Root Canal Treatment

Endodontic treatment (root canal) is a procedure that we use when a cavity has progressed into the tooth’s nerve, or if trauma to the tooth has exposed the nerve or severely damaged the nerve tissue. While root canal treatment has a reputation for being uncomfortable, modern root canal treatment can be virtually pain-free.

What is the root canal procedure?

In the root canal procedure, the goal is to remove the tooth’s inflamed or infected nerve tissue so the tooth can still be maintained in your mouth (recall that the nerve in a tooth is located in a canal within the root – hence the term “root canal”). We remove the nerve from the tooth, clean the tooth, and then fill the root canals with a non-reactive filling material.

What is the next step after I’ve had a root canal procedure?

Once a root canal has been completed, the next step is to have a crown placed on the tooth. If there isn’t a lot of tooth structure remaining above the gum (not an uncommon situation), we might place a post. Remember that while the goal of a post is to help us give the tooth more support, not every root canaled tooth needs to have a post. That being said, almost all root-canal treated teeth (with a few exceptions) should have a crown placed as a final restoration in order to protect the tooth.

Can teeth with root canals still get decay?

Yes. Teeth that have had root canal treatment can still get decay. The reason for this situation is that the bacteria in your mouth can still affect the surfaces of your teeth – regardless of whether or not the tooth has a nerve. If you are a patient with dry mouth, or a history of getting multiple cavities, you need to be extra thorough in your oral hygiene. When a tooth with a nerve starts to get decay, you will likely feel it; but when a tooth that has had root canal starts to get decay, you won’t feel it because the tooth has no nerve. Thus, if you have had root canal treatment, it’s imperative that you keep your mouth clean, and you come for your routine 6-month checkups.

Should I have a root canal and a crown, or should I have a dental implant?

This is a great question because there’s a time and a place for both- it depends upon how much tooth is left, and how much time and expense it would cost to save the tooth vs. having the dental implant.

Root Canals Q & A

Why are Root Canals Performed?

Root canals are performed to get rid of an infection that has made its way inside the tooth. This type of infection can be extremely painful and can eventually cause the loss of the tooth if it isn’t properly treated in a timely fashion. When you visit Dr. Cortes, he uses an X-ray or other diagnostic tools to determine the exact location of the infection and then takes steps to eliminate it.

The only way to eliminate this type of infection is to remove it from the interior of the tooth. Dr. Cortes removes the nerve and surrounding pulp from inside the tooth and replaces it with a composite material that stabilizes the tooth from the inside. He then places a temporary crown over the top of the tooth to seal it and protect it from further decay.

What Causes a Root Canal to Fail?

Root canals often fail because small pockets of infection are missed. Along the nerve, many small channels travel deep into the tissue. If the infection becomes trapped, a dentist may not be able to locate it all without removing extensive amounts of pulp tissue.

If a root canal fails, Dr. Cortes removes the temporary crown from the tooth. He re-enters the tooth and attempts to locate the rest of the infection. Once he’s finished, he replaces the crown and allows the tooth to heal. Once he has completely removed the infection, your symptoms begin disappearing over a period of three or four days.

Why are Temporary Crowns Used?

A crown — typically made of a composite or resin material and are easily replaced — is meant to be permanently attached to a tooth. Dr. Cortes puts a temporary crown in place after a root canal so he can easily remove it if the infection wasn’t eliminated with the first procedure.

Once Dr. Cortes determines that the infection is gone and the tooth has fully healed, he removes the temporary crown and replaces it with a permanent one made out of dental porcelain.

The permanent crown is designed to be as permanent as possible. Some may last as long as ten years or longer without experiencing any damage.