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Root canal, Endodontic Therapy – Indications, Procedure, Risk

Endodontic therapy

A root canal is a dental procedure to remove dead or dying nerve tissue and bacteria from inside a tooth.

Description

A dentist will use a needle to place numbing medicine (anesthetic) around the bad tooth. You may feel a slight prick when the needle is being inserted.

Next, your dentist uses a tiny drill to remove a small portion of the top part of your tooth to expose the pulp. This is typically called access.

Pulp is made up of nerves, blood vessels, and connective tissue. It is found inside the tooth and runs to the jaw bone. Pulp supplies blood to a tooth and allows you to feel sensations such as temperature.

The infected pulp is removed with special tools called files. The canals (tiny pathways inside the tooth) are cleaned. Medicines may be placed into the area to make sure all the germs are removed and to prevent further infection.

The cleaned tooth area is sealed with a soft, temporary material. Once the tooth is filled, a permanent crown may be placed on top.

You may be given antibiotics to treat and prevent infection.

Why the Procedure is Performed

A root canal is done if you have an infection that affects the pulp of a tooth. Generally, there is pain and swelling in the area. The infection can be the result of a tooth crack, cavity, or injury. It may also be the result of a deep pocket in the gum area around a tooth.

If this is the case, a dental specialist known as a periodontist should examine the area.

A root canal can save your tooth. Without treatment, the tooth may become so damaged that it must be removed.

Risks

Possible risks of this procedure are:

  • Abscess
  • Loss of tooth
  • Nerve damage
  • Tooth fracture

After the Procedure

You will need to see your dentist after the procedure to make sure the infection is gone. A dental x-ray may be taken. Regular dental checkups are necessary. For adults, this usually means a visit twice a year.

Outlook (Prognosis)

You may have some pain or soreness after the procedure. An over-the-counter anti-inflammatory drug, such as ibuprofen or naproxen, can help relieve discomfort.

Most people can return to their normal routine the next day. Until the tooth is permanently filled or covered with a crown, you should avoid rough chewing in the area.

 

Mehta NR, Scrivani SJ, Spierings ELH. Dental and facial pain. In: Benzon HT, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW, eds. Practical Management of Pain. 5th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 31.

Neville BW, Damm DD, Allen CM, Chi AC. Pulpal and periapical disease. In: Neville BW, Damm DD, Allen CM, Chi AC, eds. Oral and Maxillofacial Pathology. 4th ed. Philadelphia, PA: Elsevier; 2016:chap 3.

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