The nerve of the tooth lies within root canals. The root canals are located within the roots (or legs) of the tooth. These canals travel from the tip of the tooth’s root into the pulp chamber, which is the soft area within the center of the tooth. The pulp chamber houses blood vessels and connective tissue that nourish the tooth.
A tooth that is badly decayed or that has become infected may be saved by performing root canal therapy. During a root canal procedure, the nerve and pulp are removed, and the inside of the tooth is cleaned and sealed.
Once a tooth has emerged through the gums, the tooth’s nerve is no longer vitally important to the tooth’s health and function. The primary function of the nerve at this point is only to sense hot and cold. If the nerve is removed, the tooth is still able to function properly.
Damaged nerve or pulp tissue begins to break down and bacteria begin multiplying in the pulp chamber. Therefore, it is necessary to remove the pulp to prevent infection caused by the buildup of bacteria. If the tooth becomes infected, an abscess or pus-filled pocket may form at the end of the roots of the tooth. This abscess can result in swelling of the face, neck, or head. It can lead to loss of bone that supports the tooth. Then, drainage problems from the tooth’s root might develop, as well, sending bacteria into other parts of the body.
The nerve and pulp in a tooth can become damaged as the result of deep decay, a crack or chip in the tooth, repeated dental work done on the tooth, large fillings, or trauma to the face. The damage can result in mild irritation, inflammation, or infection of the tooth.
Symptoms do not always occur when root canal therapy is needed. However, when certain symptoms are present, it is likely that a root canal procedure might be warranted. Symptoms to be aware of include severe pain when chewing or applying pressure to the tooth; sensitivity or pain caused by hot or cold temperatures that persists, even after the source of the hot or cold has been removed; darkening of the tooth; swelling and tenderness of the gums surrounding the tooth; and a persistent or recurring sore on the gums.
Root canal therapy typically requires more than one office visit. The procedure begins with an X-ray to determine the shape of the root canals and to detect any signs of infection in surrounding bone tissue. Local anesthesia will then be administered to numb the area near the tooth. A rubber dam may be used to keep saliva away from the tooth during the procedure.
A hole will be drilled in the tooth to allow access to the root canals and pulp chamber. Using a series of root canal files, the canals and chamber are cleaned out, removing bacteria, pulp, decayed nerve tissue, and any related debris from the tooth. Water or sodium hypochlorite will be used periodically to flush away the debris.
Once the tooth has been thoroughly cleaned out, the tooth will be sealed. If infection was present, the dentist may choose to put a medication inside the tooth to clear up the infection prior to putting a permanent sealant and/or crown on the tooth. In such instances, temporary fillings are used until the permanent sealant is applied.
Your tooth may be somewhat sensitive for awhile after the root canal procedure, especially if infection or pain was present beforehand. This discomfort is due to inflammation of the tissue and can usually be controlled with an over-the-counter pain medication such as ibuprofen.
If a temporary filling has been put on the tooth, it might be a good idea to avoid chewing on that tooth as much as possible until a permanent crown or filling has been placed. This extra care could prevent recontamination of the tooth’s interior and prevent breakage of the tooth before it has been fully restored.
Overall, root canal therapy has a great success rate. About 95% of procedures performed have been successful! With proper oral hygiene and dental care, a tooth that has undergone a root canal can last a lifetime.