Root canal treatment – Procedure, Cost, Pain, Side Effects

Key Facts

• Root canal treatment is a dental procedure that aims to save a tooth that is severely infected or decayed
• It involves removing the infected pulp tissue, cleaning and disinfecting the inside of the tooth, and then filling and sealing it
• Root canals are typically performed by dentists or endodontists
• Modern technology and anesthesia make the procedure relatively painless

What is the Root Canal Treatment?

Root canal treatment, often simply called a root canal, is a dental procedure that aims to treat infection or damage within the pulp (the soft core) of a tooth. The pulp comprises nerves, blood vessels, and connective tissue. It can become infected due to a variety of reasons such as deep decay, repeated dental procedures on the same tooth, or a crack or chip in the tooth.
The principal goal of root canal treatment is to eliminate bacteria from the infected root canal, prevent reinfection, and as the main objective to save a tooth that might otherwise need to be removed. The procedure involves removing the infected or damaged pulp, cleaning and shaping the inside of the tooth, and then filling and sealing the space.

Why You May Need a Root Canal

Root canal treatment is typically needed when there is infection or inflammation in the roots of a tooth. Common causes include deep decay, repeated dental procedures on the tooth, a crack or chip in the tooth, or trauma. Symptoms might include severe toothache, sensitivity to heat or cold, swollen and tender gums, or darkening of the tooth.

What Does the Microscopic Root Canal Treatment Involve?

Microscopic root canal treatment involves the use of a dental operating microscope during the procedure. This allows the dentist to magnify the tooth, providing a detailed view of the intricate structures within the root canals. The enhanced visualization ensures that the cleaning and shaping of the canals are more precise and thorough. This is particularly beneficial in complex cases where the root canals are narrow or difficult to locate.

What Does the Root Canal Treatment Involve?

Root canal treatment typically involves a series of steps:

• X-rays: The dentist will first take X-rays or CBCT scan (Cone Beam Computed Tomography) to get a clear view of the tooth and the surrounding bone.
• Anesthesia: Local anesthesia is administered to numb the tooth and surrounding area, ensuring the patient is comfortable and pain-free throughout the procedure.
• Pulpectomy: The dentist will make an opening in the crown of the tooth to access the pulp chamber. The infected or damaged pulp is then removed.
• Cleaning and Shaping: The dentist will clean, enlarge, and shape the canals within the tooth using special instruments. This process removes bacteria, debris, and toxins.
• Filling and Sealing: The cleaned and shaped canals are filled with a biocompatible material, often a rubber-like substance called gutta-percha. The tooth is then sealed with a temporary or permanent filling.
• Restoration: Often, a tooth that needs a root canal is already weakened. A crown or other restoration is usually necessary to protect the tooth and restore it to full function.

Getting Started on Root Canal Treatment

If you have symptoms suggestive of a root canal infection, it’s important to visit a dentist. They will assess your symptoms and may refer you to an endodontist, a specialist in root canal treatment. The endodontist will discuss the procedure with you, and if you both agree that a root canal is the best option, you will be scheduled for the procedure.

Diagnostic and Preparation

Before the procedure, the dentist takes X-rays to get a clear view of the tooth and the surrounding bone. This helps in assessing the extent of the damage. Local anesthesia is then administered to numb the tooth and surrounding area, ensuring the procedure is painless.

Clearing Up Root Canal Infection

A small protective sheet called a dental dam is placed to keep the tooth dry. An opening is made in the crown of the tooth, and small dental instruments are used to clean the pulp from the pulp chamber and root canals, and to shape the space for filling.

Filling the Root Canals

After cleaning and shaping, the root canals are filled with a biocompatible material, usually a rubber-like material called gutta-percha. The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals.

Final Stage of a Root Canal

In most cases, a temporary filling is used to close the opening. The temporary filling will be removed by your dentist before the tooth is restored. A crown or other restoration is placed on the tooth to protect and restore it to full function.

After Your Root Canal

After the procedure, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications.

Outcome and Prognosis

A properly done root canal treatment generally lasts a long time, possibly a lifetime. However, sometimes the tooth that received treatment does not heal properly and can become painful or diseased months or even years after treatment.

Root Canal Complications

Though root canals have a high success rate, complications can occur, including:

• Infection
• Undetected canal cracks
• The breaking of a file in a canal
• Inadequate sealing

Pros & Cons of Root Canal Treatment

Root canal treatment is a common dental procedure aimed at treating infection in the pulp of a tooth. Like any medical procedure, it has its pros and cons.
PROS:

• Saving the Natural Tooth: One of the biggest advantages of root canal treatment is that it allows for the saving of the natural tooth which otherwise might need to be extracted.
• Relief from Pain: Root canal treatment eliminates the pain caused by infection.
• Preventing the Spread of Infection: By removing the infected pulp, root canal treatment prevents the infection from spreading to other areas.
• Restoring Function: The procedure helps in restoring normal biting force and sensation.
• Cosmetic Improvement: Often a discolored tooth will look normal again after root canal treatment.

