Root canal treatment – course, indications, price. Does root canal treatment hurt?

The ideal situation for each of us would be to have naturally healthy, strong teeth. Unfortunately, in most cases, visits to the dentist are a must, especially when there is pain or a part of the tooth is chipped, which looks unsightly. Root canal treatment (i.e. endodontics) is one of the most popular and effective methods of treating teeth. To find out about its great potential for positive effects, it is best to get to know the course of treatment step by step.

Tooth structure

The teeth are used to cut and grind food, as well as to protect the nerves and blood vessels (called dental pulp) located in the root canal and responsible for its life processes. They are mainly made of a hard material called dentin, which is covered with enamel in the crown area. It is the core of the tooth.

The part of the tooth that goes under the gum line is called the root. The root helps to anchor the tooth in the jaw. The front teeth usually only have one root, while the molars up to three. There may be multiple canal spaces in each root. The empty center of the tooth is called the pulp chamber. This area contains blood vessels, nerves, and pulp. The pulp is a sensitive tissue that provides the teeth with oxygen, nutrients and sensation. The pulp extends from the pulp chamber vault to the bottom of each root canal. If infected, all space must be disinfected.

The main function of the dental pulp is to regulate the growth and development of the tooth during childhood. When the tooth is fully formed, the nourishment of the tooth comes from the tissues surrounding the root. Therefore, the tooth can function without the pulp.

Where does the inflammation in the tooth come from?

In certain situations, microorganisms can get into the delicate structure of the pulp, and by multiplying, they can cause the formation of inflammation of the pulp, which is manifested by severe pain. The infection can spread to the bone around the aching tooth or cause purulent condition and death of the pulp. In such a situation, root canal treatment is the best solution.

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Root canal treatment – indications

In some cases, you may not know the tooth is infected. However, many people notice some symptoms.

Symptoms that require root canal treatment include various factors, including pain and swelling.

1. Toothache that doesn’t go away: Many dental problems can cause toothache. If you experience deep pain in your tooth, you may need root canal treatment. Discomfort can also radiate to your jaw, face or other teeth.
2. Sensitivity to heat and cold: If your tooth hurts while drinking hot coffee or eating ice cream, it may be a sign that you need root canal treatment. This is especially true if the pain lasts longer than a few seconds.
3. Swollen gums: When a tooth is infected, pus can build up in the area. This can lead to swollen or tender gums.
4. Pimple on the gums: You may develop a pimple or ulcer on your gums. Pus from an infected tooth can run off the pimple, causing an unpleasant taste or smell.
5. Swollen jaw: Sometimes the pus won’t drain out of place. As a result, your jaw may become visibly swollen.
6. Tooth discoloration: Infection of the tooth pulp may cause the tooth to appear darker. This is due to poor blood supply to the tooth.
7. Pain on pressure: If you feel pain while eating or touching a tooth, it could mean damage to the nerves around the pulp.
8. Chipped or cracked tooth: If you have broken a tooth in an accident, while playing sports, or even biting something hard, bacteria can find their way into the pulp of the tooth.
9. Loose tooth: An infected tooth may become loose. This is because pus from infected pulp can soften the bone that supports the tooth.

Sometimes the pulp of the tooth can become damaged or sick without any symptoms. In these cases, the problem is usually diagnosed with special tests or x-rays during a dental checkup or treatment for other dental problems.

Also check: The lower jaw – how is it built and what can pain symptoms mean?

Complications of root canal infection

It is possible to treat a root canal infection, so it is important to take appropriate action when possible to prevent further problems. If a root canal infection is left untreated, complications may include:

1. Spreading Infection – Once infected, the pulp loses its ability to fight the spread of infection. If bacteria enter the pulp chamber, they will multiply. This can cause an infection or abscess around the teeth.
2. Bone atrophy – the infection can spread around the ends of an infected root canal and erode the surrounding jaw bone
3. Tooth loss – A tooth may need to be removed which can affect a person’s diet or appearance. Tooth replacement options are available, but may be limited if the infection has already caused advanced bone loss.

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Root canal treatment – diagnostics

Your dentist will listen to your symptoms, examine your teeth, and perform other tests, including x-rays. X-rays help the dentist plan the root canal treatment by showing the number, size, shape and depth of the roots, which shows how complicated the procedure can be.

