The banter above is emblematic of what people have historically thought about root canals. Something that is very painful—and a dental treatment that we should put off until it is absolutely necessary. However, with today’s advanced anesthetics and cutting-edge dental treatment, the horror-like fables of root canals are just that—fables, and they can assume their place in history.
Before we talk about today’s modern tooth canal procedures that we practice at Hitomi Dental Office, let’s first answer the question: What is a root canal and why do we do them?
Root Canal Basics
A root canal is a treatment to repair and save a badly damaged or infected tooth instead of removing it. They’re called “root canals” because during the process, a dentist cleans the canals inside a tooth’s root. Decades ago, root canal treatments often were painful; however, thanks to improvements in dentistry like we practice at Hitomi Dental Office’s Tokyo locations, most people have little if any pain during a root canal. In fact, it’s probably more painful living with the decayed tooth instead of getting a root canal. Alternatives include extracting the damaged tooth or replacing it with a dental implant, bridge or removable partial denture.
Why a Root Canal May Be Needed
Teeth have a soft core called dental pulp. The pulp extends from the crown—the visible part of the tooth — to the tip of the tooth’s root in the jawbone. The pulp contains nerves, blood vessels and connective tissue. When a tooth is cracked or chipped or has a deep cavity, bacteria can enter the pulp. Injury to the tooth, such as a crack, can also cause pulp damage and inflammation. Left untreated, bacteria and decaying material can cause a serious infection or a tooth abscess, leading to pulp death and loss of the bone or tooth. Signs and symptoms may include swelling around your face and neck, a hole in your tooth, toothache or tooth pain, gum swelling, and temperature sensitivity. In some cases, if a root canal has not been done correctly, the canaled tooth can get infected, and the procedure will have to be done again.
A root canal is usually done by an endodontist or a general dentist. The root canal usually takes one or two visits, but occasionally more visits are required because some teeth prove difficult to treat, especially if the tooth is badly infected or the root tubes are unusually complicated.
First, you have dental X-rays to check the extent of damage. You also receive a local anesthetic to control pain during the procedure. Then a rubberlike sheet called a dental dam is placed in your mouth around the tooth to keep the tooth clean, protected and free of saliva. At Hitomi Dental Office we always use this sheet, but that is not the case at most other Japanese dental offices because it takes time. The next step is to remove the decay, and an opening is then made through the crown of the tooth to gain access to the pulp chamber. Using small dental instruments, the infected or diseased pulp is removed.
Controlling Infection during a Root Canal
After the diseased pulp is removed, the pulp chamber and root canals are flushed and cleaned. The root canals may be reshaped and enlarged to allow better access for filling. Before permanently filling the root canals, they are cleaned of all infection and dried. Medication is sometimes put into the pulp chamber and root canals to clear any infection. If infection has spread beyond the tooth, you may need a prescription for antibiotics. After root canal therapy, a temporary filling is placed in the crown to protect the tooth and keep out debris and saliva. The patient should avoid biting or chewing on the tooth until it’s been permanently treated and restored. To assure the quality of our treatment at Hitomi Dental Office, our English-speaking dentists use a dental microscope to clean the roots and check our work using a CT scan in 3D. We also utilize a laser type treatment to kill bacteria and NiTi (nickel and titanium) rotary files to effectively clean the root wall.
Filling the Root Canals
After cleaning and drying, it’s time to fill the interior of the tooth—the empty pulp chamber and root canals. You may not need additional anesthetic for this step. If you had a temporary filling, it will be removed to allow access to the inside of the tooth. A sealer paste and rubber compound is used to fill the tooth, followed by a dental filling to make sure the root canals are protected from saliva. Hitomi Dental Office uses only the latest material: MTA (mineral trioxide aggregate) and bio glass sealer.
Finishing the Root Canal
The final stage of the root canal is restoring your tooth. Because the tooth typically has a large filling or is weakened from extensive decay, it needs to be protected from future damage and returned to normal function. This is usually done by placing a crown over your tooth. A crown is typically made of gold, porcelain, or porcelain fused to metal, but other materials may be used. Crowns made of porcelain or porcelain fused to metal can be tinted to match the color of your other teeth. Traditionally, a metal post is inserted in the tooth for structural support and to keep the crown in place, but at Hitomi Dental Office we feel that metal is too hard for a fragile root canaled tooth. It sometimes fractures. That’s why we use glass fiber. It is strong and better for your overall health.
What to Expect after Your Root Canal
After your root canal, your restored tooth with the new crown should work like a natural tooth and look cosmetically pleasing. If you follow good dental and oral hygiene, your restored tooth could last many years. That’s why we remind all of our patients that a root canaled tooth is different than the original tooth, and so extra vigilant dental hygiene and regular dental visits are important.
The first few days after your root canal, the tooth may be sensitive. Nonprescription pain medications can help. If pain or pressure lasts more than a few days, be sure to let us know.
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