Learning the Truth About Root Canals
What is a root canal treatment?
Basically, what that is, in your tooth, there is a nerve, and the nerve lives inside a tube which we call the canal, the root canal, right? When you need a root canal, we're cleaning out all the debris or whatever's left of the nerve inside that canal and then we seal the tooth afterwards.
What are some signs or symptoms that I might need a root canal?
There are several, and they vary. Some of them could be pain to hot and cold, but not pain that goes away like when you sip something cold or when you drink a sip of hot coffee. It's pain that lingers after you've had that coffee, a few minutes at a time.
Also, sometimes it's pain when you bite, like when you're chewing on something a little bit hard and you get pain. That can be a sign, or spontaneous pain when all of a sudden, the side of your jaw hurts or your tooth is hurting. Oftentimes, that is a sign that you need a root canal.
Can a root canal save a cracked tooth?
Yes and no. It depends on the extent of the crack. If we're able to do the root canal and put the protective cap or crown over the tooth before that crack propagates down the side of the tooth to the nerve or the root, a lot of times we're able to save it. But once it crosses into the roots or what we would call the pulpal chamber, where the tooth is very compromised, almost split in two, sometimes a root canal will not fix that.
When is it too late for a root canal?
It's really hard to say, but often if you have what we were talking about earlier, a vertical fracture in the tooth where the tooth is split in two, it's usually not savable. Sometimes when the infection is too great and it's just not going to heal, that could be a reason why it's not going to heal. If you wait and the cavity that you had in your tooth or whatever is causing the need for the root canal gets so bad that literally your tooth cannot be fixed or restored, then it's too late.
What exactly happens during the root canal?
After we get you numb and place what we call a rubber dam over your tooth, which is like a raincoat for your tooth, so that nothing gets in the tooth and nothing gets in your mouth, we open up the tooth and put a series of small instruments called files to the tip of the root of your tooth. Each file gets bigger as we go along. This progressively cleans the root canal.
Once we have it cleaned out and disinfected with some chemicals, we dry the tooth and then seal it with a root canal sealer and usually a material called gutta-percha, which is like a rubber material that we place inside.
How long is the appointment for a root canal?
Generally, front teeth are quicker. If you're doing a root canal on a crown, it could be an hour and a half. The root canal portion on a front tooth could be like 20 minutes. Molar back teeth have multiple roots, so that root canal may take anywhere from 30 minutes to an hour. You're looking at anywhere from one to two-hour appointments usually.
Will I need a crown over my tooth after I get the root canal?
The answer is usually yes. Usually when you do a root canal, the tooth has been broken down and weakened. So, we put a crown, a cap over the tooth to protect it from breaking. Sometimes, but not always, you could need a root canal on a front tooth due to a blow. You bumped your tooth somehow, and we just need to do the root canal. In those cases, sometimes we can just make a little hole to clean out the tooth, do the root canal, and then place a filling. But I would say probably 95% of the time you will need a protective crown.
Will a root canal hurt?
Many people are nervous about getting a root canal because they think it's going to hurt. Generally, all we need to do is put a little local anesthetic like we do for a filling or an extraction or any kind of dental procedure. That's usually enough to numb the tooth, and then we do our procedure.
A lot of times in the media, you hear things about root canals being scary or dangerous. It's a very common procedure and a very safe procedure. As a matter of fact, I have had two root canals in my own mouth. One was from a cavity when I was a little kid, and one was because I was gritting my teeth as a young adult working on my car, and I broke my front tooth.
They're a safe procedure. There's really nothing to worry about. What you need to worry about is when you don't do the root canal and leave infection in your body. That infection has been shown to cause heart disease, diabetes, dementia, Alzheimer's, and all kinds of other health problems. If you need a root canal, you need to get that done.
How do I prepare for a root canal?
Usually, I'll say the sign of the cross, but really there's nothing you need to do to prepare for a root canal. Just show up, relax, and if you have any questions for your dentist, ask them. But usually, just relax and let them do what they're going to do.
How am I going to feel after a root canal?
Usually, there's going to be a great amount of pain relief because when you need a root canal, it hurts a lot. You can still feel some soreness, but the pain should be greatly diminished. If the dentist thinks that you need antibiotics, possibly you have some antibiotics and possibly some pain medication. Usually, Advil and Tylenol in combination is the best pain medicine for something like a root canal.
Will my tooth still be sensitive after a root canal?
It's possible that you will still have some sensitivity after a root canal. It should be different than what you had before. Sometimes it can be a little tender to biting because when we clean out the tooth, you're filing out all the bacteria, debris, and the nerve that's dying. Some bacteria can get pushed out into your bone or soft tissue, causing what we call apical inflammation. It could be a little sore around the tip of the tooth when you bite, but usually, it's not a big deal.
How long does it take to recover from a root canal?
Usually, by the time your anesthetic is worn off, you're good to go. You want to be a little gentle on that tooth for the first few days because you could have a bit of post-op discomfort or sensitivity to biting, but really, you should be good to do anything.
What is the best way to recover after a root canal?
I say, "Just relax." Maybe don't do any yard work or anything crazy. Have a beer, chill, watch your favorite movie. There's really not much to the recovery.
What's the difference between getting a root canal or getting your tooth pulled and an implant?
There's a lot to unpack in that question, but I always say that if possible and your tooth is savable, I would do the root canal and the crown. Sometimes the tooth is very broken down or it's already had a root canal and it's failing. At that point, I would suggest an implant.
Let's go by the statistical probability of it working and how long it's going to work for. It's always best if you can keep your own tooth. But if the tooth is so broken down that maybe it's only going to be good for five or 10 years, consider taking it out and doing the implant that hopefully would give you a longer lifespan. In the long run, it may be a better option. They're two different procedures.
Why do I have to have a crown on my tooth if I have the root canal?
When you do a root canal, usually it's a tooth that has a lot of problems, like a hole, a cavity, or already had a huge filling or it's broken. You need to put something like a crown, a protective crown over your tooth, so it doesn't deteriorate. It's very rare that you don't need a crown over a root canal. You need to protect your investment. It doesn't make sense to do a root canal, not do the crown, and then have that tooth break because it's in a weakened state.
How much does a root canal cost?
It varies from a front tooth to a back tooth, from one root to three roots. It probably varies from $800 to maybe $1,500. If you have insurance, they may help with part of that payment.
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