The course of root canal treatment

The doctor determines the length and shape of the canal from an X-ray or using a canal length measuring device, then carefully opens the canal entrances. To prevent bacteria from the saliva from entering the exposed tooth and to protect it against chemicals used to clean the canal, the treated tooth is covered with a special rubber called a cofferdam.

The canals are cleaned and processed with special tools made of nickel-titanium alloys to thoroughly remove bacteria from the infected pulp fragment and from the surrounding dentin. Modern equipment allows for thorough cleaning and rinsing with bactericides, even very narrow and tortuous channels.

Another element of root canal treatment is shaping the canals in the tooth root into smooth, empty tunnels free of irregularities, in which bacterial residues can settle. This shaping process involves small tools, special disinfectants, and medications. It may take several weeks or months for these solutions to have maximum effect against stubborn bacteria in the tooth, and this step may need to be repeated several times.

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Root canal treatment under a microscope

In order to reach the narrow channels as well as possible, it is necessary to use specialized equipment for optical image magnification. Modern dental microscopes allow you to obtain an accurate, multiple magnification, and thus a more accurate image of the treated tooth for the meticulous performance of even complex treatments.

Root canal treatment – filling the canal

The final stage of treatment is filling the root with light-cured material, which guarantees hermetic root closure and protection against bacteria and inflammation.

See also: Composite fillings – characteristics, advantages, disadvantages, price

Root canal treatment – restoring the efficiency of the tooth

So that no bacteria in the mouth can get back to the tooth, a large, well-sealed restoration is placed over the tooth. Teeth that require root canal treatment sometimes have lost much of their tooth structure due to previous caries or cracks and may require further protection in the form of inlays, crowns, or other similar materials.

Recovery after root canal treatment

After a root canal treatment for several hours, the lips will feel numb. Most people can go back to work, school, or other activities right away. You should wait for the numbness to disappear before eating.

For the first few days after the end of the root canal treatment, the tooth may be sensitive due to inflammation of the tissues, especially if there was pain or infection before the treatment. This can usually be alleviated with over-the-counter pain relievers such as ibuprofen or naproxen.

Until the root canal treatment is completely completed, with a permanent filling or a crown in place, biting the tooth should be avoided. This helps keep the area clean and can prevent a brittle tooth from breaking before it can be fully restored. You should care for the tooth by brushing, flossing, and using an antiseptic mouthwash just like you would for the rest of your teeth. You should also visit your dentist at normal intervals.

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Root canal treatment – tooth color

A normal tooth with a healthy pulp has a yellowish white color. A non-pulp tooth that is sealed with a filling rather than covered with a crown may eventually turn gray. Your dentist can advise you on appropriate cosmetic treatments (cosmetic dentistry) to help with this.

Also check: What causes tooth discoloration?

Advantages of modern methods of root canal treatment

The current, modern and very often almost painless root canal treatment procedures are characterized by:

1. shorter treatment time,
2. reduced discomfort during the procedure,
3. more thorough cleaning of bacteria,
4. the possibility of developing and filling even the most winding and narrow canals,
5. tight filling prevents recurrence of infection,
6. a well-healed tooth can serve us for many years to come.

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What is a root apex resection?

In the case of periodontitis and inflammation of the bones around the affected tooth, endodontic treatment alone (root canal treatment) may not be sufficient. Root apex resection involves surgical excision of the apex of the diseased root along with the focus of inflammation. The procedure is performed under local anesthesia.

Root canal treatment – contraindications

Currently, most dentists state that systemic diseases are not a major contraindication to root canal treatment. Nevertheless, there is a group of diseases that constitute the so-called high-risk group (these are diseases that can be aggravated as a result of root canal treatment), they include:

1. heart diseases,
2. joint diseases,
3. kidney disease
4. states of immunosuppression,
5. some endocrine disorders.

Before starting or during endodontic treatment, people with the above diseases require certain measures to be taken to prevent odontogenic infection of other organs. These activities consist of:

1. consultation with a doctor treating a general disease, planned method of dental treatment in a given case,
2. agreeing on the need for an antibiotic cover and the dose of an antibiotic,
3. if necessary, administration of other drugs improving the patient’s health condition during endodontic treatment.

