Root canal therapy

There are two options for removing the infected portion of an abscessed tooth: one is to extract the entire tooth, and the other is to perform root canal therapy. Root canal therapy is a procedure designed to eliminate infection from the soft center of a tooth (where the nerve and blood supply reside) while saving the rest of the tooth structure. Because it saves your tooth, it’s the best option for retaining your natural teeth. Root canal therapy is more expensive initially than an extraction, but it leads to better longterm outcomes and it is actually less expensive in the long run. This is because extractions create gaps between your teeth, which will cause the rest of your teeth to migrate over time; to avoid this migration, a patient will often require an implant, a bridge or a partial denture after an extraction is performed. (Which, all together is more expensive than root canal therapy.)

Why would someone need root canal therapy?

Sometimes when a patient has a tooth ache or complains of gum pain, the problem is actually an infection inside a tooth, known as an abscess. An abscess occurs when the soft, inner tissues of a tooth become infected because tooth decay or trauma have broken through the hard outer layers and then exposed the inner layers to bacteria and infection. While you may not feel pain when the hard outer layers of your teeth have decay, you will certainly feel it when the decay reaches the soft inner tissues, where nerves reside. If the inner portion of a tooth becomes infected, usually a patient seeks treatment right away due to the pain involved. From a clinical perspective, we must stop the infection from spreading to the gums, the rest of the mouth, your jawbone, and even your circulatory system.. Root canal therapy resolves the infection while saving the rest of your tooth.

What are my alternatives to root canal therapy?
If you have an abscessed tooth, the infection must be removed to stop it from spreading. The only alternative to root canal therapy is extraction of the entire tooth. Simply using antibiotics will never heal an abscessed tooth; it may provide temporary relief, but the infection will always return. This is because the normal flora (bacteria) in the mouth will reinfect the abscessed area; there will always be a supply of new bacteria infiltrating the abscessed area until the tooth either undergoes root canal therapy to seal it off or is extracted.

While extraction may seem initially like the least expensive option, Dr. Ertl will also recommend replacing your extracted tooth. An extracted tooth that is not replaced can leave a gap that causes problems for the surrounding teeth, and this gap can potentially affect your bite because your other teeth while naturally migrate (move) to fill the gap. Root canal therapy is often less expensive in the long run than extracting and replacing that same tooth with a partial denture, bridge or a dental implant. Ask Dr. Ertl to explain all the options, and why root canal is recommended.

What is a root canal?

In terms of anatomy, the root canal is a specific part of the tooth; but usually the term “root canal” refers to a common dental therapy. The goal of root canal therapy is to save a patient’s natural tooth. The portion of the tooth that is visible above the gumline is called the crown. Although the outside is hard, the inside is soft and filled with blood vessels and nerves, which continue down below the gumline into the tooth’s roots inside a thin tube called a root canal. When these soft tissues inside the tooth become infected, a condition known as an abscessed tooth occurs. The infection can easily spread from the root canals to the gums, and from the gums to bone. The infection must be stopped from spreading before it causes further damage. To stop its spread, Dr. Ertl will recommend a root canal therapy. This involves culling the soft tissues from inside the affected tooth, cleaning the root canals and surrounding hard tissues, and then filling them with a solid, inert material. This is a commonplace procedure and it can be performed with minimal discomfort. Dr. Ertl favors this procedure to its alternative, extracting the infected tooth, because it saves your natural tooth structure.

What can I expect from the root canal procedure?

Because they affect nerves, root canals have a bad reputation, but it’s not necessarily deserved. Many patients find the procedure on par with having a cavity filled. Depending upon your situation, Dr. Ertl will either perform the procedure in his office, or he may refer you to a specialist. If he performs the procedure, he’ll take care to make you are properly numbed before beginning. You may feel pressure during the procedure, but you should not feel any pain. If you harbor fears of dental procedures, please don’t let this prevent you from seeking the dental treatment you need—ask Dr. Ertl about whether oral sedation measures may be appropriate for you.

Once the procedure has begun, Dr. Ertl will open the hard outer surface of the tooth and use specially-designed tools to clean out the affected soft tissues, nerves, and infection. He’ll use a solution to sterilize the empty spaces and the root canal; this will kill off any remaining bacteria. Last, he’ll place an inert material to fill the voids and the canal down to the root tip. The material is necessary to prevent future infections. Last, he’ll close the tooth and seal it back up to prevent the normal bacteria in your mouth from re-infecting the tooth’s inner spaces.

After the root canal therapy is completed, the tooth will be more friable that a live tooth, so a crown will be recommended. (If the patient declines the crown, the tooth will be vulnerable to damage and may still require work further in the future.) When the new crown has been fitted. the new tooth will function and feel just like the original healthy tooth.

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