Nothing is as good as a natural tooth! And sometimes your natural tooth may need root canal (endodontic) treatment for it to remain a healthy part of your mouth. Most patients report that having root canal (endodontic) treatment today is as unremarkable as having a cavity filled.
If you've been told you need root canal (endodontic) treatment, you can find the answers to your questions below.
Who performs endodontic treatment?
What is an "endodontist"?
Why is there a need for endodontic treatment?
What are the signs of needing endodontic treatment?
How does endodontic treatment save the tooth?
Will I feel pain during or after the procedure?
How much will the procedure cost?
Will the tooth need any special care or additional treatment?
What causes an endodontically treated tooth to need additional treatment?
What is endodontic surgery?
Who performs endodontic treatment?
All dentists, including your general dentist, received some training in endodontics while in dental school. Often general dentists refer patients needing root canal treatment to endodontists.
What is an "endodontist"?
Endodontists are dentists who specialize in treating the soft inner tissue of your tooth's roots. After they complete dental school, they attend another dental school program for two or three more years. This program is called an advanced specialty education program. They study only endodontic treatment and learn advanced techniques so they can give you the very best care.
Why is there a need for endodontic treatment?
Sometimes the pulp inside your tooth becomes inflamed or infected. This can be caused by deep decay, repeated dental procedures on the tooth, a crack or chip in the tooth, or a blow to the tooth.
What are the signs of needing endodontic treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. But sometimes, there are no symptoms.
How does endodontic treatment save the tooth?
After obtaining good anesthesia, the endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the pulp space with the gutta percha root filling material. Afterwards, you return to your general dentist, who will place a crown or other restoration on the tooth to protect it and restore it to full function.
Will I feel pain during or after the procedure?
While many patients may be in great pain before seeing an endodontist, most report that the pain is relieved by the endodontist and that they are comfortable during the procedure. For the first few days after treatment, the tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. The endodontist will tell you how to care for your tooth at home.
How much will the procedure cost?
The cost varies depending on how severe the problem is and which tooth is affected. Many dental insurance policies cover endodontic treatment. Generally, treatment and restoration of your natural tooth is the least expensive option. The only alternative is having the tooth extracted and replaced with a bridge, implant, or removable partial denture to restore chewing function and prevent adjacent teeth from shifting.
Will the tooth need any special care or additional treatment?
You should not chew or bite on the treated tooth until you have had it restored by your general dentist because your tooth could fracture. Otherwise, just practice good oral hygiene - brushing, flossing and regular checkups and cleanings. Endodontically treated teeth can last for many years, even a lifetime.
What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, your endodontist may discover very narrow or curved canals that could not be treated during the initial procedure. Sometimes a previously root canaled tooth may develop an infection of the external surface of the root and may need endodontic surgery to be saved.
What is endodontic surgery?
The most common endodontic surgical procedure is an apicoectomy or root-end resection. It is used to relieve inflammation or infection in the bony area around the end of your tooth that continues after endodontic treatment. The endodontist lowers the gum tissue and removes the infected tissue and may remove the very end of the root. A small filling may be placed to seal the root canal.
Endodontists use local anesthetics, like those used when you have a cavity filled. Most patients return to their normal activities the next day. For more on surgery, see Endodontic Surgery.
Myths About Root Canal Treatment
There are many misconceptions surrounding root canal (endodontic) treatment. It is important for you to have accurate information. As always, when considering any medical procedure, you should get as much information as you can about all of your options. Your dentist or endodontist can answer many of your questions, and if you still have concerns, it is often wise to seek a second opinion.
Truth-Root canal treatment doesn't cause pain, it relieves it.
Most patients see their dentist or endodontist when they have a severe toothache. The toothache can be caused by damaged tissues in the tooth. Root canal treatment removes this damaged tissue from the tooth, thereby relieving the pain you feel. (For more about root canal procedures, see About Root Canal Treatment)
The perception of root canals being painful began decades ago when root canal treatment was painful. But with the latest technologies and anesthetics, root canal treatment today is no more uncomfortable than having a filling placed. In fact, a recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as "painless" than patients who have not had root canal treatment.
Truth-Root canal treatment is a safe and effective procedure.
Research studies performed in the 1930s and 1940s and those conducted in later years showed no relationship between the presence of endodontically treated teeth and the presence of illness. Instead, researchers found that people with root canal fillings were no more likely to be ill than people without them.1,2
Over the past several years, however, a very small number of dentists and physicians have been claiming that teeth that have received root canal (endodontic) treatment contribute to the occurrence of illness and disease in the body. This claim is based on the outdated research performed by Dr. Weston Price from 1910-1930. His research stated that bacteria trapped in the teeth during root canal treatment can cause almost any type of disease, including arthritis, heart disease, kidney disease, and others.
