What is a root canal?

Root canal treatment, or as dentists call it, non-surgical endodontic therapy is a procedure designed to save the tooth that otherwise has to be extracted. This procedure involves removing pulp tissue, shaping and disinfecting the remaining space, and sealing the inside of the tooth to prevent further ingress of bacteria. The pulp is a conglomerate of nerves, blood, and lymph vessels that initially is charged with the task of building the tooth. After the tooth is fully formed, it gets trapped inside of the tooth in a space called root canal system. Commonly, but incorrectly, people call pulp “the nerve.” If the pulp is diseased, necrotic, or infected, it cannot protect the root canal system from the invasion of bacteria. Consequently, it must be removed, and the remaining space sealed. Simply speaking, a root canal treatment is creating a deep, slim, sophisticated, watertight filling for the root canal system.

The patient is kept comfortable with local anesthesia. We use materials and techniques similar to those employed by general dentists. Depending on the severity of the pulp involvement, and complexity of the root canal system, the procedure may involve one or two appointments. Generally, the procedure takes 30 to 90 minutes, but please allow about 2 hours for the entire office experience.

After the root canal system is permanently sealed, the access opening is filled with a temporary filling material, which will be replaced by the dentist with an appropriate permanent restoration within two weeks.

 What happens after treatment?

After the root canal appointment, the overwhelming majority of patients can resume their regular daily routine. There are no driving restrictions for patients who did not use conscious sedation anesthesia. Post-operative complications such as discomfort, requiring prescription pain medication, are infrequent. As a rule, antibiotics are not required after the procedure. Your endodontist will discuss post-operative instructions in great detail, as well as alert you to what to expect during the initial healing period.

We will email a report to your referring dentist, usually by the next business day. You must contact him or her within two weeks to schedule an appointment for a permanent restoration. Your general dentist will determine the type of permanent restoration needed for your case.

Healing after the root canal treatment is usually uneventful. The success rate of the procedure is somewhere between 80 to 98 percent, and the time necessary to heal is directly related to the involvement of the pulp. In other words, the sooner the root canal procedure is initiated, the more predictable the outcome and shorter the recovery period. If bacteria had been allowed to remain in the root canal system for a while, the success rate of the treatment might be reduced.

Why should I need endodontic surgery?

Sometimes, infection associated with the tooth fails to resolve even though the non-surgical endodontic procedure was completed. Mostly it happens when the body’s natural defenses are not enough to heal the diseased tissue around the root of the tooth. In a rare case like this, it becomes necessary to remove the infected and inflamed tissue around the tooth through the endodontic surgery called an apicoectomy.

Apicoectomy is a Latin term which means the removal of the tip. During apicoectomy a small portion of gum tissue is temporarily lifted, and the diseased tissues, mostly at the tip of the root, are exposed. Such tissues are removed along with the tip of the root, which is immersed in that tissue. Hence, the name apicoectomy. In most cases, a small filling is placed at the root tip, and the gum is sutured back in place.

The post-operative period is unlikely to bring discomfort or swelling. Your endodontist will discuss what to expect in your particular case.

We use non-resorbable sutures that need to be removed a few days after the procedure. Resorbable sutures dissolve by an inflammatory process, and it is our approach to minimize unnecessary inflammation.

Your endodontist must be aware of any blood thinners, aspirin, non-steroidal antiinflammatories, or Vitamin E that you may be regularly taking.

Please plan to rest for the remainder of the surgical day. Do not plan any trips for two weeks after the surgery.

All surgical procedures in our office have to be preceded by a consultation appointment. Apicoectomy cannot be performed on a tooth that has an acute abscess.