Root Canals

What is a root canal treatment?

A root canal treatment involves every tooth which has a hollow spot in the middle, known as a root canal system. This is where the blood supply and the nerve to the tooth are located. Root canal therapy aims to clean and seal this center space when the nerve and the blood supply become unhealthy.

What are some signs that indicate I may need a root canal?

Some signs include severe sensitivity to hot or cold, intense sensitivity to sweets or salty things, temperature changes, and sometimes just a sensation of pressure. Sometimes we find teeth that need root canals and they're completely asymptomatic. We look at an x-ray and we see an infection.

Can a root canal save a cracked tooth?

Yes and no, it depends on how bad the crack is. When teeth become cracked, the surface of the tooth loses its integrity, and hot and cold sensations can penetrate into the center of the tooth where the nerve resides, causing discomfort. So, if the crack is relatively superficial or minor, a root canal, which involves removing the agitated nerve, can usually settle the tooth down, followed by a crown. However, in some cases, a crack may be so severe that even a root canal cannot resolve it because the inside of the tooth has been treated while the nerve on the outside remains.

There are still many nerve fibers around each root, surrounded by a ligament known as the periodontal ligament, which is heavily innervated. Thus, even if a root canal has been performed, and the tooth is considered dead, if the fracture persists and cannot be resolved with a simple crown, it may still flex during chewing, causing discomfort. In such instances, the tooth may require further treatment, sometimes even leading to extraction.

Furthermore, a severe crack can lead to gum disease because bacteria can infiltrate under the gums alongside the root, causing additional problems. So, to answer the question, root canal therapy can sometimes resolve the issue of a cracked tooth, but not always; it depends on various factors.

When is it too late for a root canal?

It's too late when the tooth is severely cracked, too much of the tooth structure is missing, or there's not enough good bony support around the tooth. In such cases, a root canal may not be appropriate.

What happens during a root canal?

Thankfully, it's a very straightforward procedure. We perform root canals routinely in general dentistry, and it's considered a standard procedure. Root canals have gained a somewhat negative reputation. Often, you'll hear horror stories about the perceived difficulty of root canals. However, in the vast majority of cases, they are quite simple.

The process begins with an examination where we identify the need for a root canal, create a treatment plan, and then you come in for the procedure. The first step is to anesthetize the tooth, using the same type of anesthesia you'd receive for a filling or any other dental work. Once the tooth is numbed, you typically won't feel much discomfort. Sometimes you'll feel nothing at all, and sometimes there might be slight discomfort. The procedure itself feels similar to having a filling or crown done, like typical dental work.

Here's what happens during the procedure: the dentist accesses the center of the tooth by drilling through the top, where the nerve is located. The dentist then cleans, disinfects, sterilizes, and seals the area. It's a straightforward process. There are instances, however, when a tooth is highly irritated, resulting in an intense and challenging toothache that is difficult to numb. In such cases, a root canal can be uncomfortable, and the dentist may struggle to ensure complete numbness due to the heightened sensitivity of the nerve tissue. Fortunately, for most patients, root canals are surprisingly easy, quick, and result in minimal discomfort afterward.

How long does a root canal procedure last?

If performed effectively, a root canal can be a permanent solution, as long as the remaining tooth structure remains intact. We've encountered cases where root canals done during adolescence have lasted a lifetime.

There isn't a specific expiration date for root canals; they don't require redoing every five or seven years. The key to long-lasting success is ensuring the root canal is performed meticulously, the tooth is adequately restored afterward with a filling or, most often, a crown.

If these steps are executed well, and the patient maintains good oral hygiene practices such as regular brushing and flossing, avoids habits like smoking that can compromise tooth integrity, and refrains from clenching, grinding, or chewing on hard objects, the root canal can indeed last a lifetime.

However, there are unpredictable factors in root canals. While the general pattern of root canals is consistent across patients (e.g., front teeth have a certain number of canals, back teeth have a different number), individual variations exist. No two patients are identical, and their teeth are unique as well. Occasionally, some teeth may have more complex root canal systems than expected.

A skilled dentist uses X-rays and examines the mouth during the procedure to ensure all canals are identified, cleaned, and sealed. Despite the best efforts, sometimes a canal may be inadvertently missed or inaccessible. In some cases, the root canal system may bifurcate at the tip of the root, making it challenging to clean or even detect.

If the procedure is performed diligently, addressing all known factors to the best of our ability, it can endure for a significant duration. In the rare event of a root canal failure, we investigate what might have gone wrong and attempt to correct it. It's possible to repeat a root canal if necessary, but fortunately, this is uncommon. Typically, when performed effectively the first time, it should last for the foreseeable future without the need for a repeat procedure.

Will I need a dental crown after a root canal?

Most of the time, yes. Now, why is that? Well, most of the root canals we perform are on back teeth, which are where most of the chewing takes place. Studies have shown that after a root canal is done, back teeth have a significantly higher risk of fracturing. A tooth that has had a root canal but isn't crowned is six times more likely to fracture. Therefore, it's common for dentists to recommend crowns for back teeth that have undergone root canal therapy.

