Endodontics.

A root canal treatment is a common dental procedure used when a tooth is badly damaged or infected. Due to the unique variations of your dental anatomy and individual physical condition the approaches to treatment may differ. In our practice, root canal treatment in general follows the outline below.

What is it? Root canal therapy is a way to treat the interior structures of the tooth, which extend into the root(s). Keep in mind that while incisors have only 1-2 roots or canals, bicuspids and lower molars have 2-5 roots or canals each, and upper molars have 3-7 roots or canals. This contributes to the complexity and the length of treatment. The structures within each tooth include the pulp tissue (composed of nerves, blood and lymph vessels, and connective tissue) which is located within the canal inside each root. The pulp can become infected, for example, if the tooth is damaged by a deep cavity, if the tooth has cracked, or if an old filling has begun to leak. In some cases, patients may feel no pain: often the first symptoms of an infection are sensitivity to hot foods or liquids, swelling, or pain when chewing. When an infection becomes established, root canal therapy is necessary. If left untreated, the result is not only pain (which can be quite severe), but loss of the tooth, and possible bone loss in the vicinity of the infected tooth as well. A missing tooth causes problems with adjacent or opposing teeth, and solutions to address this can be much more costly than having the root canal therapy.

Before the procedure. Prescriptions. After the diagnosis is made, Dr. Gotun may prescribe antibiotics to be taken prior to the root canal procedure in order to begin controlling the infection. This course of treatment ensures a more predictable outcome and much less post procedural pain. It may also temporarily alleviate some of the pain caused by the infection, but this does not mean that the tooth has gotten better or that the procedure should be delayed. In fact, it generally confirms the presence of infection in the tooth!

Procedure. Treatment involves creating an access to the pulp by drilling a hole in the tooth and cleaning out the damaged pulp and decay. Then, one of two options is chosen: the tooth may receive medication and be temporarily sealed or it may be left open to drain, or each canal is filled with an inert material and the tooth is sealed until healing can be assessed. The goal, however, is to help you keep your tooth, because that missing tooth can cause a variety of serious problems, not to mention lead to the necessity of either a bridge or an implant. The best news is that in our practice, root canal treatments are successful in 95% of cases and teeth with treated root canals can last a lifetime, barring new insults.

Appointments. Sometimes the infection is so well established that a second treatment is necessary, or even a third attempt. In that case there will be a need for one or two more appointments to complete the root canal treatment.

After the procedure. After the root canal treatment, you may experience soreness in the area, either around the gums or when chewing. This will wear off in a few days. You can use a salt-water gargle to speed recovery of the gums (mix ½ tsp. table salt in a cup of warm water and rinse) and over-the-counter pain relievers (Ibuprofen, Tylenol, Advil or Aleve). Sensitivity to both hot and cold is not unusual in the area and may continue for weeks. These symptoms need to be reported to the office if it seems extreme. If anything else changes in your condition, such as the return of severe pain, swelling or fever, call us immediately.

The next step. A tooth that has had a root canal treatment always needs further work in order to make it structurally sound and functional. When the root canal therapy is completed, Dr. Gotun will explain the options for restoration. Whether it is a filling or a core build-up followed by a crown, this final step is necessary to preserve the tooth’s integrity and functionality. We will advise you on your next step after the root canal therapy is completed.