The removal of dental pulp when it has become infected or died. Dental pulp is the soft core of the tooth containing nerves, blood vessels, and connective tissue. It extends from the top of the tooth, called the crown, all the way down to the roots in branches called canals.Common signs of pulp problems include:

  • Pain when biting down on a tooth
  • Sensitivity to hot or cold food or beverages
  • Tooth discoloration
  • Swollen gums around the infected tooth

PARTS OF THE BODY INVOLVED

Mouth, teeth

REASONS FOR PROCEDURE

Dental pulp may become infected because of an untreated cavity, trauma to the tooth, or long-standing gum disease. When dental pulp becomes infected or dies, a painful abscess within the jawbone will occur. Removing dead or diseased dental pulp will prevent infection from spreading to other areas of the mouth and destroying bone around the tooth. If a root canal is not performed, the tooth will need to be removed.

RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE

  • Immunosuppression
  • Bleeding disorders
  • Circulatory problems (such as diabetes), which can cause healing problems
  • Heart valve conditions, which increase the risk of endocarditis from dental procedures

WHAT TO EXPECT

Prior to the Procedure - Your dentist or endodontist will do a thorough dental exam and x-rays

During Procedure - Anesthesia

Anesthesia - Local

Description of the Procedure - A small hole is made through the enamel (hard part of the tooth above the gum line) and into the pulp. Steel files are inserted to extract the pulp. All teeth have between 1 and 4 individual canals, and pulp will need to be extracted from all canals in the affected tooth. Once all pulp has been removed, the walls of the root canal are reshaped and enlarged, and medication is inserted to kill bacteria.

At this point, the dentist may insert a temporary filling to protect the tooth until the next appointment. Or, the procedure may be completed in its entirety within one visit, depending on the condition of the tooth.

The canal is drained dry, and then filled with a rubbery material called Gutta-percha to prevent recontamination.

After Procedure – The area is permanently sealed, and a gold or porcelain crown is placed over the tooth to strengthen its structure.

How Long Will It Take? The procedure may take 1-3 appointments, and each appointment may last up to one hour.

Will It Hurt? Anesthesia prevents pain during the procedure. You may have some discomfort for a few days during recovery, and pain medication may be used as needed.

Possible Complications:

  • Pain and swelling
  • Surgical-wound infection
  • Persistent abscess

Average Hospital Stay – None

Postoperative Care:

  • Use warm, salt-water rinses to soothe your mouth
  • Avoid heavy biting and chewing on the side of the mouth that has the root canal for a few days
  • See your dentist or endodontist for a follow-up x-ray about 6 months after the root canal

OUTCOME

In approximately 95% of cases, root canal therapy is successful, and the treated tooth should last a lifetime. However, root canal treatments may need to be repeated if:

  • Pulp was left inside a canal that was overlooked
  • A tooth was damaged during the procedure
  • A tooth fractures between the roots

CALL YOUR DOCTOR IF ANY OF THE FOLLOWING OCCURS

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the surgical area
  • The tooth feels loose after root canal therapy
  • Headache, dizziness, muscle aches, or general ill feeling
SOURCE:

American Dental Associates

Academy of General Dentistry

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