Root Canal Therapy

An article written with Dr. Sherry Tsai

I have met many patients who have been recommended root canal procedures and, as a result, have become very worried. This is often because the patients do not understand what a root canal procedure is, and many associates the procedure with pain, discomfort, and cost. This article will provide you with in-depth information about the procedure and enable you to make well-informed decisions when it comes to your dental health.

What are Root Canals & Why Do They Need Treatment?

To understand what a root canal is, you have to first understand the structure of a tooth. The tooth is not a solid bone-like structure, but rather with a small cavity in the center running through to the root. This cavity is filled with a soft substance called pulp, which contains nerves, blood vessels, and connective tissues. These help the growth of the tooth during its development from a child’s tooth to an adult tooth. The cavity or the pulp chamber, which you can visualize as a canal running inside the tooth, is what is known as the root canal.

Sometimes, the pulp becomes infected or inflamed due to deep tooth decay, shock, repeated dental procedures on the tooth, fractures, cracks, or poorly made crowns. If the infection is not treated, bacteria multiply in the pulp cavity and turn the pulp into an abscess. The infected root canal cavity causes pain to the person as it puts pressure on the nerve endings. This may also cause more severe dental issues such as infected adjacent teeth, bone loss, fever, etc.

In such cases, the root canal may need to be thoroughly cleaned out to remove the infected pulp, and your dentist may prescribe a root canal procedure.

What are Root Canals & How are They Done?

Root canal procedures are those in which a dentist or an endodontist clean out an infected root canal by removing the pulp within, and then seals it by filling and crowning it. To begin the procedure, Dr. Tsai will apply or inject local anesthesia to numb the surrounding area so you don’t feel any pain. Then, using a small drill, she will drill through the top of the tooth to gain access to the canal/cavity that contains the pulp. She will remove all the infected nerves, nerve endings, damaged blood vessels, etc. in the canal and thoroughly clean it out with antibacterial fluid. Dr. Tsai will then seal the cavity with gutta-percha, a polymer that is biologically inert and helps keep out future infection and bacteria.

Once the root canals are cleaned out and sealed up, a dental crown is used to protect the exposed area of the tooth from future infection of the cavities. Dr. Tsai will also place a stainless steel post inside the tooth to improve strength and structural integrity. Since the tooth no longer gets blood supply, it tends to become brittle after six months to a year. The crown and post provide structural integrity and protect the brittle tooth from chipping or breaking apart. In general, the dowel or post is used on biting teeth where pressure endured by the teeth is greatest. However, there are certain situations where Dr. Tsai will use a post on anterior teeth as well to ensure longevity.

Can There be Complications After a Root Canal Procedure?

Root canal treatments have a very high success rate in eliminating tooth-ache. However, what you should remember is that the tooth you are left with after the procedure has been compromised and, like any other procedure, there is a chance that something may go wrong.
Firstly, as mentioned above, due to the removal of blood vessels, the tooth on which a root canal procedure has been done no longer gets blood supply. Due to this, the tooth tends to become brittle after six months to a year and can easily fracture. Once the root canal has been completed, the standard of care is to add a metal post inside the empty roots and place a full coverage dental crown over the tooth. Having the post and the crown work together to provide structural integrity helps ensure the tooth will last many years.
Secondly, since the tooth is still a natural tooth, it can be affected by problems like reoccurring decay, bone loss, fractures, etc. To a certain extent, having a root canal can sometimes serve as a temporary solution only. When the tooth is too decayed or the infection has eroded too much tooth structure, patients are better off extracting the tooth and placing a dental implant.

Alternative Treatment to Root Canals?

dental implant diagram alternative to rootcanal

To avoid potential complications after a root canal treatment, to avoid all the steps required to “save” your tooth, or when a tooth has failed beyond saving, many patients elect the alternative treatment of a dental implant. With an implant, the infected tooth is extracted and infected tooth socket (hole left behind after the extraction) is cleaned out and filled with bone grafting material. This typically takes about six months to heal. If the tooth you are replacing is a front tooth, we can make a temporary stay-plate; so you still have a beautiful smile for photos. Once the bone grafting is healed, Dr. Tsai will take a CT scan to determine the size, length, and position of the dental implant. Sometimes she is able to extract the tooth and place the implant straight away. If not, she will place the implant once the bone has healed.

Another four or so months and she can place the abutment and crown (the final step). A dental implant looks and functions exactly like a natural tooth. Since the implant is not affected by the problems pointed out above, this may be a viable alternative to a root canal procedure + crowning.

If you have any lingering tooth pain, discomfort when you bite down, or if your tooth hurts from hot or cold, you may need a root canal treatment. If you are still working through complications related to a root canal treatment, please give us a call. We can evaluate and determine if the tooth can be saved or if a dental implant may be your best option. If you have any of the symptoms mentioned above, or if you think you need a dental bridge, dental crown, root canal treatment, or any other dental treatment, schedule an appointment with Dr. Tsai or give us a call.

Have questions about root canal therapy? email or call us:
(650)-583-5880

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Dr. Sherry Tsai provides Root Canal Treatment, Dental Bridges, Family Dentistry, Cosmetic Dentistry, TMJ Pain Relief, and Sleep Apnea treatment in Millbrae, San Bruno, Burlingame, San Mateo and the Bay Area