Endodontics is the field of dentistry that involves treatment of tooth nerves and management of chronic dental pain.
Depending on the situation, endodontic treatment usually involves a root canal but it also includes procedures such as an apicoectomy (removal of diseased root tips) and root canal re-treatments.
Root Canals: Do They Hurt?
One of the most common misconceptions about root canals is how much they hurt.
Thanks to modern anesthetics and pain-relievers, this is usually not the case. There are a few things that could contribute to your level of comfort during such a procedure:
- If you have an active infection, it can be difficult to numb your tooth. Anesthetic just will not work. Your dentist may need to put you on an antibiotic to reduce the level of infection before starting the procedure.
- Depending on the tooth being treated, the number of roots will vary. This means the procedure for multi-rooted teeth can sometimes be quite lengthy. You may be given a soft mouth prop to help you keep your mouth open; this can reduce any soreness in the jaws.
- Discomfort after a root canal is usually from the injection or strain to the TMJ if a prop is not used. Your tooth will no longer have a live nerve inside of it, meaning that the tooth itself cannot hurt any longer.
Do I Need Endodontic Treatment?
Your dentist may recommend a root canal if you have an infected dental nerve or cracked tooth.
To determine if this is a case, your dentist may take an x-ray or perform temperature tests to see how sensitive your tooth is. A “fistula” or abscess may or may not be present on the soft tissue alongside of your tooth. Such areas are caused by infections draining out of the root tip.
While a large cavity or abscess is quite easy to diagnose, a cracked tooth is not. Your dentist may need to perform more testing or send you to an endodontic specialist for additional screening.
Untreated dental infections can not clear up on their own or with a prescription. Although your dentist may prescribe an antibiotic to reduce infection prior to treatment, it will not prevent the infection from returning. When leakage from a cavity or crack allows bacteria into your tooth nerve, that nerve will die and infection can spread to other areas of the body. In rare situations, hospitalization or death can occur.
A root canal will seal off the entire nerve chamber, thereby preventing reinfection.
In some situations, there is no cavity or crack in the tooth, but you may have traumatized the tooth 10 or 20 years prior. An example could be getting hit in the mouth with a baseball or being in an automobile accident. The injury may cause the tooth to die years down the road. You may not notice until it begins to look darker in color, or your dentist sees a widening of the nerve chamber on your most recent x-ray. Dying teeth require endodontic treatment to prevent the need for an extraction.
What Happens During an Endodontic Procedure?
The purpose of a root canal is to remove the nerve tissues from inside of your tooth. Your dentist or endodontist will first numb the area and then remove the damaged tooth structures. Next, the nerve chamber will be cleaned and medicated, so as to create a sterile environment. Then, a filling material is placed down into the nerve chambers, extending all the way to the tip of the roots.
Because the tooth is no longer alive, it is also more brittle. You will need to have a crown placed over the remaining enamel so that it can maintain normal function and integrity without the risk of fracturing.
Sometimes a root canal can fail. This happens if bacteria is left inside of the tooth or a portion of the canal was not completely sealed off. In such a situation, pain and swelling can persist. A re-treatment is needed to re-clean the nerve canal and seal it off again. Most pretreatments are referred to a specialist.
A root resection, or “apicoectomy” is sometimes used in lieu of a root canal if residual infection is prevalent around the root tip. During this oral surgery, your endodontist will go in through the side of the jaw, remove the root tip, place a root end filling, and close the area.
What is an Endodontist? Do I Need to See a Root Canal Specialist?
“Endo” refers to the internal portion of the tooth, and as such, endodontists strictly provide treatments that relate to the dental nerve.
The American Association of Endodontists defines an endodontist as having “at least two years of additional education to become experts in performing root canal treatment and diagnosing and treating tooth pain.” Most endodontists will perform 25 or more root canals each week, compared to a family dentist who may only provide two or three a week. As such, endodontists are extremely familiar with the procedure and can perform more complex treatments in the most efficient manner possible.
If your situation is complex or on a tooth further back in your mouth, your general dentist may prefer that you see an endodontic specialist. Aetna Dental Offers can reduce the out of pocket amount that you spend on speciality treatment. Contact us today for more information!