If a tooth has damage in its core, where the pulp is located, a root canal may be necessary. When bacteria reaches a tooth's pulp due to dental decay, it will break it down, and can spread through the roots of the tooth into the surrounding tissue. This will cause problems like pain, bone loss, swelling of the gums, cheeks, and neck. A large infection may cause a swelling that can travel down the neck and affect the airways and breathing. This can be life threatening.

You may need a root canal if you experience the following symptoms. These signify nerve or "pulp" damage:

  • Severe pain when pressure is applied to the tooth
  • Pain on biting
  • Severe cold tenderness
  • Severe pain relieved by room temperature water
  • Darkening of the tooth
  • A draining fistula, bubble, or abscess is present in the gums, often recurring
  • Sensitivity to hot or cold persists long after contact is made
  • Throbbing pain at night
  • Pain on pressing the gums over the tooth

Why do I need a root canal?

The reasons a tooth would need a root canal are usually the following:
  • Deep decay that is very close or into the nerve
  • Trauma to the tooth from a fall or accident
  • Overheating or nerve damage from a crown or filling
  • Cracks on the teeth that affect the nerve
  • Internal resorption of the nerve for unknown reasons
Sometimes a patient may not have symptoms at all but the doctor can see an abscess in the x ray. This abscess is in the bone under the roots and has not reached the gums yet. A root canal should be performed to avoid a larger infection and swelling.

Another common Question:

"My tooth was fine before the filling was placed. Why am I having pain now?"

Patients often wonder why they didn't feel any pain before a tooth with DEEP DECAY was worked on. This is because the bacteria is often so close to the nerve that the removal process may speed up the inflammation of the nerve. Sometimes the nerve can heal itself so the doctor may choose to restore and watch the tooth. If symptoms show up after a month then the tooth will need a root canal for sure.

What will happen if I don't get a root canal?

With decayed teeth, you may have severe throbbing or hot/cold pain on the tooth. This indicates that the nerve is dying. If a root canal is not performed in time, the tooth will abscess, or form a puss filled pocket at the end of its roots. This can lead to serious infection and bone loss.

Antibiotics can be prescribed for an abscessed tooth but this is only a temporary problem solver. The abscess and pain will return because the source of infection still remains.

How does a root canal work?

A root canal is the process of removing the infected pulp, nerve, and bacterial debris inside of the tooth. Dr. Sally and her associate Endodontists will use anesthesia on the affected area. A rubber dam is placed around the tooth to make sure the canals don’t get re-infected with saliva. A drill is used to make a hole to reach the center of the tooth where the problem lies.

She will then carefully remove the pulp, nerve, and debris, flushing the root canal cavity with a cleaning agent.

Depending on how badly the infection has spread, she may need to apply medication inside the tooth and let it sit for a few days, before sealing it. If the damage is very minor, she can seal the roots up immediately. When the sealed material has set, a filling is applied to fill the hole created in the tooth. This is called a "build up". It may be permanent or temporary.

Depending on how extensive the damage of decay is, some patients may need a dental crown or other dental restoration treatments. This is because a root canalled tooth is no longer living and has no blood supply. This makes it brittle and more prone to breaking. That is why root canal teeth often need crowns and onlays.

After the procedure, Dr. Kashani will let you know what types of medicine you may need to take, how to take care of the affected teeth, and what to expect in terms of healing.

Are there alternative treatments?

Alternatives to a root canal would be an extraction, with some kind of prosthetic taking the tooth’s place. These alternatives will not result in the same benefits or functionality of saving the natural tooth. Dr. Sally's practice believes in maintaining the natural tooth at all times possible, but if the damage is severe the tooth may need to be replaced with a dental bridge, dental implant, or partial denture for better chewing function.

If the decay is very deep but the tooth does not have symptoms, a root canal may be avoided. Dr. Sally can place a special protective lining material over the nerve after decay removal. This can help the tooth heal itself.

Will a root canal affect the function of my teeth?

A root canal will not adversely affect the day-to-day function of your teeth. A root canal will remove the pulp and nerve located inside the tooth, and these are generally not needed once the tooth has broken through the gums. The only purpose the nerve serves is to help you sense when your teeth come in contact with hot or cold substances. A root canal will not affect the way your bite or chew after your tooth has fully healed from the procedure.

Overall, root canals are a fairly common procedure, and most take just one visit to the dentist. You may feel nervous about getting it done, but putting one off when you need the procedure can lead to even worse decay and infection. To save as much of your natural tooth as possible, and protect your oral and general health, call (818) 508–7272 to schedule an appointment with Dr. Kashani to see if you need a root canal, and learn more about the procedure.