The pulp of your tooth, which contains the nerve and tiny blood vessels, has a limited ability to heal itself and can easily become infected. This infection can be caused by a deep cavity that reaches the center of the tooth causing the pulp to die, or a traumatic injury to the tooth, or a previous extensive preparation (drilling) of the tooth. The extensive preparation may have been done to prepare the tooth for a crown (cap) or even a large filling. The pulp may or may not abscess immediately in these cases. It may take years for a problem to develop.

The infected pulp tissue is not always painful, and may or may not be visible on a dental radiograph. A tooth with this type of an abscess is not usually extracted because the infection can be treated with endodontic therapy on the tooth. This routine procedure can save the tooth and enable you to avoid the harmful effects of tooth loss. It is successful in more than 90% of the teeth in which the treatment is completed.

Endodontic treatment can take from one to three appointments to complete. Teeth can have one to four canals that need to be treated.  An opening is created to access the nerve, and the abscessed nerve is removed from the root or roots. The canals where the nerves had been located are then cleaned and shaped and a medication may be placed in the canal to promote better healing. When it has been determined that the canals are free of infection, they are filled with a special rubber-like material and sealed with a cementing medium.

You may have had no discomfort from the tooth prior to the root canal treatment or have been unaware that you even had an abscess. Whilst the procedure is entirely pain free, it is not unusual to experience discomfort immediately after treatment. The abscessed area associated with the tooth may take several months before healing is completed and for the tooth to become asymptomatic, that is, for all soreness in the area to disappear.

Once the endodontic therapy has been completed, the tooth is usually restored with a cast crown or onlay. This is done to protect the tooth and prevent it from fracturing. Failure to follow through with this after endodontic therapy  can result in a vertical fracture. If there is very little tooth structure remaining, we may also advise the use of a post and core to further help the tooth retain its final restoration.

If you have any questions about the root canal procedure or the final restoration of the tooth, please feel free to ask us.