Root canal treatment consists of a number of steps that take place over several office visits, depending on the situation. These steps are:
- The endodontist examines and x-rays the tooth, then local anesthesia is administered to the affected tooth.
- A dental dam is usually placed over the affected tooth to isolate it and keep it free from saliva.
- The endodontist makes an opening through the back of a front tooth or the crown of a molar or pre-molar to remove the diseased pulp, called a pulpectomy.
- Next, the pulp chamber and root canals are cleaned and shaped in preparation for a filling.
- The endodontist fills the root canal with gutta percha material.
- If more than one visit is needed, a temporary filling is placed in the crown opening to protect the tooth between dental visits. The temporary filling is removed and the pulp chamber and root canal are permanently filled with gutta percha into each of the canals and is sealed in place with cement. Sometimes a metal or plastic rod is placed in the canal for structural support. In the final step, a crown is usually placed over the tooth to restore its natural shape and appearance. If the tooth is broken, a post may be required to build it up prior to placing a crown.
Many people worry that a root canal will be painful, something that was true in the past. Today, with advanced anesthesia options and surgical techniques - a root canal is as comfortable as getting a filling. An infected tooth (pre-root canal), is usually what causes tooth pain, and a root canal is the solution to this problem. In fact, infected tooth pulp can cause a tooth abscess and can destroy the bone surrounding the tooth.
A treated and restored tooth can last a lifetime with proper care. Root canals have a high success rate and are significantly less expensive than the alternative, tooth extraction and replacement with a bridge or implant.
But tooth decay can still occur in treated teeth, so good oral hygiene and regular dental exams are necessary to prevent further problems.
To determine the success or failure of root canal treatment, dentists typically compare new X-rays with those taken prior to treatment. This comparison will show whether bone continues to be lost or is being regenerated.
Sometimes root canals are not successful because an infection develops inside the tooth, or the original infection was not fully removed. In these cases, an apicoectomy, a procedure where the infection and the root tip are removed and a filling placed, is done. Other times a second root canal is recommended.