The root canal is a cylindrical cavity that is located in the center of each tooth. The pulp, or pulp chamber, is a soft area within this space that contains the nerve of the tooth. A root canal treatment is an endodontic procedure that allows you to repair and preserve a tooth whose pulp has been badly affected by caries or infected. During the treatment it is necessary to remove the nerve and pulp inside the tooth which is then cleaned and sealed.
Steps
Part 1 of 3: Understanding the Procedure
Step 1. Know why the pulp needs to be removed
When nerve tissue or pulp becomes damaged, bacteria and other tooth decay residues can build up in this area and cause an infection or abscess. The latter indicates that the infection has spread beyond the ends of the tooth roots. In addition to the abscess, root canal infection can lead to:
- Swelling of the face;
- Swelling of the head or neck
- Bone loss near the tooth root
- Problems with secretions;
- Damage to the jaw that may require very invasive surgery
- Bacterial infections of the oral cavity that are related to serious diseases such as some heart diseases.
Step 2. Find out about the procedure
This typically involves the following steps:
- Once the x-ray has revealed the shape of the root canals and an infection is found in the surrounding bone, the dentist applies a rubber dental dam around the tooth to be treated. In this way the surgical field remains free of saliva.
- At this point the dentist or odontostomatology surgeon will make an access hole in the tooth through which he can remove the pulp, bacteria, debris and all infected nerve tissue using a root file. He will periodically wash the area with water or sodium hypochlorite to eliminate all bacteria.
- When the process is complete, the dentist applies a sealant. If an infection is present, the doctor may also wait a week before finally closing the tooth. If you do not have root canal treatment on the same day, a temporary filling will be applied to the hole to protect the interior from contamination.
- During your appointment for the procedure, your dentist or dental surgeon will seal the inside of the tooth with a paste and fill the root canals with a rubbery compound called gutta-percha. At the end it will fill the tooth.
Step 3. Eliminate all residual bacteria once the dentist has sealed the tooth
You will most likely be prescribed an antibiotic to treat the previous infection or to prevent one from developing.
Step 4. Ask for a crown to be placed over your tooth to complete the procedure
When a tooth undergoes root canal therapy, it is no longer alive and its enamel begins to become brittle. For this reason the dentist will protect it with a crown, with a pin and a crown or with another type of reconstruction.
Part 2 of 3: Preparing for root canal therapy
Step 1. Don't make a hasty decision
If you are in the dentist's chair for another procedure and he recommends a root canal, know that you should not and should not make an immediate decision. Never choose when you are under pressure, unless absolutely necessary. Tell your doctor that you want to discuss this at the end of your current appointment or during a subsequent visit, so that you have plenty of time to think about it and inform yourself.
Step 2. Ask questions
Once you have weighed the situation and done some research, remember that nothing is more reassuring during and after devitalization than knowing the dentist's point of view and how he wants to proceed with the surgery. Prepare a series of questions before sitting in the doctor's chair. These can cover different topics, here are some examples:
- Is the procedure absolutely necessary?
- Is it possible to heal the tooth without a root canal?
- Is this an operation that can be done by the dentist or will you have to go to another specialist?
- How many appointments are needed?
- Will you be able to go back to work on the same day or will you have to wait until the next day?
- How much will the procedure cost?
- What can happen if you don't undergo root canal therapy? Will the infection spread? Could the tooth break?
- How urgent is the situation? Can you wait a month or should you intervene immediately?
- Are there any alternative techniques to fix or heal the tooth?
- What will happen if all bacteria are not eliminated before the tooth is filled?
Step 3. Tell your dentist that you are concerned about the procedure
If pain scares you, be honest and state it. The staff and assistants will do everything in their power to make the experience positive and comfortable.
Step 4. Consider sedation options
In some cases, the anxiety of getting dental treatment goes beyond a little nervousness and worry. If you suffer from severe anxiety, then there are four types of sedation that dentists can currently use to alleviate or eliminate the problem. In three of these options, the doctor will also perform local anesthesia. Here are the techniques:
- Oral sedatives. These can be taken from the previous night up to 30-60 minutes before the procedure. They are drugs that relieve anxiety before the doctor injects local anesthetic to dull the pain.
