Root Canal Therapy

Root canal therapy is needed when the nerve of a tooth is affected by decay, infection, trauma, or a crack.  In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with a special dental material called gutta percha, which hermetically seals the root canal space from bacteria.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed.  Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent and opposing teeth.

Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:

  • An abscess (or pimple) on the gums.
  • Sensitivity to hot and cold.
  • Severe toothache pain.
  • Sometimes no symptoms are present, but an x-ray reveals a periapical lesion (a dark circular area at the end of the tooth's root).
  • Swelling and/or tenderness.

Reasons for root canal therapy:

  • Decay has reached the tooth pulp (the living tissue inside the tooth).
  • Infection or abscess have developed inside the tooth or at the root tip.
  • Injury or trauma to the tooth.
  • Deep cracks in the tooth that make their way to the nerve chamber

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by Dr. Brusky.  In very rare instances, you may need to see an endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.  An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria.  If tooth decay is present, it will also be removed with special dental instruments.  THIS DOES NOT HURT!  Dr. Brusky has special anesthetic delivery systems which will ensure you feel nothing.  In fact, many patients start to doze off during root canal therapy.

Once the tooth is thoroughly cleaned, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. With very rare exception, root canal therapy, even on molars, is done in one visit.

Since all back teeth that receive root canal therapy should be crowned, and assuming the tooth didn't already have one, Dr. Brusky gives you the option of having the tooth prepared for a crown at the first visit.  If a back tooth does not get a crown, the chances of fracture, especially vertical root fracture, is very high.  If this happens, the tooth must be extracted.

After treatment, your tooth may still be tender, but this will subside as the inflammation diminishes and the tooth has healed.  On average, this persists for 1-3 days.

You will be given care instructions after each appointment.  Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.