Root Canals (Endodontic Therapy)

Root Canals or Endodontic therapy is a treatment that can save diseased or injured teeth. The alternative to endodontics is extraction. Typically, a severely decayed tooth or a tooth with a large filling will begin to ache. The pain might be intermittent at first and over time progress to a constant dull throbbing pain or a severe ache that might be felt on all the teeth on the affected side. Sometimes there is no pain and an abscess might be discovered on a routine x-ray.

The pulp is the soft tissue that is located inside the tooth structure. It contains nerves, arteries, veins, and lymph tissue. It is contained in the canals located in thin tube-like spaces in the roots and in the pulp chamber located within the crown of the tooth.

When the pulp is diseased or injured and unable to repair itself, it becomes infected. Left untreated, the pulp will die and become necrotic. Pus can build up at the root tip, forming an abscess that can destroy the bone surrounding the tooth. Endodontic treatment is the removal of the diseased pulp tissue, which will enable the body's defense system to repair the damage caused by the infection.

The following steps are taken in a root canal procedure:

• To ensure the procedure will be pain free, a local anesthetic is used. The tooth will then be isolated by placing a rubber dam over it. This thin sheet of rubber provides a clean and aseptic working environment.
• An opening is then made through the top of the tooth into the pulp chamber.
• The pulp is removed and the root canals are cleaned, enlarged and finally, shaped to a form so it can be filled and sealed.
• The root canal is now filled and sealed. Should a more serious infection be involved, then a temporary filling would be placed to allow the area to drain and a second visit will be scheduled to remove the temporary filling replacing it with a permanent fill and seal. There may be some discomfort in the area of the tooth for a day or two. This completes the root canal (endodontic) treatment.

Following completion, the tooth will need to be restored. Due to the large amount of tooth structure generally lost from the decay and old fillings, a crown is generally the preferred restoration. A post may be placed into the root to give additional structural support.