Root canal treatments are quite common, saving an estimated 24 million teeth each year in the United States. Terry Riley, DDS, dentist at UI Hospital Dentistry Institute, located in University of Iowa Hospitals and Clinics, talks about root canals:
What happens to a tooth that it would need a root canal?
Usually the pulp tissue within a tooth is damaged, either by a trauma or a long-term insult. Usually the blood supply becomes inflamed or necrotic and it may become more acute via a chronic issue, so it usually has to be dealt with.
What are the symptoms, or how might someone know they need root canal work on a tooth?
Most root canal issues come up because people have pain and swelling, but sometimes there’s not those overt signs and we determine the need by a radiograph that we take.
How does a dentist identify a tooth in need of a root canal?
We can tell using radiographs, but usually we look at what kind of pain they’re experiencing, the longevity of it, some temperature sensitivity, whether it’s difficult to bite, and things like that.
Who is most likely to need a root canal (older people, athletes, trauma?)
I think that the older you get, the more likely you’re going to have some kind of issues. But any time the tissue has any kind of insult, whether it’s decay, fracture, something like that, you have the potential.
If the tooth is damaged, why not pull the tooth? Why do a root canal procedure?
We like to save teeth if we can. Obviously when you lose a tooth, you lose the function of that tooth. You worry about the movement of the teeth to change your bite sometimes. The teeth act somewhat to support the muscle of your face, so people who lose posterior teeth lose support so their face does look a little bit more caved in and they look usually a little bit older.
At one point in time, a root canal was considered a painful experience. Is root canal work preformed today painful? What has changed?
I think when you have a root canal, usually one of the signs of needing one is having pain to begin with, so you’ve already experienced a little bit of pain. I think we’re doing better with our anesthetics, we have some techniques we rely on that have been developed. I think it can typically be a more comfortable procedure now, but sometimes there are some painful experiences, and we try to keep those to a minimum.
How is a root canal preformed? Is it one visit or several visits?
Basically the pulp tissue and the nerve tissue within the tooth must be removed and replaced by an inert material. Several procedures are done. Typically they’re done on a two-visit procedure, but more and more commonly, one-visit procedures are done with good outcomes.
If somebody needs a root canal but don’t actually do it, what might happen?
You worry about having infection and subsequent cellulitis or intense swelling and there can be some drastic and pretty dramatic issues that come up if those symptoms go on unchecked.
Once a tooth is repaired with a root canal procedure, will it need more dental care - perhaps another root canal procedure - over time?
Typically we have about a 90-95 percent success rate over about 10 years. Usually a crown needs to be placed on that tooth to prevent further fracture, but occasionally additional procedures are required, but with the techniques that we’re using now, there’s fewer and fewer of those that need to be done. |
