Marielaina Perrone DDS is a family, implant, and cosmetic dentist serving Las Vegas, Summerlin, and Henderson, NV. Dental services include dental implants, teeth whitening, orthodontics, Botox, and treatment of periodontal disease. "We believe in a comprehensive approach to restorative and cosmetic dentistry, that fully... more
Root canal treatments and pain go hand in hand in many people’s minds. Usually, our fears and anxiety stem from other people telling us their experiences and not from our own. A root canal (also referred to as RCT or root canal therapy) is a dental procedure where the damaged nerve (also called the pulp) of a tooth is removed. After the removal of the nerve, the canals of the tooth are cleaned and sterilized. Following this cleaning process, the canals are filled and sealed permanently to avoid future dental infection. If treatment is not applied, the dental infection will affect the tooth along with surrounding oral structures (like gums and bone tissues) and a dental abscess can form in the area as the infection looks to escape.
The reason for the removal of the tooth’s nerve is because these nerves (along with associated blood vessels) are responsible for providing hydration and nutrients to the teeth. They also give us the ability to sense hot and cold temperatures.
Surveys show that root canal therapy is considered the most feared of all dental procedures. These surveys also found that people’s views on root canals are based on what others have told them and not their own individual experiences. This leads to people believing mostly inaccurate stories about root canals. It is the fear of the unknown as I like to call it.
Is Root Canal Painful Or Can It Be Painless?
A root canal is a necessary treatment when the nerve of a tooth becomes infected or inflamed. This inflammation or dental infection can develop in a number of ways:
– Tooth decay that pushes into the area of the nerve or pulp chamber.
– Fracture or chip in the tooth that gives bacteria an opportunity to spread into the tooth’s nerve canal.
– Trauma. Traumatic injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to a dental abscess.
A tooth causing this type of pain is irreversible. To save the tooth, a root canal must be performed.
Signs that a root canal is probably necessary can include pain, extended sensitivity to temperature (either hot or cold or both), tenderness to the touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes, bone and surrounding gingival tissues. In some cases, no outward dental symptoms will present at all.
A root canal usually requires one or more visits to the dentist and can be performed by either a general dentist or an endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. Your dentist will generally make the call on who should perform the root canal procedure. You will be referred to an endodontist if any of the following are needed:
- Degree of difficulty. Some teeth have an anatomy that is slightly abnormal which makes the canals of the tooth harder to access.
- Re-treatment of a previous root canal.
- Patient’s preference.
You and your dentist will discuss who is best suited to complete the root canal procedure and make the best, informed decision for your dental treatment.
Root Canal Procedure
– Have an X-ray taken if one has not already been taken. This will give your dentist a chance to evaluate the anatomy and shape of the tooth’s canals. It can also show the presence of a dental infection.
– Anesthetic. Your dentist will use a local anesthetic to numb the surrounding areas to prevent pain and also allow the procedure to be completed pain free. Some patients do not require any anesthetic, but it will make it more comfortable.
– Cleaning of tooth canals. Tiny instruments are used to slowly clean out and debride bacteria, decayed nerve tissues, and bacteria from inside the tooth’s canals. Sterile water, peroxide, or sodium hypochlorite are used periodically to flush away the debris and kill any bacteria present.
– Filling of canals. Each canal is filled to the end of the tooth with a rubbery compound called gutta percha and permanently sealed. The process can be related to a cork, to prevent bacteria and fluid from re-entering the tooth, and keep it sterile. Many dentists prefer to wait a week or so before sealing the tooth. This will give the inflammation that has developed a chance to decrease back to normal levels. Others prefer to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed to keep out contaminants like saliva and food until the next appointment.
Following treatment, your tooth may feel sensitive for a few days or even a week. This is especially true if there was pain or dental infection before the procedure. This discomfort can be relieved with over-the-counter or prescription pain medications or an antibiotic if an infection was present. Follow the directions given to you very carefully and feel free to ask your dentist questions if an issue comes up.
Your tooth may feel slightly different from your other teeth for some time after your root canal treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your dentist immediately.
– Restoration of tooth. Typically, but not always, a tooth that needs a root canal often is one that already has a large dental restoration or extensive tooth decay. Even when tooth decay was not a factor, the tooth treated with a root canal is weaker than a “live” tooth. Therefore, a crown, crown and post, or other extensive dental restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it back to full function again. After a completed dental restoration, you will not be able to notice any difference in its function or form or feel. You and your dentist will discuss this and make an informed decision together for the best course of action for your dental care.
Root Canal Treatment
A root canal is extremely successful with a more than a 95% rate of success. Many teeth with a completed root canal can last a lifetime with no issues. Most root canals are completed to relieve the pain of toothaches caused by pulpal inflammation or dental infection. With modern advancements in dental techniques, materials, and anesthetics, most patients state that they do not feel any pain once the procedure is underway.
Root canal procedures have an undeserved reputation of being painful. Usually, most patients report that the procedure itself is no more painful than having a routine dental restoration placed. This misconception developed because the majority of the pain stems from the dental infection and pulpal inflammation that has developed. A good dentist will make sure you are comfortable during the procedure.
As mentioned above, the pain from root canals in modern dentistry are mainly from a previous dental infection. The actual procedure should be pain and worry-free. The best defense against developing a toothache and the need for a root canal is to see your dentist regularly, maintain proper oral hygiene, and call your dentist if you have any pain or discomfort.