An endodontist performs root canal therapy for tooth pain by removing the infection source

The intention of root canal therapy is to eliminate infection and tooth pain.  An Endodontist, a root canal specialist, should typically perform this procedure.  This information on root canal therapy or endodontics was created in our NYC Root Canal office.

Symptoms that might indicate the need for root canal therapy include: 1) significant, constant pain, including pain that can wake you up at night, 2) increased symptoms specifically when you lie down, 3) significant sensitivity to hot or cold, 4) pain upon chewing on that tooth, 5) a darkening of the color of only one tooth, or, 6) the appearance of a pimple or fistula in the gum.

A tooth might need root canal therapy even in the absence of any pain.  This can occur if the damage to the nerve is so severe that all sensation of pain is lost.  Root canal therapy may still be indicated to prevent the spread of infection, asymptomatically, in the surrounding jawbone.

The two main objectives of root canal therapy are:  1) to completely clean out diseased tissue and bacteria from within the tooth to the end of the tooth roots and 2) to completely fill the internal hollow root with a good filling material also to the end of the tooth roots.

There are many techniques and materials available to accomplish this; some are great and many are bad.  Some of these bad techniques allow the dentist to quickly, yet incompletely clean out and incompletely fill the internal hollow root and this can be the cause of future problems including continuing pain and infection.  Patients should ask to see the final x-ray following root canal therapy.  It’s better to get something done right the first time in a premium dental practice.

Root canal therapy is NOT painful when properly performed in a tooth that has not yet reached the point of becoming a painful emergency.  Some people mistakenly wait until they have severe pain before seeking root canal therapy.  They are the cause of the pain, not the procedure itself.  An important lesson is therefore to seek out root canal therapy if you think a tooth is becoming more symptomatic; don’t wait for the emergency.

Root canal therapy should ideally be left to specialists and this is what patients should expect in a premium dental practice.  The skill level of the dentist determines the amount of time/visits required for root canal therapy. The Journal of The American Academy of Endodontics consistently shows comparable success rates of 95% for either single or multiple visit root canals therapies, assuming they are performed at the same skill level. A good root canal specialist should be able to complete your root canal in one hour in one visit.  There should usually be no pain during the procedure.

Post Operative Info for Root Canal Therapy

Teeth are living tissue similar in structure to bone.  There are nerves and blood vessels that are contained within the center of bones and teeth.  We refer to this combination of nerve and blood vessel within a tooth as the root canal.  Each tooth can have between one to four root canals; typically front teeth have less root canals and back teeth have more.  Root canal therapy involves the removal of the nerve and blood vessel within the tooth; the tooth and tooth root remain intact.  Root canal therapy is most frequently needed when decay (a cavity), which is a bacterial infection, eats through the tooth enamel and dentin and invades the circle within the circle which is the root canal.

Patients will frequently, though not necessarily, experience pain when a dental nerve dies because the infection releases bacterial excretory byproducts as gases which build up pressure within bone.  It is this buildup of gas pressure which patients feel as pain.  The nerves within the ligaments, which attach the tooth to the tooth socket, remain intact following root canal therapy and it is these nerves which might be initially sensitive afterwards.  This typically resolves as the inflammation around the tooth subsides over a period of several weeks.

Please refer to the section on Post Op Dental Treatment instructions for more information regarding the use of pain medication.