- Intravenous sedation. This technique works in a similar way to the oral one and the dentist will also inject an anesthetic directly into the intervention site.
- Sedation with nitrous oxide. This gas (also known as laughing gas) provides sedation through continuous inhalation and is able to relax the patient. To eliminate the pain, the doctor also injects an anesthetic into the tooth area.
- General anesthesia. In this case, an anesthetic is used to remove the patient's state of consciousness. No local anesthetic is required.
Part 3 of 3: Undergo root canal therapy
Step 1. Tell your dentist if you are in pain
You shouldn't feel anything during the procedure. If you feel even the slightest pain, even a twinge, then you must tell the doctor who will change the dosage of the anesthetic to immediately silence the pain. Modern dental medicine has now eliminated pain from its procedures.
Step 2. Meditate
You will need to keep your mouth open for a few hours, so you need to be able to keep your mind busy during this time. If you are good at meditating, you can benefit from this practice and not perceive anything that is happening.
- Try guided meditation. Imagine yourself in a quiet environment while sitting in the dentist's chair. Think of a quiet, still place, like a desert or a mountain top. Fill this environment with many details: the view, the sounds and the smells. Very soon, this calming image will replace the surrounding reality and you will feel relaxed and peaceful.
- Deep breathing exercises are another perfect technique for meditating and taking your mind off the current situation.
Step 3. Bring your electronic devices
Music is perfect for distracting you from the procedure. Your favorite play list will help keep your mind busy.
- An audiobook from your favorite author can help you to pass the time in a snap. You can also decide to learn something about a topic that has always fascinated you, but that you have never had the opportunity to deepen. You have a few hours, try to make the most of the time.
- Alternatively, you can listen to your favorite podcast to keep yourself busy.
Step 4. Be prepared to feel some numbness
The local anesthetic, assuming you don't undergo general anesthesia, is pretty strong. It will keep the area numb during the procedure, but also for several hours afterwards. Be careful when chewing as you may bite your tongue or the inside of your cheek without even noticing.
Local anesthetics have different effects on people. Be aware of your mental and physical condition before deciding to drive, use a machine or attend an important business meeting
Step 5. Know that some pain is normal
Over the next two or three days, the treated tooth will hurt a little, but you may not feel anything. Pain is quite normal in cases where severe infection or inflammation was present prior to devitalization.
Step 6. Pay attention to the intensity of the postoperative pain
If present, it shouldn't be very serious anyway, especially after 24 hours. If you experience persistent pain of any intensity, you should contact your dentist or dental surgeon immediately, as this could be a sign of a more serious post-operative problem.
Step 7. Do not chew on the affected side until the crown is in place
You can take over-the-counter pain relievers to relieve discomfort.
Step 8. Note that it may be necessary to abort the procedure
Root canal therapy, like any other medical treatment, can encounter warning signs that indicate a need to stop. The dentist may find that it is neither wise nor safe to continue devitalization. The reasons are many, but generally the complications that lead to this decision are:
- One of the surgical instruments breaks in the tooth.
- The root canal is calcified. This is a reaction of the body providing "natural root canal therapy" to protect itself from infection.
- The tooth is fractured. This situation prevents the devitalization from being completed because the fracture compromises the integrity of the tooth, even after the procedure.
- If the root of the tooth is curved, it is impossible to guarantee its complete cleaning. Since it is imperative that the entire canal be emptied and cleaned, this situation makes complete devitalization impossible and the operation must be stopped.
- If this happens, discuss possible treatments with your dentist; before deciding take a couple of days to do your research and consider alternatives. Only then inform the dentist or dental surgeon of your decision on how to proceed.
Advice
- If the nerve is dead, anesthesia may not be necessary; however, most dentists still administer a local anesthetic to put the patient at ease and relax.
- The cost of a root canal varies according to the severity of the problem and the tooth to be treated. Many private health insurances cover endodontic surgery, but check with your company before proceeding with treatment.
- Root canal treatments, at best, have a 95% success rate. Many teeth treated in this way last for the rest of the patient's life. In other cases, however, the tooth lasts for a much shorter period.
- It is always best to preserve natural teeth if possible. If one is missing, nearby ones can tilt, lose alignment, and experience excessive pressure. If you keep all your natural teeth, you also avoid more expensive and invasive treatments such as implants or bridges.
