Root canal therapy can be performed in single or multiple visits, depending on the condition of your tooth and the results of the initial x-ray. Before the procedure, though, your endodontist will advise you as to the number of appointments necessary to complete the root canal. If you had an infection or abscess in the tooth, the endodontist may choose to have you take an antibiotic. An initial dental x-ray of the tooth, displaying the entire tooth in the film (called a "periapical x-ray"), is taken for the endodontist to refer to during the procedure. Your endodontist will begin the procedure by giving local anesthetic to "numb" the tooth that is being worked on.
After your tooth is numb, you may expect the following procedures:
- The endodontist will place a rubber dam over your mouth. This plastic shield, made from either latex or non-latex materials, is used to keep the tooth isolated from your saliva and very dry before the final steps are taken to complete the procedure. The endodontist will use different solutions throughout the procedure to disinfect the inside of the tooth. The rubber dam is helpful in isolating the tooth and keeping these solutions from entering your mouth.
- Next, the endodontist will begin the procedure by drilling a small hole through the tooth into the area known as the pulp chamber -- this is where the nerve of the tooth is located.
- Your endodontist will begin using tiny files, which are designed to remove the nerve from the tooth and any infected tissue. Certain files can be used by hand; others are connected to a slower moving dental hand piece, called a "rotary instrument." The endodontist may require another x-ray at this point to determine the length of the root. It is critical that the entire nerve is removed to prevent toothaches after the procedure and re-infection of the tooth. In order to prevent this, the endodontist needs to get as close to the tip, or apex of the tooth, to remove all of the nerve. This is usually the longest part of the procedure.
- Once the endodontist is confident that the entire tooth has been cleaned out, the tooth is dried with tiny absorbent paper points. When completely dry, the endodontist will place a material called "gutta percha" along with a sealant into the tooth. Gutta Percha is a rubber material designed to seal the inside of the tooth.
- The endodontist will place a temporary restoration to seal the tooth and send you back to your general endodontist for a crown or permanent filling. Chances are, your endodontist will recommend having a crown put on to the tooth. Since the nerve and blood supply to the tooth has been taken away, the tooth may become weak over time, resulting in a cracked tooth. A crown is designed to prevent this from happening. Please avoid hard and sticky foods to keep the temporary restoration in place until you see your general dentist for the permanent restoration.