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Root Canal Treatment is Safe and Effective

Internet claims that root canal treatment causes cancer or other health problems are unfounded. Decades of research—and millions of successful treatments annually—prove that endodontic treatment is safe and effective.

If you are concerned about the safety of root canal treatment, you may find these AAE resources useful:

  • Focal Infection Theory Fact Sheet – explains the history of focal infection and research showing that there is no valid, scientific evidence linking endodontically treated teeth and systemic disease.
  • Myths About Root Canals and Root Canal Pain – this information on the AAE website explains the safety and effectiveness of root canal treatment.
  • Tooth Saving Tips – another resource explaining why saving a tooth should always be the first choice for the greatest health and cosmetic results

Watch Video: Root Canal Safety

What are Endodontists and what do they do?

An endodontist is a dentist with extensive training in the treatment of problems in the root canal of a tooth. This specialty training takes two or more years beyond dental school and means an endodontist is an expert in root canal treatments.

Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or "root canal" contains a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an Endodontic specialist removes the diseased pulp to save the tooth and prevent further infection and inflammation. After successful Endodontic treatment, the tooth continues to perform normally.
What is a Root Canal?

Endodontic treatment can often be performed in one or two visits and involves the following steps:

1. The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
An Overview of Endodontic Surgery

Why would I need Endodontic Surgery? Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your Endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an Apicoectomy? An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.
Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.
Endodontic Retreatment

With the appropriate care, your teeth that have had Endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.

Improper healing may be caused by:

  • Curved or narrow canals were not treated during the initial treatment
  • Complicated canals went undetected during the initial treatment
  • The crown or restoration was not placed within the appropriate amount of time following the procedure
  • The crown or restoration did not prevent saliva from contaminating the inside of the tooth

In some cases, new problems can influence a tooth that was successfully treated:

  • New decay can expose a root canal filling material, causing infection
  • A cracked or loose filling or crown can expose the tooth to new infection
Once retreatment has been selected as a solution to your problem, the doctor will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. Your canals are cleaned and carefully examined to assess the nature of the problematic tooth. Once cleaned, the doctor will fill and seal the canals and place a temporary filling in the tooth. At this point, most likely you will need to return to your dentist as soon as possible in order to have a new crown or restoration placed on the tooth to ensure full functionality.
Cracked Teeth

When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated.  When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain, Irritation of the dental pulp can be repeated many times by chewing.  Eventually, the pulp will become damaged to the point that it can no longer heal itself.  The tooth will not only hurt when chewing but may also become sensitive to temperature extremes.  In time, a cracked tooth may begin to hurt all by itself.  Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.

                                Watch Video:  Cracked Teeth


Treats Traumatic Injuries

 Dislodged Teeth

Injuries to the mouth can cause teeth to be pushed up into their sockets Our doctors or your general dentist may reposition and stabilize your tooth. Root canal treatment is usually started within a few weeks of the injury and a medication, such as calcium hydroxide, will be placed inside the tooth. Eventually, a permanent root canal filling will be implanted.

Sometimes a tooth may be pushed partially out of the socket. Again, Dr. Kaldestad, Dr. Niazi or your general dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. Yet, if the pulp becomes damaged or infected, root canal treatment will be required.

Avulsed Teeth

If an injury causes a tooth to be completely knocked out of your mouth, it is important that you are treated immediately! If this happens to you or your child, keep the tooth moist.  A tooth can be saved if it remains moist.  You can even put the tooth in milk or a glass of water (add a pinch of salt.) If possible, put it back into the socket. Your Endodontist may start root canal treatment based upon the stage of root development. The length of time the tooth was out of your mouth and the way the tooth was stored, may influence the type of treatment you receive.
Injuries to Children

An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:

This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth.
In this case, the unhealthy pulp is removed. The doctor places medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. So it is important to have the tooth properly restored by your dentist.
After Completion of Endodontic Treatment

Endodontic treatment has now been completed. The root canal system has been permanently sealed. However, the outer surface is sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay, unless we placed a permanent restoration in your existing crown.

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact his/her office for a follow-up restoration within a few weeks of completion at our office if needed. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for Endodontic patients to experience complications after routine Endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.
General Instuctions

Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation during treatment and previous condition of your tooth. This tenderness is normal and is no cause for alarm. Do not chew food on the affected side until your Endodontic therapy is completed and your tooth is covered with a protective restoration provided by your restorative dentist. You may continue your regular dental hygiene regimen. Discomfort may be alleviated by taking ibuprofen (Advil), aspirin, or acetaminophen (Tylenol) as directed. NOTE: Alcohol intake is not advised while taking any of these medications. Should you experience discomfort that cannot be controlled with the above listed medications, or should swelling develop, please contact this office immediately. The office telephone is answered day and night. If you need to call after hours, please have your pharmacy number available.