The removal of dental pulp when it has become infected or died. Dental pulp is the soft core of the tooth containing nerves, blood vessels, and connective tissue. It extends from the top of the tooth, called the crown, all the way down to the roots in branches called canals.
Dental pulp may become infected because of an untreated
cavity, trauma to the tooth, or long-standing
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 performed, the tooth will need to be removed.
Risk Factors for Complications During the Procedure
Immunosuppression
Bleeding disorders
Circulatory problems (such as diabetes), which can cause healing problems
Heart valve conditions, which increase the risk of
endocarditis
from dental procedures
What to Expect
Prior to the Procedure
Your dentist or endodontist will do a thorough dental exam and x-rays.
During Procedure
Anesthesia will be administered to the site to numb the area around the tooth.
Anesthesia
Local anesthetics, such as lidocaine
Description of the Procedure
A small hole is made through the top of the tooth that extends through the enamel and dentin and into the pulp. Steel files are inserted to extract the pulp tissues. All teeth have between one and four individual canals, and 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 are reshaped and enlarged, and medication is inserted to kill bacteria.
At this point, the dentist may insert a temporary filling to protect the tooth until the next appointment. Or, the procedure may be completed in its entirety within one visit, depending on the condition of the tooth.
The canal is dried, sterilized, and then filled with a rubbery material called Gutta-percha to prevent recontamination.
After Procedure
The area is permanently sealed, and a gold or porcelain crown is placed over the tooth to strengthen its structure.
How Long Will It Take?
The procedure may take 1 to 3 appointments, and each appointment may last up to 1 to 2 hours.
Will It Hurt?
Anesthesia prevents pain during the procedure. You may have some discomfort for a few days during recovery, and pain medication may be used as needed.
Possible Complications
Pain and swelling
Surgical-wound infection
Persistent abscess
Average Hospital Stay
This procedure is typically done at the dentist office.
Postoperative Care
Use warm, salt-water rinses to soothe your mouth.
For a few days, avoid heavy biting and chewing on the side of the mouth that has the root canal.
See your dentist or endodontist for a follow-up x-ray about six months after the root canal.
Outcome
In approximately 95% of cases, root canal therapy is successful, and the treated tooth should last a lifetime. However, root canal treatments may need to be retreated if:
Pulp was left inside a canal that was overlooked.
The root canal did not seal properly.
In some instances, the tooth cannot be saved with a root canal and requires extracting or pulling. These cases involve:
A tooth that is fractured below the gum surface, down into the roots
A tooth that is too badly damaged by decay and/or trauma
Call Your Doctor If Any of the Following Occurs
Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge at the surgical area
The tooth feels loose after root canal therapy
Headache, dizziness, muscle aches, or general ill feeling
RESOURCES:
American Dental Association http://www.ada.org
National Institute of Dental and Craniofacial Research http://www.nidcr.nih.gov
CANADIAN RESOURCES:
Canadian Dental Association
http://www.cda-adc.ca/
The Canadian Dental Hygienists Association
http://www.cdha.ca/
References:
Academy of General Dentistry website. Available at:
http://www.agd.org/.
American Dental Association website. Available at:
http://www.ada.org.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
