We must first explain what a root canal treatment is. It’s simply removing the nerve of the tooth, the disinfection and sealing of canals. All this can be done in one or two sessions without feeling any pain. Normally, root canals are not painful. The patient has an emergency appointment when he or she is in pain and a root canal treatment is performed to remove sensitivity. When the nerve of the tooth is in a state of inflammation, the pain becomes unbearable and the best option is to calm the tooth with medication prior to treatment.
When a tooth is damaged, either due to cavities or a fracture, or if it required a big restoration that put the healthy structure of the tooth at risk, we try to save it since we always consider a natural tooth to be better than any artificial one. To save such a tooth, we are forced to devitalize it, which means that we remove its pulp (which is often already dead, infected or inflamed). The pulp contains nerves and blood vessels that nourish the tooth. In some cases, radiological examination allows us to know if a tooth is alive or not by finding an abscess in the bone (the patient may not feel any pain and the tooth may not show signs of destruction). Other times, the tooth will change color or the patient will have a significant inflammation in the nerve.
If there is an abscess (this means that the pulp is dead and that the infection has penetrated the bone that supports the teeth), the infection must be removed before sealing the tooth: we’ll then have to use antibiotics.
After administrating local anesthesia and isolating the tooth using a dental dam to prevent further bacteria from entering the canal, we remove the cavity that might be on the tooth or any previous restoration. We then make an opening into the pulp cavity to access the canals. To properly clean the canals, we use sterile solutions to disinfect while we remove the infected tissue of the root. After thoroughly drying the canals, we seal the tooth with a biocompatible sealant called gutta-percha. The root canal treatment is completed, but since some patients may experience inflammation and / or mild tenderness (which disappears after a few days), we let the tooth rest with a temporary filling, but the tooth is not functional yet. Then we will decide on the type of final restoration, which depends on the degree of yellowing or decay of the tooth in question (in most cases, we will cover the teeth that have blackened using a crown).
A root canal treatment and the installation of a crown do not stop the formation of other cavities or gum infections.
Although an endodontic treatment offers a high success rate, sometimes it does not succeed. In most cases, we can still save the tooth. We will then proceed to a minor oral surgery. Unfortunately, it happens in very rare cases that all attempts fail: the complete extraction the tooth will be required and it will be replaced with an implant.