Endodontic (Root Canal) Treatment

Endodontic treatment can often be performed in one or two visits and involves the following steps:

The endodontist makes the diagnosis by listening, clinical examination, and tests. Digital imaging is taken to study the tooth and surrounding bone structure. Once the need for root canal treatment is confirmed and the informed consent is obtained from the patient, then the endodontist administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to protect the airway and isolate the tooth and keep it clean and free of saliva during the procedure.

The endodontist makes an access opening in the crown of the tooth to enter the pulp chamber. Very small instruments called endodontic files are used to clean the inflamed pulp and infection from the pulp chamber and root canal space and to shape the space for filling. Root canal length measurements are taken to ensure the complete cleaning and shaping by using electronic or digital imaging equipment.

After the space is cleaned and shaped, the endodontist dries and fills the root canals with a material called gutta-percha which is biocompatible. The gutta-percha is placed with a root canal sealer. 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 with final filling or crown.

After root canal treatment is completed with the endodontist, the patient must return to the dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function. Root canal treatment without final restoration or crown usually fails due to recurrent infection, cracks, or fracture. Having the final restoration or crown ensures the longevity of the root canal treated tooth. Endodontist and referring dentist work together with their own expertise to help the patient to keep the tooth for lifetime. The patient continues to maintain the health of the gum and surrounding bone through home care and regular dental check ups and cleaning visits to the dentist.

If the tooth does not have sufficient structure to hold the restoration in place due to significant damage above the gumline, the dentist or endodontist may place a post inside the tooth in order to rebuild the tooth structure before the crown is made. The dentist or endodontist will discuss the details about the specific restoration planned for root canal treated tooth.

Frequently Asked Questions about Endodontic Procedure

What does the term Endodontic (Root Canal) Treatment mean?

“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Therefore, the term “endodontic’ refers to the “pulp” which resides in “pulp chamber” and “root canal space”. The term Endodontic treatment means treatment of inflammation or infection of the “pulp (root canal) space”.

To understand endodontic (root canal) treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a bone-like layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and helps to form the crown of the tooth and to grow the root(s) during development.

The pulp extends from the crown of the tooth to the tip of the root(s) where it connects to the ligament and bone tissues surrounding the root. The pulp is important during the growth and development of the tooth. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the ligament and bone tissues surrounding it.

Why would I need an Endodontic (Root Canal) procedure?

Endodontic (Root Canal) 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. These variety of causes allow the microorganisms to enter the pulp and set off the inflammation in the root canal space. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess may cause swelling.

What are the signs of needing Endodontic (Root Canal) treatment?

Signs to look for include spontaneous pain, prolonged or lingering 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 gum tissues. Sensitivity to cold or heat indicates the inflamed pulp. Tenderness to touch and chewing indicates the inflamed ligaments or bone surrounding the root. Sometimes, however, there are no symptoms. Endodontists (Root Canal Specialists) are experts in making diagnosis of the diseases of the pulp and surrounding ligament and bone tissues.

How does Endodontic (Root Canal) Treatment save the tooth?

The endodontist (root canal specialist) removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal space, a channel inside the root, then fills and seals the root canal space in order to keep the microorganisms from re-entering. Afterwards, the patient will return to the dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. Around 90% of the time, the tooth continues to function and look like any other healthy tooth.

Will I feel pain during or after the Endodontic (Root Canal) procedure?

In the real world, “Pain Relief” is achieved through “Root Canal”. In vast majority of time, endodontic (root canal) procedures successfully relieve the pain or toothaches caused by pulp inflammation or infection in reality. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.

Endodontist (Root Canal Specialists) are experts in managing pain caused by inflamed or infected pulp. Ask endodontist (root canal specialists) about how best to manage pain before the endodontic (root canal) procedure begins.

For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications such as ibuprofen and acetaminophen. If necessary, the endodontist (root canal specialist) will prescribe pain medications to keep you comfortable.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic (root canal) treatment is completed. However, if severe pain or pressure or pain that lasts more than a few days, call the endodontist (root canal specialist).

How much will the Endodontic (Root Canal) Treatment cost?

The cost varies depending on how complex the problem is and which tooth is affected. Teeth with multiple roots are generally more difficult to treat. The more difficult to treat, the fee is usually higher. Most dental insurance policies provide some coverage for endodontic (root canal) treatment.

Generally, endodontic (root canal) 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 which can cause discrepancy in biting. The procedures to replace the extracted tooth with a bridge or dental implant tend to cost more than endodontic (root canal) treatment and the follow up restoration. Root canal treatment not only saves natural teeth and but also money.

Will the tooth need any special care or additional treatment after Endodontic (Root Canal) 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 to avoid failure. 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 (root canal) 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, revising the endodontic (root canal) procedure or surgical procedure can save the tooth.

What causes an endodontically (root canal) treated tooth to need revisional treatment?

New trauma, deep decay, or a loose, cracked or broken filling can allow new infection inside your tooth. In some cases, the endodontist (root canal specialist) may discover additional very narrow or curved canals that could not be treated during the initial treatment.

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 or split, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontic knowledge and technology are making it possible to save teeth that even a few years ago would have been lost. When endodontic (root canal) treatment is not effective, endodontic (root canal) surgery may be able to save the tooth.