Endodontic Instructions

PURPOSE/OPTIONS: Root canal therapy is the one course of action that can save an infected, vital tooth or an irreversibly inflamed tooth. It is also used to treat a non-vital tooth (a tooth with a dead pulp). Alternatives to endodontic treatment or root canal therapy include extracting the tooth or refusing treatment. Leaving the area untreated can cause ongoing pain, infection, a cyst, an abscess and/or swollen gums. If you are in cur pain or have an infection, you will probably want to do something soon. Some type of tooth replacement could follow up extraction of the tooth.

PROCEDURE: Inside your tooth is a tissue called pulp. The pulp can become infected or inflamed for a number of reasons: decay, a crack, a blow to the tooth or repeated dental procedures on the tooth, such as having cavities filled and refilled (a history of moderate to deep caries or recurrent caries are often the cause). Before and during the root canal procedure, we examine and x-ray your tooth. A local anesthetic is administered if needed and a dental rubber dam is placed to isolate the tooth. The pulpectomy is the first step in the root canal procedure. The pulpectomy removes the soft pulpy material inside the tooth. It does not, however, provide complete treatment for the tooth. An opening is made in the tooth to remove the infected or inflamed pulp. Small, precise instruments are used to clean the pulp chamber and root canals. The dentist shapes the space to be filled and sealed with a rubber like material called gutta percha. The procedure is done in one or more visits, depending on your tooth's problem and anatomy. You must keep subsequent appointments and follow up visits to complete therapy. A tooth that has undergone root canal therapy is pulpless, or non-vital, but it is not dead. It still receives support and nutrients from the surrounding tissue.

SUCCESS RATE: About 19 out of 20 endodontic treatments are successful the first time. Success depends on many factors, such as your general health, the health of the bone around your tooth, the strength of the tooth itself, the shape and condition of the roots and nerve canals and whether or not fracture lines are present.

RISKS: During the procedure, a dental instrument may be become separated in the canal itself. The tooth may also require endodontic surgery in addition to the root canal therapy in order to be saved. Occasionally, even though the entire procedure has gone smoothly, the root canal can fail and the tooth is lost.

COMPLICATIONS: Discomfort and pain may begin after the anesthesia wears off and could last up to several days. Ibuprofen or aspirin will usually be sufficient to relieve the discomfort. Some minor swelling may begin or increase after treatment. Try not to chew on the tooth being treated.

WHEN TO CALL US: Call if you experience ANY sign of infection, such as fever, chills, swelling, or malaise. Call if you are in a lot of pain or the pain increases in subsequent days.

FOLLOW-UP: A crown is almost always needed to restore an endodontically treated tooth to its full strength. Unrestored teeth, especially back teeth, can fracture beyond repair if not crowned. A post is sometimes placed in the canal of the tooth to support the crown and/or a build up is done. This procedure provides a stable foundation on which to place the crown.