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People assume removing the pulp containing the nerves, blood vessels, and connective tissues would mean their tooth now has a limited lifespan. They think we are basically killing the tooth. That’s not the case — the pulp is only important to the tooth during growth and development. Once the tooth is fully mature it can survive without the pulp, as the surrounding tissues nourish the tooth. A tooth that has had a root canal can last for the rest of the patient’s life.
If the infection spreads from the pulp chamber into the surrounding gum tissue, it’s likely the tooth will need extraction. At this point, the patient is also in danger of the infection spreading elsewhere in the body, which can be life threatening. That’s why it’s important to not miss your six-month exams and professional cleanings with Dr. Frey.
A root canal on a molar usually takes about 90 minutes, usually an hour on smaller teeth. The placement of the crown in the second appointment should take about an hour.
Root canals with Dr. Frey are performed with the patient under only local anesthesia. We can provide sedation, if you choose, to help you relax.
The term root canal sends terror into many people. This is an odd reaction because this procedure actually isn’t any more painful than removing decay and placing a filling. During the procedure you feel nothing. Afterwards, you may have some soreness, but the pain is in no way acute. It’s usually due to your surrounding gums calming down now that the nearby infection in the tooth has been removed.
If you think about it, a root canal can’t be painful afterwards. Why? All of the pain mechanisms of the tooth, the nerves, have been removed along with everything else in the tooth. The tooth is now empty and incapable of feeling anything.
People confuse the pain that creates the need for the root canal — the infection in the tooth — with the actual procedure. In reality, this is an easy procedure to take and it will instantly remove the excessive pain the infection is causing.
Root canals with Dr. Frey usually require two appointments. During the first appointment, Dr. Frey first numbs the tooth and the surrounding tissues so you won’t feel a thing. If you’re nervous about it, we’ll provide sedation to ease your anxiety. Next a small hole is drilled in the crown of the tooth to gain access to the pulp. Through that hole, Dr. Frey uses very small files to clean out the entire pulp cavity and root canals. He removes all of the decayed connective tissue, blood vessels, and nerves. The entire pulp cavity is cleaned out and then thoroughly disinfected with sodium hypochlorite.
The now-empty tooth is then filled with a rubber-based material known to golfers, called gutta-percha. The tooth is sealed with adhesive cement and the entry hole is closed with a regular composite dental filling. If the tooth is small, such as an eyetooth, this may be sufficient and the procedure is complete. In most cases, however, Dr. Frey will want to place a crown on the tooth to protect it, provide strength, and return function (remember the tooth is now empty except for the gutta-percha). In a crown is required, we take impressions of the tooth and send them off to a dental lab to fabricate the crown. When it is finished, you return and we place the crown permanently.
When the pulp of a tooth becomes infected or inflamed you’ll know. That tooth will be very sensitive to hot and cold, to biting, even to a gust of cool air. The surrounding gums will likely be swollen. The tooth may become discolored, usually grey. The pain can be intense. This is probably the root of the misconceptions about a root canal. Of course, the root canal is going to alleviate the pain — it isn’t the cause. The cause of your pain is the infection.
In rarer cases, the patient won’t have any idea there is a problem in the pulp, but a routine x-ray will show it. This is another reason keeping your twice-yearly exams and cleanings with Dr. Frey is so important.
Should you choose not to have your tooth treated at this point, your infected tooth may develop an abscess, a puss-filled pocket that extends up the roots of the tooth. Now even a root canal won’t be able to save the tooth. It will need extraction and replacement with a dental implant or bridge.