If you have pain while chewing, swollen gums, sensitivity to hot or cold, a chipped or broken tooth, or a cavity that you’ve ignored, the answer to “when is a root canal needed?” is most likely “Now!”
Of course, a dentist or endodontist (a root canal specialist) will be the one to decide if it’s really necessary. The simplest answer to the question “when is a root canal needed?” is when the root of a tooth is infected. But anyone who asks this question almost certainly wants more details.
- How did it get infected?
- Can I tell when it’s infected?
- If I ignore it, will it go away?
- Aren’t root canals painful?
- How much is this going to cost?
- What exactly is a root canal, anyway?
Learning the answers to these questions will help you understand the importance of root canal therapy and know if and when a root canal is necessary.
What is in the Root Canal?
All teeth have roots. It is the part of a tooth that holds it in place in the gum, much like a root holds a plant in the ground. The root canal is at the center of the root known as the pulp chamber. Blood vessels and nerves run through the canal, bringing nutrients up into the tooth. When people talk about “getting a root canal,” they’re really talking about a root canal procedure.
When the pulp inside of the root gets infected (also known as pulpitis), a root canal is necessary to save the tooth.
How Do Teeth Get Infected?
Infections happen when bacteria attack living tissue. The vessels and nerves that make up the living tissue inside teeth are normally protected by the hard layers of the teeth themselves. The layer that surrounds the living tissue is called dentin. Encasing that is a harder layer: the tooth enamel.
Infections can make their way through the enamel and then through the dentin in a couple of ways. First, a cracked or broken tooth can give bacteria a way to slip in.
The most common way is through tooth decay. Tooth decay is caused by plaque—a buildup of bacteria and acids on the teeth. No matter how healthy a person’s diet, plaque will form when the mouth’s bacteria mixes with their saliva. This, plus the acids naturally found in almost everything we eat and drink, combine to create plaque. When plaque isn’t cleaned off the teeth with brushing and flossing, it starts to eat away at the enamel.
These spots where the enamel is worn away are cavities. Regular dental visits can detect cavities when they are small so they can be treated before they reach the dentin beneath the enamel.
When Cavities Aren’t Filled
When a cavity is left untreated, it will spread and get deeper. Eventually, all of the enamel in that spot will be eaten away down to the dentin. Dentin is softer than enamel, so the bacteria will travel faster, working its way through to the pulp chamber. Once it gets through these protective layers, it will attack the nerves and blood vessels living inside the pulp tissue.
The infection will swell the tissue, causing pressure and pain. It may be hard to chew and the gums might become inflamed and swollen. Pus can collect and form an abscess. At this point, the dentist can offer two options. The root canal procedure or extracting the tooth.
The option of leaving the infected tooth alone is not wise, and could even be dangerous to the patient’s health. Not only will the pain be extreme, but the infection can spread to other teeth, and eventually into the jaw, sinuses and other parts of the body.
When Cost is a Factor
Cost is understandably a factor in many dental care decisions. But patients should be aware that in most cases the longer dental problems are ignored, the more expensive the solutions become.
Avoiding a trip to the dentist to have a cavity filled may seem like a way to save money. But having a root canal procedure will cost more than filling. Having dental decay treated sooner rather than later can help a patient avoid both physical and financial pain.
If cost is stopping you from seeing the dentist when a root canal is needed, ask them about a payment plan. Many dentists offer payment options that will work with most budgets. If you need to find a dentist or endodontist, try our online search tool.
The Root Canal Procedure
One of the biggest reasons people shy away from the root canal procedure because of its reputation for being extremely painful. This is not really the case (read Does a Root Canal Hurt as Much as They Say?). Root canal treatments are usually no more painful than other dental procedures. And many patients feel the pain endured while their tooth is infected is worse. Not only will the procedure give the patient relief from the pain, but it is also the only way to save the tooth.
The basic steps of a root canal procedure are as follows:
- The dentist or endodontist administers a local anesthetic to numb the tooth and surrounding area.
- A hole is drilled into the tooth down to the pulp chamber.
- The infected tissue is cleaned out of the pulp chamber and an antibiotic is applied.
- The hole is filled with a rubbery compound.
- A temporary crown is fitted over the tooth, capping it off.
- In a lab, technicians will fashion a permanent crown that will look and feel like the natural tooth.
- The patient will return to the dentist to have the temporary crown removed and the permanent affixed to the tooth.
Recovery from a root canal procedure includes a day or two of pain and discomfort. This, however, is manageable with over-the-counter pain relief products. The dentist may request a follow-up appointment to make sure the crown fits and the tooth is healing properly.
Root Canal Treatment—The Best Way to Save a Tooth
Root canal procedures are successful 95% of the time. On rare occasions, the tooth may become reinfected. In these cases, the patient may have the procedure repeated.
If you’re wondering when a root canal is needed, ask yourself these questions:
- Am I in pain?
- Is my dentist telling me my tooth is infected?
- Do I want to save my tooth?
When the answers to these questions are “yes,” it is time to schedule a root canal procedure. You’ll be glad you did.