Back teeth typically refer to the premolars and molars, which are the teeth located behind the canines and incisors. In other words, every molar and premolar that has had a root canal should ideally be crowned.

However, the situation is a bit different if there is no tooth above it. For instance, if a bottom or top tooth is missing, and the opposing tooth requires a root canal, you can often skip the crown because the force on that tooth is minimal or nonexistent. This may also apply if the tooth is opposing a denture since plastic denture teeth exert less force on a tooth compared to natural teeth.

So, the necessity for a crown after a root canal depends on the specific clinical scenario. Generally speaking, back teeth (premolars and molars) typically require crowns after root canal therapy. On the other hand, the eye teeth (canines) and incisors often do not require crowns after root canal therapy. However, in cases where the root canal is performed due to a severe cavity or significant structural damage, crowns may still be recommended for proper restoration.

What type of anesthesia will be used during a root canal procedure?

The anesthesia used for a root canal is the same type you would receive for various dental procedures, such as getting a filling, having a tooth removed, getting an implant, or even undergoing a deep cleaning. It involves a simple series of injections in the mouth, which we strive to make as minimally uncomfortable as possible. The goal is to put the tooth to sleep, just like we do for any other dental procedure.

Typically, the first step is to apply a topical anesthetic, a jelly-like substance that we rub on the gums in the area where we'll be injecting. This numbs the surface and makes the injections a bit less uncomfortable. We also use distraction techniques to help ease any anxiety or discomfort. Then, we inject the anesthetic as gently and quickly as possible to ensure the tooth is completely numb. There are various types of anesthesia and anesthetics we use, depending on the situation, but the process is generally similar to what you'd experience for a crown, extraction, or deep cleaning.

Additionally, we offer different types of sedation for patients who are very anxious or have had unpleasant experiences with root canals in the past. At Integrity Dental, we provide sedation options to help you relax and tolerate the procedure well. Many patients even have no memory of the procedure, allowing them to avoid recalling the details of the treatment. However, it's important to note that anesthesia is typically a necessary and straightforward part of root canal procedures.

How safe is a root canal?

Root canals are a routine and common procedure for us at Integrity Dental. We perform them almost daily, often completing multiple root canals in a single day. The procedure is considered very safe, with a long history of successful use spanning decades. Extensive scientific research supports its safety. When a tooth is infected, a root canal is often the best way to save the tooth and restore both the patient and the tooth to good health.

How do I prepare for a root canal?

There isn't much preparation required for a root canal procedure, and it's quite similar to preparing for any other type of dental treatment. It's a good idea to ensure your teeth are clean and your gums are healthy before coming in for a root canal. If your gums are highly irritated or inflamed, the procedure may be a bit more uncomfortable afterward. So, as always, maintaining clean and healthy teeth is important.

You might want to consider taking some ibuprofen or Tylenol, preferably ibuprofen if you can tolerate it, before your appointment. A dose of 400 to 600 milligrams is typically effective, as long as your health history doesn't have any contraindications. Taking ibuprofen before the appointment not only helps alleviate any existing tooth discomfort but also eases the transition into the recovery period, reducing post-procedure discomfort.

There isn't much else you need to do to prepare for a root canal. Just make sure you understand what the procedure entails so that your questions are answered. Arrive on time for your appointment, and be ready to proceed. Taking ibuprofen beforehand is a good proactive step to ensure a more comfortable experience.

How will I feel after a root canal?

Unfortunately, it's challenging to provide a definitive answer because the post-operative experience can vary widely depending on the individual situation. However, we gather a lot of feedback as we conduct extensive research on root canals, and we usually follow up with patients on the same evening or the day after the procedure to learn about their experiences.

Generally speaking, many patients report experiencing mild soreness in the area where the root canal was performed. This discomfort is often effectively managed with ibuprofen or Tylenol. It's important to note that the level of discomfort may depend on how uncomfortable the tooth was before the root canal, as immediate healing is not always complete. So while most patients begin to feel better after the procedure, some may experience significant discomfort for a day or two until the body fully recovers.

In most cases, patients describe their post-root canal experience as mildly sore. Ibuprofen or Tylenol typically suffice for pain management, although occasionally other medications may be recommended. It's common for the tooth to remain somewhat sensitive to chewing in the aftermath of the procedure. The gums in the area may be tender when brushing and flossing, but this tenderness usually resolves within a day or two. Chewing on the treated tooth can also feel tender for a while.

Additionally, there might be a sensation of a slightly elevated bite due to minor swelling in the area. However, in the majority of cases, patients report mild soreness as the primary postoperative symptom.

Will my tooth be sensitive after a root canal?

