Why Would You Need Root Canal Treatment?
Root canal treatment is needed for two main reasons. The first is infection. An untreated cavity is a common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it reaches a root canal. This allows bacteria to infect the pulp. Antibiotics can't get to infections inside teeth. The inflammation caused by the infection reduces the blood supply to the tooth. The reduced blood supply also keeps the pulp from healing.
The second reason for a root canal is damage to the pulp that can't be fixed. Trauma or a fractured tooth can damage the pulp. So can a lot of restoration, such as several fillings placed in the same tooth over a period of time. Sometimes, common dental procedures, such as preparing a tooth for a crown, can hurt the pulp. Then the tooth might need a root canal.
When the pulp is inflamed but not infected, it may heal on its own. Your dentist may want see if this will happen before doing root canal treatment. If the pulp remains inflamed, it can be painful and may lead to infection.
An infection in the pulp can affect the bone around the tooth. This can cause an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty root canals with a material called gutta percha.
If root canal treatment is not done, an infected tooth may have to be extracted. It is better to keep your natural teeth if you can. If a tooth is missing, neighboring teeth can drift out of line. They also can be overstressed from chewing. Keeping your natural teeth also helps you to avoid other treatments, such as implants or bridges. Also, if you ignore an infected or injured tooth the infection can spread to other parts of your body.
Having root canal treatment on a tooth does not mean that the tooth will need to be pulled out in a few years. Once a tooth is treated, it almost always will last the rest of your life.
Signs and Symptoms
If you have an infection of the pulp, you may not feel any pain at first. But if it is not treated, the infection will cause pain and swelling. In some cases, an abscess will form.
Your tooth might need a root canal if:
It hurts when you bite down on it, touch it or push on it
It is sensitive to heat
It is sensitive to cold for more than a couple of seconds
There is swelling near the tooth
It is discolored (whether it hurts or not)
It is broken
To determine whether your tooth needs root canal treatment, your dentist will often place hot or cold substances against the tooth. The purpose is to see if it is more or less sensitive than a normal tooth. He or she will examine the tissues around the tooth and gently tap on the tooth to test for symptoms.
You also will be given X-rays of the bone around the tooth. The X-rays may show a widening of the ligament that holds the tooth in place or a dark spot at the tip of the root. If either of these is present, your dentist probably will recommend a root canal procedure.
Your dentist may need more information about the tooth. He or she may use an electric pulp tester. This hand-held device sends a small electric current through the tooth. It helps your dentist decide whether the pulp is alive. This test does not cause pain or a shock. You may feel a tingling sensation. It will stop when the tester is removed from the tooth.
An electric pulp tester should not be used if you have a cardiac pacemaker or any other electronic life-support device.
Length of Treatment
Root canal treatment can be done in one or more visits. It depends on the situation. An uncomplicated root canal treatment often can be completed in one visit. Some teeth may be more difficult to treat because of where they are in the mouth. Some teeth have more roots than other teeth. Treating a tooth with many roots takes longer. Some teeth have curved root canals that are difficult to find. If you have an infection, you will visit the dentist several times so that he or she can make sure that the infection is gone.
Once the root canal treatment is finished, you will need to see your general dentist to have a crown or filling placed on the tooth. You are likely to receive a crown if the tooth is discolored or if it is used for chewing. The purpose of the crown is to prevent the tooth from breaking in the future.
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