Frecuently Asked Questions about Endodontic Treatment
- What is Endodontics?
- What is a root canal?
- What is the dental pulp?
- What happens if the pulp gets injured?
- Why does the pulp need to be removed?
- Why would I need an endodontic procedure?
- I'm worried about x-rays. Should I be?
- What about infection?
- What are the signs of needing endodontic treatment?
- How does endodontic treatment save the tooth?
- Will I feel pain during or after the procedure?
- What is the normal Endodontic Procedure?
- How much will the procedure cost?
- Will the tooth need any special care or additional treatment after endodontic treatment?
- What causes an endodontically treated tooth to need additional treatment?
- Can all teeth be treated endodontically?
What is Endodontics?
Endodontics is the branch of dentistry concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including the biology of the normal pulp, and the etiology, diagnosis, prevention, and treatment of diseases and injuries of the pulp and associated periradicular conditions.
What is a root canal?
Root canal treatment involves the use of biologically acceptable chemical and mechanical treatment of the root canal system to eliminate pulpal and periradicular disease(s) and to promote healing and repair of the periradicular tissues. First, the endodontist will administer local anesthetic to make the procedure comfortable. Next, an access will be made through the crown or tooth. Once all of the canals are located, the lengths of the roots will be determined. The debridement and shaping of the canal system with the use of hand files and engine driven rotary files facilitates the chemical cleaning and disinfecting of the canal system. Once the canal system is as clean as possible, it is dried and sealed with a biologically acceptable nonresorbable semi-solid or solid root canal obturating material. Your endodontist will typically place a temporary filling in the access opening. After root canal treatment, a permanent filling or crown will be necessary to restore the tooth back to function.
Your dentist uses root canal treatment to find the cause and then treat problems of the tooth's soft core (the dental pulp). Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment has given dentists a safe way of saving teeth.
What is the dental pulp?
The pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.
What happens if the pulp gets injured?
An abscessed (infected) tooth caused by tooth decay. When the pulp is diseased or injured and can't repair itself, it dies. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tip, in the jawbone, forming a "pus-pocket" called an abscess. An abscess can cause damage to the bone around the teeth.
Why does the pulp need to be removed?
When the infected pulp is not removed, pain and swelling can result. Certain byproducts of the infection can injure your jaw bones. Without treatment, your tooth may have to be removed.
Why would I need an endodontic procedure?
Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
I'm worried about x-rays. Should I be?
No. While x-rays will be necessary during your endodontics treatment, we use an advanced non-film computerized system, called digital radiography, that produces radiation levels up to 90 percent lower than those of already low-dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to co-therapists via e-mail or diskette. For more information contact Schick Technologies, Inc.
What about infection?
Again, there's no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.
What are the signs of needing endodontic treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.
How does endodontic treatment save the tooth?
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, a channel inside the root, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Will I feel pain during or after the procedure?
Although the average treatment time is about 24 months, this varies with individual patients. Usually, adult treatment takes a little longer than a child's treatment. Other things to keep in mind are the severity of the problem, the health of the teeth, gums and supporting bone and how closely the patient follows instructions. While Endodontic treatment requires a time commitment, most people feel the benefits are well worth the time invested.
What is the normal Endodontic Procedure?
1. The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure. |
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2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling. |
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3. After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored. |
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4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function. If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth. |
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How much will the procedure cost?
The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat, the fee is usually more. Most dental insurance policies provide some coverage for endodontic treatment.
Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.
Will the tooth need any special care or additional treatment after endodontic treatment?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.
Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.
What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure.
Can all teeth be treated endodontically?
Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.