the anatomy can vary among teeth.
The most common causes of pulpal nerve damage are:
Physical irritation – generally brought on by aggressive tooth decay (cavity) reaching down to the nerve or through deep fillings, which allows harmful bacteria to reach the nerve resulting in infection and decay
Trauma – a blow to a tooth or the jaw can cause damage to sensitive nerve tissue within the tooth.
The most common symptoms of pulpal nerve damage are pain in the tooth when biting down, tooth pain while chewing, oversensitivity of the teeth with hot or cold drinks and facial swelling. However, each individual may experience symptoms differently.
What is involved in root canal therapy?
If your general dentist recommends a root canal, he or she will perform the treatment or refer you for treatment to an endodontist, which is a specialist who treats injuries, diseases, and infections of the tooth pulp.
A space is created into the tooth’s pulp chamber, which, along with any infected root canal, is cleaned of all diseased pulp and reshaped.
Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination or the dentist may immediately fill the canals.
Temporary fillings are usually removed and the pulp chamber and canals are filled on the next visit. If the tooth is still weak, a post may be inserted above the canal filling to help rebuild the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve its appearance.
Post-Operative Care Following a Root Canal:
Once the root canal therapy is completed, there will be changes to adapt to, including:
Brittleness – a pulp-less tooth is more brittle than a non-treated tooth and great care should be used to avoid fracture and chipping.
Discoloration – a non-vital tooth may become discolored over time, which can be treated with bleaching. In most cases, the discoloration poses no threat to the health of the tooth.
After treatment there may be some inflammation around the gum tissues, which may cause discomfort for a few days. This can be controlled by an over-the-counter pain reliever. A follow-up visit to your dentist will help him or her review how the tissue is healing. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth, and see your dentist on a regular basis for cleanings and examinations.
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