Root Canal Treatment

Root canal treatment is the removal of the filamentous tissue (dental pulp) in the center of the tooth. We commonly name it ‘tooth nerve removal’. During the treatment, the dentist (endodontist) removes deep caries and damaged tissues from the tooth. Then, the dentist cleans the bacteria from the emptied part and fills it with filling material.

The tooth damaged due to caries regains its normal function after root canal treatment. In this respect, the purpose of root canal treatment is to preserve the hard tissue of the tooth and save it.

Since the treated tooth is dead (devital tooth), it cannot feed and protect itself. Accordingly, after root canal treatment, discoloration may occur in the dead tooth. This discoloration problem can be solved with devital teeth whitening. The dentist can increase the durability of the treated tooth by making a crown if necessary.

We can summarize the situations that require root canal treatment as follows:
– Even after filling or crowning the tooth, the patient’s complaints continue,
– Deep dental caries and recurrent dental caries under the filling or coating,
– In case of root and crown fractures caused by impact,
– Damage to the dental pulp due to chewing habits or teeth grinding,
– In case of advanced gingival diseases or dental pulp damage after gingival surgery. Some toothpaste (eg, ADA-approved toothpaste such as Parodontax Antigingivitis Toothpaste, Crest Enamel Repair, and Gum, Crest Advanced Gum Protection, etc.) are particularly effective in these situations.

– In cases where the dental pulp has lost its vitality,
– During a wisdom tooth extraction, to adjacent teeth,
– When removing the large cysts of the jawbone, to adjacent teeth,
– During the prosthetic restoration of crooked teeth.

Do dead teeth also require root canal treatment?

The patient may have teeth that have lost their vitality even before root canal treatment. We call “devital teeth” the teeth that have lost their pulp sensitivity. The dental pulp dies when it cannot repair itself. This may be due to a broken tooth or bacteria in a decayed tooth. When the damaged pulp tissues are not removed, inflammation of the tooth and surrounding tissues occurs and the patient feels pain. These cases need treatment to prevent complete loss of the tooth.

The tooth that has lost its vitality before root canal treatment may not cause any complaints in the patient. However, this does not mean that the tooth does not need root canal treatment. The treatment for this tooth is necessary to prevent tooth decay and prolong its life. In this way, future infection of the tooth does not occur or we prevent this from the very beginning.

Which dental complaints of the patient require root canal treatment?

– Toothache that starts spontaneously for no reason,
– Toothache that increases at night and does not go away with painkillers,
– When cold, hot, or tooth contact triggers long-lasting toothache,
– Swelling around the tooth, gums, or related lymph nodes,
– Fistula caused by an infection in the tooth and discoloration of the tooth.

How is the treatment done?

For root canal treatment the dentist,

– numbs the tooth and surrounding tissues with local anesthesia,
– creates a cavity to enter the root canals,
– determines the length of the area to be operated in the root canal,
– reshapes the root canal space,
– cleans the root canal cavity and disinfects there with antiseptics,
– places substances in the root of the tooth that prevent infection,
– and seals the root canals with a filling material.

How long does root canal treatment take?

Dentists (endodontic specialists) usually plan to finish the root canal treatment in one or two sessions. In particular, it is recommended to complete the treatment in a tooth with a living pulp in a single session. But if the tooth is infected, the dentist first treats the infection and waits for it to disappear. This may require several sessions.

In cases where the tooth loses its vitality before the treatment and when the treatment is repeated, the number of sessions may be two or more. Except for this situation, dentists can complete most treatments in a single session, which usually takes an average of 1 hour. During the treatment, the dentist may perform several imaging tests (dental X-ray) on the tooth.

Do root canals hurt?

Before the treatment, the dentist numbs the related teeth and surrounding tissues with local anesthesia. Therefore, the treatment is not a painful procedure under normal conditions. Sometimes there may be a problem with numbing teeth that have pain or infection. In such cases, the dentist numbs the area with advanced methods. However, in some cases, the patient may feel a little pain.

Are antibiotics necessary before root canal treatment?

In cases where the patient does not have a general health problem, does not need to use antibiotics before root canal treatment. However, if the patient has diabetes, heart disease, immunosuppressive drug use, etc., the dentist may use antibiotics before treatment.

Does a treated tooth hurt afterward?

During the treatment, the dentist removes tooth root nerves. Therefore, it is not possible to have pain in the tooth after the treatment against external factors such as cold and heat. For the first few days or weeks after treatment, the patient may feel very little pain.

It is normal to feel slight pain or to have sensitivity in the tooth, especially in situations where pressure is put on the tooth, such as chewing. The main reason for this is that the tooth tissue needs time to heal. In this case, the medications recommended by the dentist against pain will relieve the patient. The healing process can also vary from person to person.

What the patient should do after root canal treatment?

With the effect of local anesthesia applied during root canal treatment, a feeling of numbness occurs in the area. Immediately after the treatment, the patient should not eat for at least 2 hours. Because of the numbness in the area, the incisors can damage the surrounding soft tissues. In particular, the patient should avoid extremely hot and cold foods. Because the area is numb, the patient may not feel the damage to the soft tissue.

Even when temporary fillings harden, they can easily break and damage the surrounding tissues. Therefore, the patient should take care to use the other part of the chin until the dentist does a permanent filling. The patient should never consume hard foods with a tooth whose treatment has not yet been completed. Because very hard foods can easily break even a healthy tooth. To increase the healing speed of the treated tooth, it is necessary to avoid hard foods for a while.

Even if the dentist completes the temporary filling of the tooth and there is no pain, the treatment must continue. Because the tooth without permanent filling can cause bigger problems after a while. If the placed temporary or permanent fillings fall out, the patient must be examined by the dentist without wasting time.

Pain in the tooth even months after root canal treatment

If the dentist does root canal treatment correctly and completely, the treated tooth will never hurt. If the tooth hurts, it is possible that the dentist,
– has overlooked one of the roots/canals or forgot treatment,
– has not  thoroughly disinfected the canal area,
– or has filled the tooth with a high filling or the crowning is not good.

How long is the life of a treated tooth?

If the dentist does the treatment completely, it is often possible to preserve the tooth for many years. With the correct oral care, the patient can use the treated tooth for many years. However, the patient should not forget that the damage to the tooth may recur and should take the necessary precautions. In this respect, a regular dental examination is important to prevent future problems.