Root Canal – What Is It? Why Is It Necessary?
A Root canal is where the nerve tissue is removed from the length of a tooth root. 99% of the time root canals do NOT hurt.
The hollow root is then filled with a filler and medicine to calm the tooth and kill any bacteria. Root canals are needed when decay, fracture, or a deep filling or crown are very close to or have grown into the nerve pipe. They can be needed when a tooth becomes sore and painful from clenching the teeth or for no apparent reason.
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Most teeth needing a root canal do not hurt before needing a root canal, but if the decay was removed and the tooth filled or crowned close to or into the nerve, the new restoration would irritate the nerve, which would then become quite painful.
So the root canal is done to prevent pain and infection. Often a tooth is so broken off that there is not enough tooth structure remaining to restore the tooth. Then a post and a build-up filling are needed. But to do this the nerve must first be removed so a post and build-up can be placed to strengthen the tooth so that it can then hold a needed crown.
Many times a root canal is required if there is an infection in the bone below the end of the root. On an x-ray, if the dark area below the root is fairly small and diffuse. It is probably an abscess, which is a little pus (infection) in the bone below the root tip. Most smaller abscesses can be treated with a root canal.
If the x-ray shows a darker, larger, less diffuse, but more definite dark spot below the root tip, it is probably a cyst, which is an abscess which is lined by gum tissue. A root canal will not treat these. Only extraction of the entire tooth or surgery to remove the cyst is effective. Some people have heard from other people or read stories on the internet that root canals are never effective or may cause other medical problems. Our experience for many years and practically all dental research and anecdotal data does not support these scary theories.
What is important is for the dentist to not do root canals on teeth with large, non-diffuse dark lesions at their apices.
Sometimes there is some discomfort after a root canal. This usually short-lived and is because there is a small amount of infection remaining in the bone at the end of the root.
Usually, the patient’s white blood cells and a little antibiotic will kill the remaining infection and stop the pain. The pain can be from the tooth hitting the opposing tooth too hard either because the tooth’s restoration is a little high or infection has pushed the tooth up to hit the opposing tooth too much, in which case slightly shortening the root canal tooth and making sure that the patient is taking antibiotics stops the pain. Post-op pain can be from the patient biting hard on their root canal tooth and causing a small fracture in the root. For this, the tooth must be removed.