Root Canal Care:

Understanding Root Canal Care

By Dr. Ben Kim

Do you know exactly what it means to need a root canal? This article will help you understand what needing and having a root canal entails, and what you can do on a daily basis to take good care of your teeth, including your root canals.

The roots of your teeth make up approximately two-thirds of your teeth, and are imbedded into your facial bones to keep your teeth securely in place.

Your root canals are the canals that exist within the roots of your teeth. Your root canals travel up the roots of each tooth to meet the main chamber that lies in the center of each tooth, called the pulp chamber. Together, the root canals and pulp chamber of each tooth house soft tissue called pulp, which contains blood vessels and the nerve that supplies each tooth.

If you develop a dental cavity or a small fracture in a tooth, microorganisms in your oral flora can gain access to the pulp chamber and root canals in the affected tooth. Once inside a tooth, these microorganisms can cause infection and inflammation.

Root Canal Procedure - By Jeremy Kemp

The first block in the picture to your right shows a tooth that has an infection below one of its root canals. The second block shows drilling of the crown of the affected tooth to gain access to the pulp chamber and root canals. The third block shows the tooth being cleaned. And the last block shows the tooth after it has been filled, and then fitted with a crown. These are the basic steps that make up a root canal procedure.

This root canal procedure typically removes the pulp -- including the nerve -- within the affected tooth. Removing the nerve isn't a problem because the nerve is mainly there to allow your tooth to differentiate between hot and cold, and is not needed for chewing and breaking down food.

Ultimately, the goals of a root canal procedure are:

  1. To address an infection that is causing pain.
  2. To protect the affected tooth so that it can continue to function.

Common Signs and Symptoms that Indicate the Need for a Root Canal Procedure

  • Severe pain in a tooth while chewing
  • A persistent or recurring canker-like sore or pimple on the gum region above a tooth
  • Swelling and tenderness in gums above and around affected tooth
  • Darkening (discoloration) of affected tooth
  • Prolonged sensitivity to hot and cold (discomfort is still there even after source of hot or cold sensation has been removed)

Generally speaking, a conventional root canal procedure has a high success rate, and treated teeth can last a lifetime if they are taken care of.

Personal Observations on Troublesome Teeth that Have Already Received a Root Canal Procedure

If your initial symptom is gum swelling and tenderness or a canker-like sore on your gums around a tooth that has already been treated with a root canal procedure, your dentist may attempt to address your situation by draining the sore and having you take a course of antibiotics. The goal in this scenario is to clear out the infection without having to drill your tooth or cut into your gums. Generally speaking, I think that this is a good first-line approach. You can take a high quality probiotic after your course of antibiotics to help replenish healthy bacterial flora in your body.

If a canker-like sore persists or returns after drainage and a course of antibiotics, your dentist may refer you to an endodontist, a specialist in addressing root canal issues. While x-rays can provide beneficial information to an endodontist, he or she will have to rely upon observation, palpation, and experience to determine the best course of action.

Often times, the endodontist will elect to cut into your gum to gain access to the infected area for extensive draining and cleaning. If the tooth is not fractured, then this procedure, coupled with a course of antibiotics, can result in a full recovery.

If a fracture is discovered in one of your roots, then you are likely to experience recurring problems with that tooth, and in such cases, the best approach may be to simply pull the tooth. Root fractures are sometimes not visible on x-ray; they are usually discovered after your gums have been cut into for draining and cleaning.

An important point on root fractures: while they are readily discovered if they are on the front surface of the roots of your teeth, if they are on the back surface of one of your roots, it's quite possible that the fracture will not be detected by the endodontist. This is why it is important that your endodontist carefully observes and palpates your gums in front of and behind your teeth before he or she elects to cut, drain, and clean. If your gums are swollen and tender in front of and behind the affected tooth, there is a fairly good chance that one of the roots of the tooth has a fracture, in which case it may be best to pull the tooth rather than pay several hundred dollars cutting, draining, cleaning, and hoping. Please remember: all of this applies to a tooth that has already gone through a root canal procedure.

Ways to Keep Your Teeth and Gums Healthy

Here are some simple steps that you can take on a daily basis to keep your teeth and gums healthy, and reduce your chances of developing an infection that may necessitate a root canal procedure:

1. Give your mouth a good rinse after each meal. If possible, brush your teeth as well, paying careful attention to the back corners of your back molars. Keeping your mouth free of bits of food and their juices is essential to preventing tooth decay.

2. Each evening before going to bed, give your mouth a good rinse and gargle with salt water. About 1/2 teaspoon of salt in 8 ounces of water is enough for most people. Salt water can act as a mild disinfectant, and is an effective cleansing solution for the oral cavity.

3. Be sure to floss at least once a day.

4. Eat plenty of green vegetables and chew them well. Consider including mineral-rich broths in your diet on a regular basis. Green vegetables and mineral-rich broths can help to build and maintain healthy teeth from the inside-out.

5. Be sure to ensure adequate vitamin D status; vitamin D is needed to maintain healthy teeth and bones.

For cleaning, I recommend a combination of Tooth Soap and any brand of natural tooth paste that agrees with you.

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