What it is
A tooth has an outer layer of enamel and, beneath it, a softer layer of dentin. At the center is a chamber that holds the pulp, the nerve tissue and blood vessels inside the tooth. The pulp extends down through the root in narrow channels called root canals.
The pulp contributes to the growth of a tooth during youth, and a fully developed tooth can survive without it because the tissue around the root continues to nourish the tooth. Root canal therapy removes the pulp when it can no longer recover.
When you might need it
Root canal therapy is indicated when irreversible damage has occurred to the inner tissue of the tooth. The usual causes are a deep cavity, a crack or chip that opens a path for bacteria, or a blow that injures the pulp even when the tooth looks intact. Once bacteria reach the pulp, the body cannot clear the infection on its own.
Left untreated, the disease often progresses to necrosis, or death, of the pulp, and the infection spreads past the tip of the root into the adjacent bone, where it can form an abscess. The symptoms range from a painful response to hot and cold to spontaneous and continuous pain in the late stage. Pain on biting, a darkening tooth, or a tender bump on the gum may also appear, and some infected teeth cause no symptoms until a dentist finds the problem on an X-ray.
Call (303) 978-1522 for a toothache that lingers or wakes you at night. Swelling that spreads to the face or neck, or trouble breathing or swallowing, requires emergency medical care. Go to an emergency room or call 911.
What happens at each visit
The number of visits depends on the tooth and on the extent of the infection, and the dentist explains the plan before treatment starts. The first step is an examination. The dentist tests how the tooth responds to touch and to cold and takes X-rays to show the roots and the surrounding bone.
The dentist then numbs the tooth and the gum around it, and a thin rubber sheet may be placed around the tooth to keep it clean and dry. A small opening in the top or back of the tooth gives access to the pulp. Small instruments remove the infected tissue from the chamber and each canal, and a disinfecting solution rinses the canals so that the bacteria are cleared. The canals are shaped, filled, and sealed, and a temporary filling closes the opening.
Materials and what to expect afterward
A rubber-like material fills the canals, and a sealing cement closes them. The tooth then needs a permanent restoration, either a filling or a crown.
A crown is typically applied for protection and healing. A tooth that has lost its pulp and much of its structure to decay, a crack, or a large filling is more likely to fracture, and a crown covers the tooth and holds it together. Back teeth, which carry the heaviest chewing forces, are the most likely to need one, while a front tooth with ample sound structure may need only a filling. The dentist advises which restoration the tooth requires.
Afterward the numbness wears off. Avoid chewing on that side until it does, so that the cheek or tongue is not bitten. Soreness in the tooth and gum is common and usually eases over the following days, and the dentist advises what to take for it. Call if pain worsens instead of easing, if swelling appears, if the temporary filling comes out, or if the bite feels uneven. Keep your checkups so that the dentist can follow the tooth on X-rays.
Why Dutch Creek Dental
Dr. Mike Itoafa has owned Dutch Creek Dental since 2018. Root canal treatment is provided in this office on West Coal Mine Avenue, where the practice has been for more than 30 years. When a case calls for a specialist, Dr. Itoafa refers you to one he trusts.
Common questions
Does a root canal hurt?
The tooth and the gum around it are numbed before treatment starts. You usually feel pressure and movement during the visit. Tell the dentist if anything feels sharp. The toothache that brings many patients in originates in the infected tissue, so removing that tissue treats its source.
Why save the tooth instead of pulling it?
Dentists generally try to keep a natural tooth when it can be saved. Extraction leaves a gap, which is usually filled with a bridge, an implant, or a denture. Whether a tooth can be saved depends on how much sound tooth remains and on the health of the bone around it.
What happens if I wait?
The infection does not clear on its own. The pain may ease or stop when the nerve inside the tooth dies, but the infection remains. It can spread to the bone and gum and cause swelling or an abscess. A tooth that has stopped hurting still needs an examination.
Can a treated tooth become infected again?
It can. A crack, a leaking filling or crown, or new decay can let bacteria back in, and a sound permanent restoration, daily brushing and flossing, and regular checkups lower that risk. If a treated tooth becomes sore or swollen, call the office.