Root Canal Treatment

Root canal treatment is necessary when cavities or cracks reach the nerve of the tooth, or if the tooth fractures and the nerve is exposed. The nerve is removed and the canals inside the tooth are filled and sealed.

The reputation is worse than the reality. A root canal is the treatment that stops the pain — it is not the cause of it. The pain people associate with root canals is the toothache that brought them in.

Signs a tooth may need one

• Lingering pain to hot or cold that continues after the source is removed
• Pain that wakes you at night, or is not relieved by over-the-counter medication
• Pain on biting or on release
• A pimple or swelling on the gum near a tooth
• A tooth that has darkened after an injury

Some teeth need treatment with no symptoms at all, and show up only on an x-ray. Others are unmistakable.

What treatment involves

The tooth is numbed and isolated. We open into the pulp chamber, remove the inflamed or infected nerve tissue, clean and shape the canals, and fill them with a sealing material. Depending on the tooth this takes one or two visits.

You should be comfortable during the procedure — modern anesthetic handles this well, including in most cases where the tooth is already inflamed. Tell us if you feel anything and we will address it before continuing.

Afterwards: the tooth needs a crown

Often a tooth that has been treated with a root canal will also require a crown to protect the weakened tooth. This step is not optional in the way it sometimes sounds.

A root-canal-treated tooth has lost its blood supply and a good deal of internal structure, and it becomes brittle. Back teeth especially will eventually split under chewing load without full coverage — and a tooth that splits below the gum line usually cannot be saved. The crown is what makes the root canal worth doing.

Root canal or extraction?

If a tooth can be predictably saved, saving it is almost always the better choice. Nothing replaces a natural tooth as well as the tooth itself, and taking it out starts a chain of consequences for the teeth around it.

Some teeth cannot be saved — a vertical root fracture, a tooth with too little structure remaining, or advanced bone loss around it. In those cases extraction and a plan to replace the tooth is the honest recommendation, and we will say so.

If you are in pain now

Call the office at (210) 824-3243. We make every effort to see patients with dental emergencies promptly. After hours, call the same number for emergency contact information.