Endodontics (Root Canals)>  Laurel Hills Dental Center            

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Laurel Hills Dental Center

your partner in great oral health and beautiful smiles.

 

 

 

5215 Garfield Avenue  Sacramento    California    95841    916.331.4781 voice   916.331.4785 fax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Decayed tooth with pulpal exposure (by decay) and necrotic (diseased and dying) pulp.

How we save teeth with damaged, dead and infected nerves    

 

 

 

 

 

      

v     Periodontal Care and Maintenance

v     Restorative Dentistry

v     Implants

v     Cosmetic Dentistry

v     Endodontics

v    Bone Loss

v    Bite Collapse

v    Post Operative Answers

 

 

 





 

What is the purpose of root canal treatment?

The purpose of root canal treatment is to have tissues surrounding a tooth's root in a healthy status and have the tooth in function.
 

How does root canal treatment accomplish this goal?

The process of root canal treatment first removes (as thoroughly as possible) bacteria, nerve tissue, the organic debris left over from the breakdown of nerve tissue, and bacterial toxins from the inner aspects of a tooth (the pulp). These produce the irritants that cause an inflammation reaction.


Cleaning out the canal

Once this space has been cleansed root canal treatment involves filling in and sealing off the interior of the tooth. This minimizes the possibility of bacteria re-colonizing the inside of the tooth.(This would produce a state of persistent inflammation in the bone that surrounds the tooth's root.)

  Canals sealed

Problem teeth can be identified by:

X-rays: The nerve tissue in a tooth can die quietly. The degeneration of a tooth's nerve is not always a painful experience. Because of this, on occasion, a tooth's need for root canal treatment can remain undiscovered, even for some years. This is because in these instances the virulence of the infection in the tooth is low and your body's defense mechanism, while not being able to clear up the infection totally, is able to keep it in check.
 

A persistent or reoccurring pimple on your gums: Sometimes a tooth whose nerve has died will produce a pimple like lesion on a person's gums. The presence and/or size of these pimples (dentists call them fistulous tracts) can come and go. Because they are literally drains for pus from an infected tooth, a person might notice that they discharge a bad taste (the pus). It is possible that a dentist will pick up on the presence of this type of lesion during their examination, even though the patient hasn't noticed it at all.

Exposure of a tooth's nerve: Sometimes in working on a tooth, the decay is so deep as to enter the pulp chamber.  The term "exposure" simply means that your dentist, while performing your dental work, has literally been able to visualize your tooth's nerve tissue. An exposure can lead to the degeneration of a tooth's nerve tissue. It is usually best to go ahead and perform root canal treatment on the tooth now so to avoid possible problems and complications with the tooth later (such as a painful tooth abscess).
 

Teeth which have been traumatized in an accident: The health of the nerve tissue in teeth which have a history of having been traumatized (such as being bumped in an accident) can deteriorate, leading to the need for root canal treatment.  Immediately after a traumatic event the outlook for the health of a tooth's nerve can be difficult to predict. Sometimes these teeth do quite well, even for many years.  It is always possible however that at some point the health of the tooth's nerve tissue will go ahead and degenerate (often without symptoms). A tip off that the nerve tissue inside a tooth is undergoing degenerative changes is that the tooth, in comparison to its neighbors, appears darkened.
 

 

This page last updated: Saturday, February 10, 2007

Why go to all of this trouble?

If you get an infection, say from bacteria entering a cut in your skin, your body will transport white blood cells to and from the area (by way of your blood vessels and lymphatic system) so to combat the bacteria that have caused the infection. In most cases your body will win the battle and kill off the offending bacteria.

The problem with teeth and infections is that once a tooth's nerve tissue has started to degenerate and bacteria have taken up residence in the tooth's nerve area, there is no effective way for white blood cells to get at the bacteria to combat them. The dying nerve tissue's blood and lymphatic vessels that are normally used to transport white blood cells will have begun to degenerate too.

The net result of all of this is that the nerve space inside a tooth can provide a nice, cozy location for bacteria to persist. It's a place where  your body's defensive mechanisms can't effectively get at them. With this scenario, at best your body will only be able to cordon off the infection caused by the bacteria living inside your tooth. At worst, this bacterial infection will overwhelm your body's defense mechanisms and pain and swelling will ensue (an acute tooth abscess).

The idea of root canal treatment is that it provides the bulk of the clean up work for your body. It removes bacteria and tissue irritants that are present inside the tooth, especially those in the locations where your body would have the most trouble combating them. As an end result, once root canal treatment has been completed it provides your mouth with a sound tooth for your use.

 

Will you experience pain during your root canal treatment?

Root canal treatment has a reputation for being painful, but we'd be the last to agree that this reputation is deserved. It seems most likely that a majority of the derogatory remarks you hear in regards to root canal treatment must be including in them references to that period of pain and discomfort the person experienced leading up to their need for their treatment.


For the average person and the average case, root canal treatment is a non-event and not any more uncomfortable than having a filling placed.

Sometimes, especially when the infection has been long standing and/or aggressive, post operative pain can result.

Tooth restored with post, build-up and crown

 

 

For an excellent presentation of root canals CLICK HERE and select the root canal tab.  Close the window when done viewing the presentation.

 

How do you know when your tooth needs root canal treatment?



It will take an examination by your dentist to determine if root canal treatment is indicated for your tooth. Not only must your dentist determine that this treatment is an appropriate solution for your situation but also that the overall condition of the tooth in question warrants the time and expense involved.



Here are some situations where root canal therapy might be the proper solution:
  • A tooth is currently causing you pain or else has a history of being painful.

     
  • You have noticed the presence of tenderness and/or swelling in your gums near a tooth.

 

  • Sometimes, there is no pain, no swelling, yet the nerve is dead and is just waiting to cause a problem.

 

What additional dental work is needed for a tooth that has had root canal treatment?

Many times tooth that has required a root canal is one that has a large filling or else has large portions of tooth structure missing due to extensive decay or breakage. It is usually recommended that a tooth that has had root canal treatment should be restored using either a dental crown or else a dental crown in combination with a dental post. This seals and restores the tooth to function. 

A tooth that has had a root canal should not receive full biting pressure until it is restored and the restoration should be done as soon as possible!