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Grace Dental Clinic

NABH Accredited On CGHS Panel

Our locations in gurgaon : Call at +9953076985,             Landline : 0124-4832254  for appointment

Sector 31 Location

Grace  Medical and dental Clinic

H.no 1298, Sector 31

Opp. Ajanta Public School, Gurgaon

Call +91-9953076985

landline: 0124-4832254

Opening Hours: 10AM to 9 PM

 

Sector 4 Location

Grace Medical and Dental Clinic 

Shop No.167, Sector 4 market 

behind ICICI bank, Gurgaon

Call +91-9953076985

Opening Hours   5:00 PM to 9:00 PM,  

  
  

 

Root Canal Treatment

A Step-By-Step Guide To Root Canal Treatment

Endodontic Care Doesn't Cause Pain — It Relieves It!

   

 

If you're about to have your first root canal treatment, you might be feeling pretty apprehensive about the whole thing, especially given all the stories floating around. Well, don't worry — all will be revealed in this step-by-step walk-through of root canal treatment. Knowing what will happen ahead of time is more than half the battle; you will soon learn that it really is much ado about nothing.

So let's start by dispelling a common myth: Root canal treatment doesn't cause pain — it relieves it!

At The Root Of It All

Normal pulp and root canals.
A cross section of a healthy tooth showing a normal pulp (with nerves and blood vessels) and the root canals.
Infection from tooth decay.
A cross section showing infection from tooth decay spreading into the pulp and bone at the end of the roots.

Some background will be helpful. As you will note from the illustrations, a space inside the tooth called the pulp chamber houses the root canal system and pulp — the living tissue that keeps the tooth vital (alive). The pulp includes blood vessels, nerves and connective tissues, and, during childhood, creates the surrounding hard tissues of the tooth.

Endodontic treatment (“endo” – inside; “dont” – tooth), commonly known as root canal treatment, is needed when the pulp becomes inflamed or infected. The causes could be deep tooth decay, repeated dental procedures on one tooth (replacing a large filling, for example), or traumatic damage such as a crack, chip or even a root fracture. Gum disease can also give rise to root canal problems necessitating root canal treatment.

Any of these issues can result in acute inflammation of the pulp, which causes swelling and pressure inside the tooth (that has nowhere to go), leading to tooth pain and, eventually, irreversible damage to the pulp. Once the pulp dies, the pain may subside initially, sometimes to return as an acute (painful) infection spreading into the periapical tissues (“peri” – around; “apex” – end), particularly the bone. It could also become a chronic (long-standing) infection with symptoms ranging from mild to severe.

Generally speaking, whatever the cause of root canal or pulpal disease, root canal or endodontic treatment will be necessary to save the tooth. All dentists receive training in endodontic treatment and can perform root canal procedures, but often a general dentist will refer individuals who need endodontic treatment to an endodontist, a root canal specialist.

Endodontists are dentists who have completed an additional two or more years of advanced residency training in the diagnosis and management of diseases and disorders of the dental pulp, and in the diagnosis of dental pain; their focus is therefore on saving teeth. In order to make a proper assessment and accurate diagnosis of which tooth is affected and exactly what is causing the pain, a thorough history and examination is necessary, together with a radiographic picture (x-ray) of the tooth or area.

Your dentist or endodontist will check your medical history and current medications to ensure your health and treatment safety. If you are very nervous, an oral sedative or anti-anxiety medication may be helpful — discuss the options with your dentist or endodontist ahead of time.

(Continued)

Endodontic (Root Canal) Treatment, Step By Step

Preliminary treatment to remove the decay and the source of infection of the pulp is necessary, along with a determination of whether the lost tooth structure can be restored. If a fracture of the tooth has reached the pulp, or infection is associated with gum disease, it could be more difficult, if not impossible, to save the tooth.

The general sequence of a root canal procedure is as follows:

Step 1

Local anesthesia is administered via injections to numb the tooth to be treated and the surrounding tissues. If the pulp in a tooth is acutely inflamed, and therefore very painful, it may take a while to get it numb, but your dentist will not start the treatment until it is.

Step 2

Dental dam.
Dental dam in place, used to isolate infected tooth from the rest of mouth to facilitate root canal treatment.

