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Root Canal Treatment

Definition

This procedure removes dental pulp when it has become dead or infected. Dental pulp is the soft core of the tooth. It contains nerves, blood vessels, and connective tissue. The pulp extends from the top of the tooth, called the crown, all the way down to the roots, in branches called canals.

Normal Tooth Anatomy

Reasons for Procedure

Dental pulp may become infected because of:

An untreated cavity
Trauma to the tooth
Gum disease

When dental pulp becomes infected or dies, a painful abscess within the jawbone will occur. Removing dead or diseased dental pulp will prevent infection from spreading to other areas of the mouth and destroying bone around the tooth. If a root canal is not done, the tooth will need to be removed.

Common signs of pulp problems include:

Pain when biting down on a tooth
Pain when the tooth is not being used
Sensitivity to hot or cold food or beverages
Tooth discoloration
Swollen gums around the infected tooth
A draining boil-like structure (called a fistula) on the gum adjacent to the tooth

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your dentist will review potential problems, like:

Pain and swelling
Surgical-wound infection
Persistent abscess
Inability to save the tooth

Factors that may increase the risk of complications include:

Smoking
Immune system disorders
Bleeding disorders
Circulatory problems that can cause healing problems, such as diabetes

Be sure to discuss these risks with your dentist before the procedure.

What to Expect

Prior to the Procedure

Your dentist will:

Do a thorough dental exam
X-ray your mouth to look at the extent of damage to the tooth

Anesthesia

Local anesthesia will be used. The dentist will numb the area in your mouth. The anesthesia will be given as an injection.

Description of the Procedure

A small hole will be made through the top of the tooth and into the pulp. Next, steel files will be inserted to extract the pulp tissue. All teeth have 1-4 individual canals. Pulp will need to be extracted from all canals in the affected tooth. Once all pulp has been removed, the walls of the root canal will be reshaped and enlarged. Medication will be inserted to kill bacteria.

At this point, a temporary filling may be inserted. This filling will protect the tooth. The procedure may be done within 1 visit or at multiple appointments. This depends on the condition of the tooth. Lastly, the canal will be dried, sterilized, and filled with a rubbery material. This material will prevent recontamination.

Immediately After Procedure

The dentist will:

Permanently seal the area with cement
Place a gold or porcelain crown over the tooth to strengthen its structure

How Long Will It Take?

A root canal may take 1-3 appointments. Each appointment may last 1-2 hours.

How Much Will It Hurt?

You will have discomfort for a few days after each visit. Your doctor may give you pain medication.

Post-procedure Care

Be sure to see your dentist for regular visits as advised.

Call Your Dentist

Call your dentist if any of the following occur.

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the area around the tooth
Tooth loosens after root canal treatment
Headache, muscle aches, lightheadedness, or general discomfort
Pain that you cannot control with the medications you were given

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

Mouth Heatlhy—American Dental Association
https://www.mouthhealthy.org

National Institute of Dental and Craniofacial Research
https://www.nidcr.nih.gov

CANADIAN RESOURCES

Canadian Dental Association
http://www.cda-adc.ca

Dental Hygiene Canada
http://www.dentalhygienecanada.ca

References

Root canals: FAQs about treatment that can save your tooth. Mouth Healthy—American Dental Association website. Available at: https://www.mouthhealthy.org/en/az-topics/r/root-canals. Accessed March 5, 2018.

Root canal treatment. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/Pa-St/Root-Canal-Treatment.html. Accessed March 5, 2018.

What is a root canal? Know Your Teeth—Academy of General Dentistry website. Available at: http://www.knowyourteeth.com/infobites/abc/article/?abc=R&iid=326&aid=1310. Updated January 2012. Accessed March 5, 2018.

6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

Revision Information

Reviewer: EBSCO Medical Review Board Monica Zangwill, MD, MPH
Review Date: 03/2018
Update Date: 08/15/2012

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.