CONS:

• Complexity and Length of Procedure: It can be a lengthy and complex procedure especially if the infection is severe.
• Cost: It can be relatively expensive, especially if a crown is needed afterward.
• Discomfort: Some patients might experience discomfort or mild pain during or after the procedure.
• Not Always Successful: In some cases, the procedure might not be able to save the tooth.

Root Canal Alternatives

The main alternative to a root canal is having the tooth extracted and replaced with an implant, bridge, or denture. In some cases, modern dental offices may offer partial pulpotomy as a treatment of last resort to save tooth vitality. This procedure includes removing only a small portion of infected pulp and covering the wound with novel biocompatible material like BioDentine. In the past, this treatment was only performed only in kids, but thanks to the progression of science and dental materials some offices have had success with adult teeth too. After a successful procedure, your tooth remains alive which is always a superior and preferred situation compared to a tooth after Root Canal Procedure.

How Long Does the Root Canal Treatment Take?

The length of the procedure can vary depending on several factors including the number of canals in a tooth, the location of the tooth, and the complexity of the procedure. Generally, root canal treatment can take one to two appointments, each lasting about 90 minutes to 2 hours.

Can I Eat Before a Root Canal?

It is generally recommended to eat a normal meal a few hours before the procedure as the local anesthetic or sedation used may require you to avoid food for a few hours post-procedure.

Can You Drive After a Root Canal?

If only local anesthesia is used, it is generally safe to drive after the procedure. However, if sedation was used, it’s advisable to have someone drive you home.

Do Root Canals Cause Cancer?

There is no scientific evidence to support the claim that root canal treatment is a cause of cancer. This is a myth based on outdated and flawed research.

Will a Root Canal Give Me a Blood Infection (Bacteremia)?

There is a very low risk of developing a blood infection from a root canal procedure, as antiseptic protocols and sterile instruments are used to minimize the risk of infection.

Why Would My Dentist Not Use a Rubber Dam for My Root Canal?

Using a rubber dam is considered the standard of care in root canal procedures. It helps to keep the area sterile. However, in some cases, the tooth may not be easily accessible with a dam, the patient may have an allergy to latex or TMJ Disorder.

Can I Get a Root Canal While I’m Pregnant?

It is possible to get a root canal while pregnant, especially if it is necessary to relieve pain or treat an infection that could be harmful to the mother and baby. However, most dentists will recommend deferring any elective procedures until after pregnancy.

What Root Canal Irrigants Are Used to Clear the Pulp Chambers and Kill Bacteria Before the Tooth is Filled?

During a root canal procedure, various irrigants are used to clean the root canals and eliminate bacteria. The most common irrigant used is sodium hypochlorite, which is very effective in killing bacteria. Additionally, EDTA (Ethylenediaminetetraacetic acid) may be used to remove the smear layer, which is a layer of debris that can form on the walls of the canals during instrumentation.

What Are The Options for Root Canal Sedation?

There are several options for sedation during a root canal procedure:

• Local Anesthesia: This is the most common form of anesthesia used, where the dentist numbs the area around the tooth.
• Nitrous Oxide Sedation: Also known as laughing gas, nitrous oxide is used to put the patient in a relaxed state.
• Oral Sedation: This involves taking a sedative pill before the procedure.
• IV Sedation: This is where sedative drugs are administered through a vein.

When is Root Canal Treatment Necessary?

Root canal treatment is necessary when the pulp within a tooth becomes infected or inflamed. This can be caused by:

• Deep decay due to untreated cavities
• Repeated dental procedures on the same tooth
• Faulty crowns
• A crack or chip in the tooth
• Trauma to the tooth

Common symptoms that indicate you might need a root canal include severe toothache, prolonged sensitivity to heat or cold, discoloration of the tooth, swelling, and tenderness in the surrounding gums.

How Much Does Root Canal Treatment Cost?

The cost of root canal treatment varies depending on factors such as the severity of the problem, the tooth involved, and the region in which you are receiving the treatment. On average, root canal treatment can range from $500 to $2,000 per tooth (as of 2023). The cost can increase if additional procedures such as placing a crown are necessary. Total cost for Root Canal Therapy and dental restoration after it is completed may range from $1,100 even up to $5,000 for a single root canal and crown.
Dental insurance may cover a portion of the cost. It’s advisable to check with your insurance provider and consult with your dentist for a detailed estimate based on your specific case.

Bottom Line

Root canal treatment is an effective procedure for saving a tooth that is severely infected or damaged. With modern dental technology, it’s a relatively comfortable procedure that can typically be completed in one or two appointments. The procedure has a high success rate, but like any medical procedure, it carries risks and potential complications. Understanding the process and knowing what to expect can alleviate any anxiety associated with the treatment. Always consult your dentist if you experience any symptoms that may indicate the need for a root canal, as early intervention is key to preserving the health of your teeth.

This article is complete and was published on June 20, 2023, and last updated on August 26, 2023.