A dental dam — a thin sheet of rubber or vinyl — will be placed over the affected and adjacent teeth. The tooth undergoing treatment protrudes through a hole punched in the dam, isolating it from the rest of the mouth. This allows the root canal treatment to be carried out in a sterile environment free from contamination by bacteria found in saliva or the rest of the mouth.

Step 3

A small access hole is drilled through the biting surface of an affected back tooth or from behind a front tooth, allowing access to the pulp chamber and root canals for treatment.

Step 4

The diseased and dead pulp tissue is removed from the tooth with specially designed instruments used to clean out the root canals and pulp chamber. This is not painful; the area is numb and the tissue being removed is either dead or dying. Once the pulp, along with the nerves contained in it, is removed, the tooth itself can no longer feel pain.

Step 5

The canals are disinfected with antiseptic and antibacterial solutions.

Step 6

The canals are then shaped with tiny flexible instruments to allow them to receive root canal fillings and sealers. The canals are washed and cleaned again to remove root canal debris prior to sealing them.

Step 7

Root canal fillings are selected that will exactly fit into the freshly prepared canals. Usually a rubber-like material called gutta-percha is used to fill the canal space. It is a thermoplastic material (“thermo” – heat; “plastic” – to shape), which literally is heated and then compressed into and against the walls of the root canals to seal them. Together with adhesive cement called a sealer, the gutta-percha fills the prepared canal space. Sealing the canals is critically important to prevent them from becoming reinfected with bacteria.

Step 8

A temporary or permanent filling material will then be placed to seal the access hole that was made to treat the canals, and the dental dam is removed. If the tooth lacks sufficient structure to hold a restoration (filling) in place, the dentist or endodontist may place a post (either metal or a very strong plastic) in one of the canals inside the tooth to help retain it.

Step 9

After root canal treatment.
Root canal filling material (gutta percha) is placed in the canals and the tooth is sealed with a temporary filling to protect it from contamination. Then a crown is usually placed over the tooth to seal and protect it from recontamination and future damage.

After the procedure, an antibiotic may be prescribed to treat or prevent infection. Be sure to follow the instructions of your dentist or endodontist carefully. After-effects of treatment are minimal, generally lasting from a couple of days to about a week. It is normal to have some minor discomfort after treatment including slight soreness that can usually be managed with over-the-counter (aspirin, ibuprofen) medications or prescription (codeine-type) drugs, or a combination of the two.

Step 10

Your tooth will need a permanent restoration — a filling or a crown — to replace lost tooth structure, and provide a complete seal to the top of the tooth. Your endodontist will send you back to your general dentist to determine which type of restoration is best for you. This step is of particular importance since many studies show that if the filled root canals are recontaminated with bacteria from the mouth, there could be a recurrence of infection around the tooth.

Knowledge Is Power

Almost like the root system of a plant, the root canals of a tooth have a main branch and many smaller side branches, and the whole system needs to be sealed during root canal treatment to be successful long term. Since root canals are very small spaces, they require a great deal of precision and care to treat well. Therefore, most endodontists today use state-of-the-art technology including digital (radiographic) imaging to diagnose root canal problems, and after treatment to verify that the canals are properly sealed; ultrasonic instrumentation to remove old canal fillings and posts and clean canals; and operating microscopes to accurately locate, visualize and seal root canal systems; it really is quite high-tech.

I have found that people who are nervous tend to lack information about endodontic (root canal) treatment; knowledge gives them the power to understand what's to come and to eliminate their fears. I hope that this step-by-step explanation will alleviate any apprehension. Root canal treatment really does relieve pain, not cause it — and saves teeth.

Common Concerns About Root Canal Treatment

Getting to the “root” of the problem

   

A Consultation with Dr. James A. Abbott

Root canal anatomy

Dear Doctor,
I have a lot of questions about root canal problems and treatment — can you give me some guidance?

Dear Jennifer,
You're not unlike most people — the term “root canal” can send shivers down spines. However, preconceived notions that root canal treatment is filled with pain and discomfort are nothing more than outdated myths. In fact, root canal treatment doesn't cause pain but actually relieves it. Advances have made the treatment a virtually pain-free experience, many times accomplished in a single visit.

Despite this, many patients still don't exactly know what to expect and what root canal treatment is. Hopefully the answers to your questions will make you feel at ease — so ask away.

Root canal abscess

Q: Why is root canal treatment necessary?