Read: What is tooth poisoning?

Complications after root canal treatment

New infections may develop after root canal treatment. The likely causes include:

1. A greater than normal number of root canals in a tooth will remain uncleaned.
2. Tooth root fracture undetected.
3. The problem with the restoration that allowed the bacteria to enter the tooth through it.
4. The internal sealant material will deteriorate over time, allowing bacteria to contaminate the tooth again.

Sometimes re-treatment can fix the problem, but other times surgery may be needed to save the tooth. The most common procedure is root apex resection. It relieves inflammation or infection in the bone area around the end of the tooth. In this procedure, the gingival tissue is opened, the infected tissue is removed, and sometimes the very end of the root is removed. A slight filling can be placed to seal the root canal.

Root canal treatment – alternatives

If possible, saving natural teeth is the best option. Teeth allow you to eat a wide variety of foods necessary to maintain proper nutrition, and root canal treatment can help save them.

The only alternative to root canal treatment is to remove the tooth and replace it with a bridge, implant or removable partial denture. However, these alternatives are more expensive than root canal treatment and require longer treatment times.

See also: What are tooth extractions?

Root canal treatment – prevention

Since some of the causes of inflammation and infection of the tooth’s nerve and pulp are due to deep decay, repeated dental procedures, or large fillings, there are steps you can take to avoid root canal treatment. These include:

1. Brushing your teeth at least twice a day.
2. Flossing teeth at least once a day.
3. Wearing mouth guards to avoid injuries while playing sports.
4. Regularly visiting the dentist.

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Root canal treatment – frequently asked questions

Can I eat after root canal treatment?

Yes, you can eat after your root canal treatment, but it’s best to wait for the numbness to subside. The effects of anesthesia usually last several hours.

For the first few days, it is recommended to eat softer foods such as pasta, mashed potatoes and yoghurts. Solid foods should be introduced when our comfort level improves. You should also avoid biting or chewing the treated tooth. It is recommended to chew the other side of the mouth until a permanent dental restoration is found.

Can I drive a vehicle after root canal treatment?

It depends. If the patient has been given local anesthesia or nitrous oxide during the procedure, he or she can come to the appointment and afterwards. People who choose oral sedation or intravenous sedation will need a friend or family member to bring them home.

Can I smoke after root canal treatment?

This is not recommended. Smoking makes healing more difficult and makes you more likely to need dental help in the future.

When is it possible to return to work or school after root canal treatment?

In most cases, people who have had root canal treatment can return to work or school the next day. However, if they have been sedated during dental surgery, it may take an extra day or two to fully recover.

How to care for the oral cavity after root canal treatment?

After root canal treatment it is important to keep the mouth clean. Use a toothbrush and floss and use an antibacterial mouthwash to keep germs away. If the patient is still wearing the temporary filling and has not yet received a permanent crown, avoid biting the treated tooth until the crown is in place.

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How long do the results of root canal treatment last?

As with all dental procedures, results are not guaranteed. However, with the proper conduct of root canal treatment, the treatment effect may last for a long time – even to the end of life.

Does root canal treatment hurt?

The patient has no cause for concern. Root canal treatment is done to stop the pain people feel because of the infection and to save the damaged tooth. Dentists usually use local anesthesia to numb the tooth and the surrounding area so that the patient is comfortable during the procedure. After the procedure is completed, some may experience some sensitivity and discomfort, but this will disappear within a few days.

Many people are also concerned that they will experience toothache after root canal treatment. However, as the source of the infection is removed during the procedure, most people experience immediate relief after the procedure. If the patient experiences throbbing pain after root canal treatment, see a doctor immediately.

Root canal treatment – price

The cost of root canal treatment is really different. The National Health Fund pays for endodontic treatment of three to three (i.e. only front teeth) with filling one infected root canal. In the case of children and adolescents up to 18 years of age, as well as pregnant and puerperal women, root canal treatment also covers teeth with two and three canals.

Root canal treatment in a private clinic can be quite an expense. Prices for the root canal treatment of one tooth under a microscope start from about PLN 400.