You've been dealing with a nasty toothache for a while now. The pain is becoming excruciating so you finally suck it up and make a dental appointment. Sadly, you need to have a root canal. Great. But, what exactly is that going to entail? Do you need a driver? Is it going to be painful? Why did this happen in the first place? Well, a root canal will require one or more office visits, depending on the severity of the case. It will either be performed by a dentist or endodontist. We all know what a dentist is, but an endodontist is a dentist who specializes in the diseases and injuries of the human dental pulp or the nerve of the tooth. The choice of which type of dentist to use depends to some degree on the difficulty of the root canal procedure needed in your particular tooth and the general dentist's comfort level in working on your tooth. After a brief consultation, your dentist will be better able to tell who might be best suited to perform the work in your particular case.
At your appointment, you will take an X-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Once everything is ready for surgery, your dentist or endodontist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetize the area to make the patient more relaxed and at ease. The anesthesia used will determine whether or not you will need to bring someone with you to drive you home.
Next, to keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth. Once your mouth is prepared, an access hole will then be drilled into the tooth. The pulp along with bacteria, all of the decayed nerve tissue and other debris is then removed from the tooth using root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked the full length of the tooth to scrape and scrub the sides of the root canals. Water or sodium hypochlorite is used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it is sealed, which may take up to a week, depending on the doctor. If there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose to seal the tooth the same day. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep out contaminants like saliva and food between appointments.
At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth's root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed. Once filled, you may have a tooth restoration procedure, but that's it. You're done and no more toothache. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your dentist will discuss the need for any additional dental work with you. Pain will be involved, but you are already in pain. This pain will eventually go away and your tooth will be good as new.
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