About root canals
Now that I’ve introduced the subject of root canals, I’d like to give you a little more information on them to do away with any fear about this important therapy.
Q. What is the root, and what is the canal?
A. The root is the long part of any tooth that’s anchored in the bone of the jaw. A front tooth has one root; a back tooth (molar) typically has two roots in the lower jaw and three in the upper. The canal is the channel inside the root that houses the nerve of the tooth and its blood supply.
Q. And root canal is also the name of the treatment?
A. Yes. We say “She’s having a root canal.” If we spoke the same way about having our appendix out, we’d say, “She’s having an appendix.” I’m not sure anyone knows why we refer to it like this—and I don’t think it matters! The correct professional term for a root canal is endodontic therapy. Maybe root canal is just easier to say.
Q. Is it just decay and cavities that cause problems requiring a root canal?
A. No, injury can too. Any event that exposes the interior of a tooth to bacteria and infection or that traumatizes the tooth can lead to the need for a root canal. Sports injuries are one example of trauma (damage) to a tooth that can develop an infection even years later and require a root canal.
Q. You said that after removing the infected material the dentist fills the canal before sealing it. What does he fill it with?
A. The canal is filled with an inert material called gutta-percha, a sterile, nonirritating form of latex from the sap of a Malaysian tree. But sealing may not end your treatment. Once a root canal is completed, the tooth becomes brittle and is prone to fracture. Often, an overlay or crown is required for protection of any back tooth (molar or premolar) that had a root-canal.
Q. Crowns are expensive. Why can’t the tooth simply be sealed
after a root canal?
A. The root-canal procedure weakens the tooth. A full crown protects it from fracture. In some cases, a porcelain overlay will serve as well. Only the front teeth, upper and lower, do not require crowns after a root canal—and then only if they don’t have previous large fillings that weaken the structure of the tooth.
For a front tooth, a simple filling is usually the best way to plug the root-canal access hole. However, if a front tooth already has a large filling, another filling for the access hole plus a crown to protect the tooth from fracture would be needed.
Q. A friend of mine had a root canal and later lost the tooth. How does that happen?
A. It doesn’t happen often, but a tooth can get reinfected either through injury or further decay. In such cases, the recommendation may be to take the tooth out and replace it with an implant, bridge, or partial. Also, as mentioned earlier, root
canals cause teeth to become brittle. If that happens and the tooth cracks, there may be no choice but to remove it.
Q. You’ve said that root canals are painless.
A. Pain prevention and sedation (when appropriate) are essential parts of the procedure, and any professional who performs root canals is trained in those very important skills.
No dentist wants you to be in pain any more than you want to be. Today, by far, most people who have the procedure report no significant pain. When the anesthetic wears off, any discomfort is almost always managed easily
with a prescription medication or with aspirin or ibuprofen.
By the way, any such pain is caused by the doctor’s attempt to remove all the infected material—a necessary process that can bruise the tissues at the base of the root. A few days of healing solves the problem, and as I said, medication takes care of any residual soreness.