Root canal or endodontic treatment (endo-inside, dont-tooth) is necessary when the inside, or pulp of a tooth becomes inflamed or infected. The pulp contains the nerves and blood vessels — essentially they keep the tooth vital (alive). It is through the pulp that temperature and pain are perceived. The inflammation or infection can have many causes but mostly are the result of deep decay or trauma.

Q: What are typical symptoms of root canal infection?

Depending on the cause, symptoms can be numerous and varied:

  • Sharp, acute and intense pain, which is difficult to pinpoint
  • Sharp pain when biting down on your tooth or on food
  • Lingering pain after eating hot or cold foods
  • Dull ache and pressure
  • Tenderness (accompanied by swelling) in the nearby gums

Root canal pulp chamber

Q: How does endodontic treatment save my tooth?

The procedure begins by administering a local anesthetic to relieve pain. This will numb the tooth and surrounding area so that the treatment is no more uncomfortable than a filling. A common misconception is that root canal treatment is a painful experience when in actuality, it's quite the opposite.

A small opening in the chewing surface of your tooth is created to gain access to the pulp. Very small instruments are used to remove dead and dying tissue and clean the pulp from the inside, allowing the root canals to be cleaned and disinfected. The canals are specially “shaped” and prepared so that they can be sealed with biocompatible filling materials. They are coated with an adhesive cement to ensure that they are completely sealed to prevent future infection.

It is becoming increasingly common today for root canal specialists to use microscopes for these intricate and detailed procedures to make the cleaning and shaping process more precise and efficient.

Root canal filling

Q: What can I expect following the procedure?

For the first few days after treatment, your tooth may feel tender or sensitive, especially if there was pain or infection before the procedure. Most discomfort can be relieved by over-the-counter (OTC) medication like aspirin or ibuprofen. If you have discomfort or pain that lasts more than a few days or if there are other increasing symptoms, call your dentist. Prescription medications including antibiotics may be indicated.

You should not chew or bite on the treated tooth until you have seen your dentist, particularly if part of the tooth has been lost to decay, a large filling or trauma. A crown or other restoration is usually needed to further protect and restore the tooth to full function and is extremely important in ensuring long-term success. Contact your dentist as soon as possible to arrange for any necessary treatment.

Root canal treatment

Q: Can an infected tooth cause a general body infection?

Root canal infection can spread into the bone immediately around the root end if left untreated, although it usually remains localized to the area. An association has been shown between periodontal (gum) and to a lesser extent, endodontic (root canal) infection and some systemic (general) body diseases, but it is rare in an otherwise healthy person. Be safe, don't wait to get a root canal treatment done; just because it has stopped hurting doesn't mean it's not infected. Root canal treatment is designed to disinfect the tooth and stop spread of infection making it safe and effective.

Q: Who is qualified to perform root canal treatment?

All general dentists have received training in endodontic treatment and can perform most endodontic procedures, depending on their comfort level. Often they refer people needing complicated root canal treatment to endodontists, who have had specialized training and limit their practices to endodontic diagnosis and treatment. Endodontists perform routine as well as difficult and more complex procedures and are also experienced in helping to diagnose the cause of oral and facial pain that can be difficult to determine.

Root canal treatment doesn't cause pain, it relieves it.

Q: How is cost covered?

The cost varies depending on how severe the problem is and which tooth is affected. Cost is based on the number of canals, degree of difficulty and location of the tooth in the mouth; for example, front teeth are easier to treat than back teeth. Root canal treatment is usually covered by dental insurance depending on your coverage. If it isn't your dentist may also offer you a payment plan.

Q: I am surprised that there is so much to consider in root canal issues?

You're right, there are a lot of topics to cover in this area. In fact, endodontics is a whole specialty of dentistry dedicated to root canal treatment. 

Contact Us

Grace Dental Clinic, Resi. cum clinic, H.No 1298 Sector 31, Opp. Ajanta public School , Gurgaon

Opening Hours 10:00 AM to 9:00 PM,      +91124- 4832254, 9953076985

 

Grace Dental Clinic, Orthodontic and implant center 

Shop. no 167 Sector 4 Market, Behind ICICI Bank,  Gurgaon-122001

M +91-9953076985,  Drhimanshu@gurgaondentalcare.com

Opening Hours , 5:00PM to 9:00PM,  Sunday Evening Closed   نعمة عيادة الأسنان