Root Canal Treatment

Root canal treatment, also called endodontic treatment, involves relieving pain and discomfort by removing the nerve tissue (called pulp) located in the center of the tooth and its root or roots (called the root canal). Treatment involves drilling through the biting surface of the tooth to expose the pulp, which is removed with very fine metal files. Medications may be used to sterilize the interior of the tooth to prevent further infection.

Each empty root canal is filled with a rubber-like material and medicated cement. Occasionally a metal pin (called a post) is also inserted into the canal to help restore the tooth. The opening in the tooth is closed with a temporary filling. At a later appointment, a cap (also called a crown) may be placed.

Twisted, curved or blocked root canals may prevent removal of all inflamed or infected pulp. Since leaving any pulp in the root canal may cause your symptoms to continue or worsen, this might require an additional procedure called an apicoectomy. Through a small opening cut in the gums and surrounding bone, any remaining pulp is removed and the root canal is sealed. An apicoectomy may also be required if your symptoms continue and your tooth does not heal.

Once the root canal treatment is completed, it is essential to return promptly to have treatment completed. Because a temporary seal is designed to last only a short time, failing to return as directed to have the tooth sealed permanently with a crown could lead to the deterioration of the seal, resulting in decay, infection, gum disease and the possible premature loss of the tooth.
Benefits and alternatives

Root canal treatment is intended to allow you to keep your tooth for a longer period, which will help to maintain your natural bite and the healthy functioning of your jaws. Extracting your tooth is the most common alternative to root canal treatment. This alternative may require replacing the extracted tooth with a removable or fixed bridge or an artificial tooth called an implant.
Common risks

1. Bleeding, pain, soreness and infection: During and after treatment you may experience bleeding, pain, swelling or discomfort for several days, which may be treated with pain medication. You may also experience an infection following treatment, which would be treated with antibiotics.

2. Reaction to anesthesia: To keep you comfortable during treatment you will receive a local anesthetic. In rare instances patients have an allergic reaction to anesthetic, which may require emergency medical attention, or find that anesthesia reduces their ability to control swallowing , which increases the chance of swallowing small bits of filling material or other small objects during treatment.

3. Stiff or sore jaw joint: Holding your mouth open during treatment may temporarily leave your jaw feeling stiff and sore and may make it difficult for you to open your mouth wide for several days afterwards. Treatment also may leave the corners of your mouth red or cracked for several days.

4. Broken instrument: Occasionally a root canal instrument will break off in a root canal that is twisted, curved or blocked with calcium deposits. Depending on its location, the fragment can be retrieved or it may be necessary to seal it in the root canal (these instruments are made of sterile, nontoxic surgical stainless steel, so this causes no harm). It may also be necessary to perform an apicoectomy to seal the root canal.

5. Overfill: As a result of filing in the root canal, the incomplete formation of your tooth or an abscess at the end of the tooth (called the apex), an opening may exist between the root canal and the bone or tissue surrounding the tooth. This opening can allow filling material to be forced out of the root canal into the surrounding bone and tissue. An apicoectomy may be necessary for retrieving the filling material and sealing the root canal.

6. Need for further treatment: Teeth that receive root canal treatment may be more prone to cracking and breaking over several years time, which may ultimately require a bridge or partial denture. In some cases, root canal treatment may not relieve all symptoms. If you suffer from gum disease (also called periodontal disease), this can increase the chance of losing a tooth even though root canal treatment was successful.
Consequences of not performing treatment

This course of treatment will help to relieve your symptoms. If you do not have root canal treatment, your discomfort could continue and you could face the risk of a serious, potentially life-threatening infection, abscesses in the tissue and bone surrounding your teeth and eventually, the loss of the tooth.