Root Canal Therapy
A root canal is performed when decay reaches the pulp of the tooth, or when trauma has injured the pulp, causing it to die and an infection to occur. In this procedure, the nerve of the tooth is removed, the area is disinfected, and the pulp chamber is sealed with a rubbery substance to prevent reinfection.
Root Canal Success
Root canal therapy has a success rate of about 95%. Reasons for the small percentage that are unsuccessful may include a cracked root (the most common cause of problems), curved or hardened canals that resist treatment, difficult access canals, severe infection around the bone that will not subside, or periodontal complications. These problems may not be apparent while the root canal is performed. Additional endodontic procedures may be successful for treatment of some problems.
Extraction of the tooth is a less desirable alternative treatment for an abscessed tooth. Loss of a tooth will affect chewing and can contribute to drifting of other teeth or bite collapse.
Rebuilding the Tooth
The root canal is the surgical treatment to eliminate infection in the tooth. After the root canal is completed, the tooth still needs to be restored. Restoration generally requires a crown and buildup, especially for back teeth. We strongly advise patients to obtain restorative treatment as soon as possible after completion of the root canal, as a root canal-treated tooth is very subject to fracture if a crown is not placed. Photo at left shows a fracture of a root-canal treated tooth that occurred because the patient delayed obtaining the crown restoration.
Complications of Root Canal Therapy
Discomfort after treatment generally is mild, like being "worked on", and should subside within two days. Any severe pain should be reported to the office. There are quick office procedures that can be performed to alleviate severe pain after treatment.
Facial swelling can occur if the infection was spreading beyond the tooth area before the root canal was performed. If a patient experiences swelling it should be reported to the office. This can be serious and treatment should not be delayed, particularly if there is a fever or flu-like symptoms are experienced.
Rarely, the tip of a fine metal file may break during treatment and may remain in the canal. There is often no problem with this, but statistically there is a slightly greater chance of root canal failure if this does occur.