A: A root canal is really our only means of saving a tooth that’s infected— if it’s not completely fractured. Usually, a tooth has a large cavity or a small break and it starts to hurt—a toothache.
So, a root canal, what that does it allows us to hold on to the tooth. We go into the tooth, remove the nerve on the inside of the tooth, clean it, disinfect it, and fill it with an inert putty.
Now, it allows us to hold on to the structure of the tooth. We eventually put a crown on it usually. What that does is prevent us from having to remove the tooth. It prolongs the usage of that tooth, such as a front tooth that started to hurt. Also, it preserves the bone in that area in case of a future potential need to use a dental implant.
A root canal is a common procedure that dentists use to prevent resorting to an extraction after the pulp has become infected. Saving an infected tooth is usually the optimal solution if possible rather than removing it.
Removing an infected tooth has negative side effects, namely the loss of jawbone mass if an implant is not used. Root canals aren’t always necessary for a cavity, only for deep cavities or significant dental trauma.
The pulp is the soft, sensitive area in the tooth that is comprised of nerves, connective tissue, and blood vessels.
In a root canal procedure, the dentist removes the infected tissue from the pulp chamber, disinfects the chamber, and then fills and seals the tooth. Usually, a crown is placed on top to mitigate the chance of cracking or chipping.
Root canal procedures are also called:
- Endodontic treatment
- Root canal treatment
- Root canals
- Root canal therapy
Why Is A Root Canal Better Than Extraction?
Regardless of what name a dental office calls it, it’s a viable solution for a tooth with pulpitis that is irreversible. Pulpitis, (inflammation of the pulp) in some cases is reversible. However, once the nerve tissue has died then it is too far gone, and the tooth can only be preserved not “saved” as a living tooth. With a root canal, you are essentially “mummifying” the tooth. It is no longer a living structure by the time you need a root canal—it’s simply a dead tooth.
Although you want to avoid letting a cavity progress to irreversible pulpitis, a root canal offers the next best option. Preserving the dead tooth structure is better than extracting it and leaving an empty socket. A root canal won’t affect your bite or jawbone health. However, extracting a tooth without replacing it with a dental implant has a serious impact as mentioned above.
Why The Crown?
When getting a root canal there is an increased risk of tooth fracture. That is because the inside of the tooth is hollowed out, leaving only the shell brittle and dry. Since it’s prone to cracking or chipping, a protective crown is applied. Dental crowns are rigid and formed like your tooth, with a material that is harder than enamel. It maintains the structural integrity of your tooth and reduces the risk of breakage as the tooth becomes more brittle over time.
Signs Of Irreversible Pulpitis
If you need a root canal it is pretty easy to narrow down the cause to a deep cavity or dental trauma. With dental trauma, there’s really nothing you can do to prevent the damage since it’s immediate. However, in the case of a cavity, you can mitigate your risk of irreversible pulpitis with quick action.
To reduce your risks make sure you fill cavities ASAP, the only way to detect cavities early is with regular checkups. See your dentist at least twice a year. Practice good oral care by brushing and flossing at least twice daily. Use clinical strength mouthwash to reduce bacteria (and bad breath) that can lead to decay.
Signs You May Need A Root Canal
If you notice some minor tooth pain here and there, it might just be sensitive teeth. However, it could be an early sign of something developing. Better to have your dentist check it out, especially if you have one of these common signs:
- Tooth pain: Pulpitis causes pain that may be constant or intermittent and might be more severe when chewing. If the pain lingers or is triggered by hot or cold foods that is a pretty solid sign of irreversible pulpitis.
- Bump on your gum: If you have a bump on your gum that is reddish like a pimple or whitish-yellow, that is a fistula. Go ahead and call the dentist and tell them you have an infection.
- Swollen gums: Similar to a fistula when an infection is present it may cause gums to get puffy and swollen and incredibly tender.
- Tooth changes color: If your tooth is turning grayish, that’s because its blood supply is being blocked—it’s dying. You can see this easier on a front tooth vs. a molar, but you need to get to a dentist ASAP as well.
- Loose Tooth: Aside from dental trauma your tooth should never come loose under normal circumstances. As the infection spreads it can soften or eat away at the bone in the socket. This would make your tooth feel loose and is a bad sign.
- Cracked tooth: If you’ve cracked your tooth and it goes to the root, that tooth is gone. A root canal is your only option to at least preserve the tooth.
What If I Have No Pain?
Just because you have no pain, doesn’t mean you don’t need a root canal if other visual signs are present. It may just be that the tooth never has died, giving you relief from the pain—but it will only be temporary.
If you do not treat irreversible pulpitis with an extraction or root canal it can lead to systemic health issues. Those issues may be more severe and possibly very painful. Diagnosing a root canal is not an open and shut type of case. It’s a difficult process that may differ from dentist to dentist. Part of it is science, the rest is experience and an art form if you will. Fortunately, Dr. Vela is a seasoned veteran and has extensive experience with root canals.
A Word Of Warning
Unfortunately, as with any industry, some dentists prescribe a root canal by default. They do this for many reasons:
- It might seem like the easiest option
- They’re in a hurry to diagnose
- Trying to meet sales goals
Yes, it’s sad that in some dental clinics, specifically what we call “dental mills,” these dentists will prescribe services you may not need. For example, a dentist may tell you that a root canal is needed for a large cavity with no irreversible pulpitis. A filling, in that case, would be sufficient but isn’t as profitable as a root canal. That is why it’s so important to know what to look for in a trustworthy dentist.
Sometimes, based on where you live, you may not have much of a choice of dentists, but you can protect yourself. If you know what questions to ask you can force the hand of the dentist to give you answers they are legally accountable for.
A dentist can suggest a treatment to you all day long as their professional opinion, even if it’s not medically necessary. However, with these specific questions, a dentist must answer truthfully or be at risk for malpractice with intent to defraud. Never just take their opinion without probing further for fact-based answers to questions like:
- Is the root canal medically necessary based on documented evidence?
- Is it possible the tooth might recover and not need a root canal?
- What evidence of irreversible pulpitis did you document?
- Do you see clear evidence of irreversible pulpitis?
Be Educated. Be Prepared.
What you’re doing with these questions is two-fold. You’re letting the dentist know that you are educated in your condition. You can’t be manipulated if you know what you’re talking about. You’re also forcing their hand legally. Up until you ask specific questions, their recommendation of a root canal is just that—an opinion. Once you start asking them what evidence they saw, then they must back that up with facts.
Vela Dental For A Root Canal Consultation
When you come to Vela Dental, you’re treated like family, not a piggy bank. We are not a dental mill and we work on quality of work, not volume. Your smile is critical to your well-being and we’re in the business of creating smiles not problems. Contact us today for an honest consultation regarding your tooth pain.