If your primary concern was hot or cold sensitivity, such as experiencing intense pain when consuming ice-cold water or anything beyond room temperature, you'll likely find relief almost immediately after a root canal. This is because we address the agitated nerve that was causing the body to react with the sensation of "ouch!" So, most sensitivity issues that lead you to seek dental care, like toothaches and extreme sensitivity to temperature, are typically resolved almost immediately or shortly after the therapy is completed.

However, the tooth can remain sensitive in other ways. It may be tender when chewing for a little while because the bone and the gums need time to recover, which can take several days. Additionally, you might experience some tenderness when flossing and brushing.

How long does it take to recover from a root canal?

Generally speaking, sensitivity should significantly diminish within two to three days for most cases. In some instances, patients may feel immediate relief and resume normal eating habits, while others might experience tenderness for a couple of days. Depending on the specific situation, such as a cracked tooth or an infection at the root's tip, it could take longer—up to a week or several weeks. Nevertheless, most patients report feeling much better within two to three days after the root canal procedure.

What is the best way to recover after a root canal?

How should you recover after a root canal? Treat the tooth as if it has been injured, considering that the dentistry involved a minor injury to the tooth itself during the procedure. Similar to how you would handle any other injury, it's advisable to avoid putting too much stress on the tooth and give it some time to recover.

Chewing on the other side of your mouth, if possible, is a good idea. Opt for easy-to-chew foods that are less likely to accidentally put pressure on the treated tooth, such as mashed potatoes, mac and cheese, or protein shakes. It's best to steer clear of gum or anything hard that could potentially cause discomfort or damage.

Additionally, ibuprofen is a helpful tool for reducing swelling and managing pain, while Tylenol is also effective for pain relief. In some cases, you might use ice and consider elevation to further alleviate any discomfort. Generally, giving the tooth some rest and using Ibuprofen should do the trick. That's all for now.

Root canal treatment versus dental implants: what are the pros and cons of each?

Well, this is a very healthy debate in dentistry. There's advantages to both. Most of the time, to keep the tooth, if at all possible, is your best resort.

It's the best possible option. What God gave you in the beginning is better than anything that we can do man-made. So that natural tooth is best whenever possible. There will come a time, in certain cases, where the tooth is broken down or there's so much going on that it is truly truly best to remove the tooth and elect to move forward with an implant. The way that that would work is, "Okay Doc, why can't we keep the tooth? Is there any chance we could keep the tooth?" Here's some reasons why you would elect to take the tooth out and move in a different direction away from a root canal and move maybe towards a dental implant.

A bad fracture; there's a fracture down the side of the tooth that's now led to the root. Root canal will fix it, a crown will fix it, it'll continue to be uncomfortable and an infection risk, unfortunately. Or there's just not a lot, maybe you have some advanced bone loss in the area and there's just not enough to structure the tooth is mobile. You could do a root canal but it’s more predictable to get an implant in there. Maybe the root canal's already been done and if for whatever reason it didn't take the first time and maybe you tried a second time and it's just not working.

Do you want to try a third? Well, it depends. You know, is there a good reason why a third or a second time would predictably address the problem? Maybe now we need to move more towards implant therapy. So there's good reasons on either side.

It's a very individual basis that these decisions are made, but the philosophy that you should take is there's nothing as good as your natural tooth when it can be maintained healthily. So try to keep the teeth whenever possible and a great way to do that is root canal therapy.

Why are dental crowns recommended after a root canal?

Generally speaking, the reason a crown is indicated after a root canal is because teeth after root canal therapy are more brittle. Unfortunately, they become more brittle when the inside of the tooth is cleaned out and sealed.

Studies will show that there is much as six times more likely to fracture. So if you're going to go through the root canal process and the investment in saving the tooth, of course, we want it to last. So after root canal on back teeth, premolars and molars, anything past that, those IT, those canines, typically need crowns to protect them to avoid future fracture.

How much does a root canal treatment cost?

Several factors influence the cost and complexity of root canal therapy. Firstly, the choice of dentist plays a pivotal role; general dentists tend to have a lower likelihood of causing fractures compared to specialized root canal specialists known as endodontists.

The overall cost can also vary depending on the dental practice you visit, as pricing structures may differ among offices. Additionally, the specific tooth requiring treatment is a significant determinant. Different teeth possess varying numbers of root canals, and consequently, the procedure's intricacy and technique requirements may vary.

As a general guideline, root canal treatment for front teeth typically falls within the range of $800 to $900 in a general dental office. In contrast, molars, located at the back of the mouth, may cost approximately $1,200. It's important to note that these figures do not encompass additional procedures such as tooth restoration or crown placement, which are often essential to complete the root canal therapy.

Should a root canal need to be redone, as in the case of a root canal retreatment, the procedure becomes notably more complex and technique-sensitive. Consequently, the cost for a root canal retreatment may range from $1,600 to $1,800.

If you require further clarification or believe that you may benefit from a root canal procedure, we invite you to contact us at Integrity Dental. Our dedicated team is available at (719) 745-5565 to schedule an appointment, during which we will conduct a thorough examination, including X-rays, and discuss treatment options tailored to your specific needs.