The presence of bacteria in teeth and mouth has been an accepted fact for many years. But presence of bacteria does not constitute "infection" and is not necessarily a threat to a person's health.3 Bacteria are present in the mouth and teeth at all times, even in teeth that have never had a cavity or other trauma.
More recent attempts to copy the research of Dr. Price (and to check its accuracy) have been unsuccessful. Researchers now believe that the earlier findings may have been caused by poor sanitation and imprecise research techniques that were common in the early 1900s.1
These more recent studies support the truth we report today-that teeth that receive proper endodontic treatment do not cause illness.
Truth-Saving your natural teeth, if possible, is the very best option.
Nothing can completely replace your natural tooth. An artificial tooth can sometimes cause you to avoid certain foods. Keeping your own teeth is important so that you can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in your diet.
Endodontic treatment, along with appropriate restoration, is a cost-effective way to treat teeth with damaged pulp and is usually less expensive than extraction and placement of a bridge or an implant.
Endodontic treatment also has a very high success rate. Many root canal treated teeth last a lifetime.
Placement of a bridge or an implant will require significantly more time in treatment and may result in further procedures to adjacent teeth and supporting tissues.
Millions of healthy endodontically treated teeth serve patients all over the world, years and years after treatment. Those healthy teeth are helping patients chew efficiently, maintain the natural appearance of their smiles and enhance their enjoyment of life. Through endodontic treatment, endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime.
References
- Easlick K. An evaluation of the effect of dental foci of infection on health. JADA 1984;42:615-686, 694-697.
- Grossman L. Pulpless teeth and focal infection. J Endodon 1982;8:S18-S24.
- Schonfeld SE. Oral microbial ecology. In: Slots J, Taubman M, eds. Contemporary oral microbiology and immunology. St. Louis: Mosby Year Book, 1992:267-274.
- Grossman L. Root canal therapy. 4th ed. Philadelphia: Lea & Febiger, 1955:15-40.
- Grossman L. Focal infection: Are oral foci of infection related to systemic disease? Dent Clin N Amer 1960:749-63.
- Bender IB, Seltzer S, Yermish M. The incidence of bacteremia in endodontic manipulation. Oral Surg 1960;13(3):353-60.
- Goldman M, Pearson A. A preliminary investigation of the "hollow-tube theory" in endodontics: Studies with neo-tetrazolium. J Oral Therapeutics and Pharm 1965;1(6):618-26.
- Torneck C. Reaction of rat connective tissue to polyethylene tube implants. Part I. Oral Surg 1966;21(3):379-87.
- Torneck C. Reaction of rat connective tissue to polyethylene tube implants. Part II. Oral Surg 1967;24(5):674-83.
- Phillips J. Rat connective tissue response to hollow polyethylene tube implants. J Canad Dent Assoc 1967;33(2):59-64.
- Davis M, Joseph S, Bucher J. Periapical and intracanal healing following incomplete root canal fillings in dogs. Oral Surg 1971;31(5):662-675.
- Baumgartner J, Heggers J, Harrison J. The incidence of bacteremias related to endodontic procedures. I. Nonsurgical endodontics. J Endodon 1976;2(5):135-40. Ehrmann E. Focal infection: The endodontic point of view. Oral Surg 1977;44:628-34.
- Wenger J, Tsaknis P, delRio C, Ayer W. The effects of partially filled polyethylene tube intraosseous implants in rats. Oral Surg 1978;46:88-100.
- Delivanis P, Snowden R, Doyle R. Localization of blood-borne bacteria in instrumented unfilled root canals. Oral Surg 1981;52(4):430-32.
- Torabinejad M, Theofilopoulos A, Kettering J, Bakland L. Quantitation of circulating immune complexes, immunoglobulins G and M, and C3 complement component in patients with large periapical lesions. Oral Surg 1983;55(2):186-90.
- Delivanis P, Fan V. The localization of blood-borne bacteria in instrumented unfilled and overinstrumented canals. J Endodon 1984;10(11):521- 24.
- Benatti O, Valdrighi L, Biral R, Pupo J. A histological study of the effect of diameter enlargement of the apical portion of the root canal. J Endodon 1985;11(10):428-34.
- Wu M, Moorer W, Wesselink P. Capacity of anaerobic bacteria enclosed in a simulated root
Langley Endodontics
Dr. Howard Bittner - Root Canal Specialist
#303-6351 197th Street. Langley, BC. Canada. V2Y 1X8
Tel: (604) 532-4090 Fax: (604) 532-4084
Email: