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© 2017 Care Endodontics Chicago/Julianne Carrara DMD MS LTD

What is Endodontic Treatment?

Root canal Treatment: the Facts

Root canal treatment, also known as endodontic treatment (“endo” – inside; “odont” – tooth), will save your natural tooth and allow you to keep it functional for decades if not a lifetime. But just as no two people are the same, teeth also vary widely, so that the success of root canal treatment depends on many factors. We are not one size fits all- and this applies to every tooth.  Before we explore some of the most important ones, let’s talk about what root canal treatment is, and why you need it.

 

Endodontic treatment is necessary to save a tooth when the pulp — the living tissue inside it, consisting of nerves, blood vessels and connective tissues — becomes inflamed or infected. Death of the pulp tissue allows infection to spread into the bone surrounding the tooth. The infected pulp of the tooth needs to be removed, and the root canals cleaned, shaped, disinfected and filled to seal them, so that they are less susceptible to future infection.

Root canal treatment is usually undertaken by a general dentist or an endodontist — a dental specialist who has two to three additional years of advanced training in the diagnosis and treatment of dental pain, and related root canal disorders and diseases. Although general dentists have some education and training in root canal therapy, they often send cases to their endodontic partners for treatment. These include the more complicated, difficult cases or those beyond their comfort level.

*** Beware of the "We have someone in our office that does Root Canals vs.

We have an Endodontist here or we are referring you to an Endodontic Specialist to treat your tooth!  

Semantics are very frustrating- same with Do you take my insurance vs. are you a network provider?

 

How can a tooth survive if it has lost the pulp tissue that keeps it alive?

 

The tooth is attached to the bone around it by the periodontal membrane or ligament (“peri” – around; “odont” – tooth), which is living, so that the tooth can still function even though the root canal system no longer contains its original tissue.  

Symptoms and Signs

It is not always pain related

​Endodontists are skilled specialists in finding the cause of oral and facial pain that has been difficult to diagnosis.  This is what we do!  We look at the area/teeth in question differently and consider systemic issues; habits and stress factors.  


While endodontists are specialists in saving teeth—meaning they are trained in performing root canal treatment and other procedures to save the tooth— they will look at all treatment options to determine the best course of action for each individual patient and case.

Even with proper brushing and flossing habits, and regular checkups, you can have problems with your teeth and gums.

Some of the signs of potential dental problems:

  • Tooth pain

  • Injury

  • Sensitivity to  Cold/Hot

  • Pain to Pressure or Palpation

  • Oral or Facial Swelling

 

Endodontists are skilled specialists in finding the cause of oral and facial pain that has been difficult to diagnosis. 

There are many causes for dental problems, including decay, an injury or infection.  If you have on-going pain or discomfort, contact your dentist or Find an Endodontist 

Root Canals and Pain

Is a root canal painful?

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection.

 

Today, endodontists understand a great deal about pain management. With modern techniques and anesthetics, the vast majority of patients report that they are comfortable during the procedure.  For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. Over-the-counter medications, such as Advil® or Tylenol®, are usually enough to manage this sensitivity. In some cases prescription medications may be necessary, and are available from your endodontist.   Follow your endodontist’s instructions carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. Of course, if you experience pressure or pain that lasts more than a few days, call your endodontist.

Future Prognosis

Root Canal Therapy Questions Answered

My dentist told me that I need to have a root canal treatment in a tooth, but how long will my tooth last if I do it? 


This is an important question, at Care Endodontics Chicago after examination/consultation, we tailor the answer to the tooth in question.  

A frequently asked question is how can a tooth survive if it has lost the pulp tissue that keeps it alive?

 

The tooth is attached to the bone around it by the periodontal membrane or ligament (“peri” – around; “odont” – tooth), which is living, so that the tooth can still function even though the root canal system no longer contains its original tissue.

 

Some Factors Affecting Root Canal Longevity

Treatment: A recent evidence-based study of teeth having a primary (first time) root canal treatment cited conditions that contributed to the success and longevity of root canal fillings.

  • One was the absence of root canal infection that had spread into the bone — in other words, the earlier the tooth is treated the better the outcome. So don’t put off treatment if you need it!

  • Another was the quality of the root canal treatment itself.

  • How quickly and effectively the damaged tooth was repaired after root canal treatment was completed was also a factor, meaning it’s important to have the tooth restored with a permanent filling or crown, which usually requires a second office visit, without delay.

 

All Teeth Are Not Created Equal: 

  • Very basically the front teeth, which are used for cutting, have single roots (and canals) and are both easier to access and treat. They also receive less biting force than the back teeth.

  • The back teeth, which by contrast are used for chewing, have two or three roots and therefore more root canals; they are more difficult to access and are more complicated to treat. In addition, a front tooth may not need a crown after root canal treatment but a back tooth will.

 

Changes Over Time: 

  • Studies have shown that there is a significant correlation between age and how resistant a tooth is to fracture, whether or not it has had root canal treatment. Over time, teeth can become more brittle and have a greater tendency to fracture, especially the back molar teeth that receive the most biting force.

  • It’s important to place crowns on root canal treated teeth to cover and protect them from undue stress, which will increase their longevity. Sometimes it is also necessary to place a post inside a treated root canal to support and reinforce a crown, especially if the tooth has been extensively damaged. However, certain posts, although sometimes necessary, may increase the possibility of root fractures over time.

 

Preserving Nature’s Gifts

  • Studies have also shown that getting root canal treatment provides a longer-lasting solution than having a diseased tooth removed and replaced with fixed bridgework, which can fail over time. The evidence for keeping a root canal treated tooth versus getting a dental implant is more equivocal, but that is a more complex issue involving other considerations besides longevity; it also includes more treatment time and costs.

Recent Studies have shown:

  • Restoration integrity may be more important to the longevity of tooth treated with endoodontic therapy.  Decay or leaking restorations will reinfect the root canal and surrounding tissues.  When we can not ideally treat your tooth due to anatomical blockages, a solid restoration will prevent contamination.  Regular radiographs and dental exams/cleaning will help with early detection.

Certainly a tooth or teeth with well-treated root canal fillings and restorations will last for many years, if not a lifetime. Suffice it to say, there is nothing like your natural teeth.

This content was edited from:

A Consultation with Dr. Susan Wolcott

This article is endorsed by the AAE

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