Root Canals

Root canals are sometimes necessary but today they can be done quickly and with very little discomfort due to modern technology and advances in the dental field.

What are some warning signs and some reasons that someone might need a root canal?

Dr. John Vitale: I think the warning signs are severe toothache pain upon chewing or application of pressure, prolonged sensitivity, pain to hot or cold temperature after the heat or the cold has been removed, discoloration or a darkening of the tooth, swelling and tenderness in the nearby gum area.

Could you explain the root canal process, and what steps are involved? And is it completed in one day, or are multiple office visits required?

Dr. John Vitale: A root canal procedure is not as complex and difficult as people make them out to be. Basically, what a dentist does is, open the cavity of the tooth through the top, go into the chamber of the nerve, which is located above the gum line and inside the confines of the tooth, locate the areas where the nerves go into this chamber, and with the use of dental or endodontic instruments, we clean out the nerve tissue and eventually fill it with an inert material called gutta-percha, so that seals off the canals of the tooth and does not allow bacteria to get back into the tooth.

And as far as multiple visits are concerned, about 70 to 80% of all endodontic procedures are now done in one visit. In the cases of extreme swelling and sensitivity, or what we would call a “hot tooth,” sometimes we would do it in two visits or more.

People think root canals are extremely painful, but we know they’re not. What type of anesthesia is used during the root canal, and how much pain is to be expected?

Dr. John Vitale: Well, the kind of anesthesia that you use for a root canal is the same anesthesia we use to do a filling in a tooth. And there is really no pain associated with a root canal in 95% of the cases. And the reason being is very simple, if the dentist administers anesthesia properly and the patient is 100% anesthetized, there will be no pain. The amount of pain that one incurs will be inversely proportional to the degree of anesthesia that you get. If you’re 50% anesthetized, you’re going to feel pain. If you’re 100% anesthetized, you’ll feel nothing. It’s really simple.

What advanced technology and techniques do you utilize during a root canal procedure?

Dr. John Vitale: Well, today with the technological advances in root canal therapy, we now have electrical instruments that we can file the canals of teeth with, and with these instruments, these electronic instruments, the machine tells you when you’re approaching the very end of the tooth, which makes the fill much more accurate when the dentist is filling the root canal, too. And that adds to the success, or increases the success of the root canal.

After the root canal is complete, is there anything the patient should watch out for while healing?

Dr. John Vitale: Absolutely. The patient should stay off that tooth for a while, until the patient gets back to see the dentist so that a post can be placed in the tooth, and a crown can be placed on it. Because when the nerve is taken out of the tooth, the tooth is dead. So, it doesn’t get the nutrient supply and the nerve and the blood supply that it gets while it’s alive. And so, the tooth becomes brittle, and subsequently it’s more liable to break upon biting and things like that.

So, you should follow it to completion and you should really stay off it until the dentist has a chance to put the post in and fix the tooth.

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