A root canal is a dental procedure that treats infected or severely damaged tooth pulp - the soft tissue inside the tooth containing nerves and blood vessels. During the procedure, the dentist removes the infected pulp, cleans and disinfects the root canals, then fills and seals the space. The tooth is typically restored with a crown afterward.

Root canal treatment allows you to keep your natural tooth instead of having it extracted, preserving your bite and jaw alignment while eliminating pain and infection.

You may need a root canal if you experience:

• Severe toothache when chewing or applying pressure
• Prolonged sensitivity to hot or cold temperatures
• Discoloration of the tooth
• Swelling and tenderness in nearby gums
• A recurring pimple on the gums

Other indicators include deep decay, repeated dental procedures on the tooth, or large fillings that have compromised the tooth structure. Sometimes there are no symptoms, which is why regular dental checkups are important. X-rays can reveal infection or damage not visible to the naked eye.

Modern root canal procedures are not painful thanks to effective local anesthesia. Most patients experience little to no discomfort during the procedure, feeling only pressure and movement. The infected tooth causing severe pain before treatment will feel relief once the procedure begins.

After treatment, some mild discomfort or sensitivity is normal for a few days and can be managed with over-the-counter pain relievers. The pain from the original infection is typically much worse than any post-treatment discomfort. Most patients are pleasantly surprised by how comfortable the procedure is.

A root canal procedure typically involves several steps:

• Local anesthesia is administered to numb the area around the tooth
• Access hole is drilled through the crown of the tooth to reach the pulp chamber
• Infected pulp removal from the pulp chamber and root canals using specialized instruments
• Cleaning and shaping the root canals, then disinfecting thoroughly
• Filling the canals with a biocompatible material called gutta-percha and sealing with adhesive cement
• Temporary or permanent filling is placed in the access hole
• Crown placement usually follows to restore the tooth's full function and appearance

The procedure typically takes 1-3 appointments depending on complexity.

A root canal procedure typically takes 60-90 minutes for most teeth, though it can vary based on the tooth's location and complexity:

• Front teeth: Usually take less time (60 minutes) as they have fewer roots
• Molars: May take longer (90-120 minutes) due to multiple roots and canals

Simple cases may be completed in one appointment, while complex infections or curved roots might require 2-3 visits. Emergency root canals to relieve severe pain can often be started immediately, with the tooth opened and infected material removed to provide relief, followed by completion at a subsequent appointment.

Root canal costs vary based on several factors:

• The tooth's location (front teeth typically cost less than molars)
• Complexity of the case
• Geographic location
• Whether an endodontist or general dentist performs the procedure

The cost usually includes the root canal treatment itself, but a crown is typically needed afterward, which is an additional expense. Most dental insurance plans cover 50-80% of root canal treatment costs. While the initial investment may seem significant, root canals are typically less expensive than tooth extraction followed by replacement with a bridge or implant.

After a root canal:

• Expect some mild discomfort or sensitivity for a few days, which is normal as surrounding tissues heal
• The anesthesia will wear off in 2-4 hours, after which you may feel some tenderness
• Over-the-counter pain relievers like ibuprofen are usually sufficient for pain management
• Avoid chewing on the treated tooth until the permanent restoration is placed
• You may notice the temporary filling feels different when biting

Symptoms should gradually improve each day. Most patients can return to normal activities the next day. Contact Dr. Preston if you experience severe pain, swelling, or if the temporary filling falls out.

Root canals have a very high success rate of 85-97%, depending on various factors. Success rates are higher for teeth without extensive infection or complicated anatomy. When successful, root canal-treated teeth can last a lifetime with proper care.

Factors that improve success include:

• Early treatment before severe infection develops
• Proper restoration with a crown
• Good oral hygiene
• Regular dental checkups

Even if initial treatment doesn't succeed completely, retreatment can often save the tooth. Modern techniques, better anesthesia, and advanced instruments have significantly improved success rates compared to older methods.

Most teeth need a crown after root canal treatment, especially back teeth (molars and premolars) that endure heavy chewing forces. Root canal treatment removes the tooth's blood supply, making it more brittle and prone to fracture. A crown protects the tooth and restores its full strength and function.

Front teeth may sometimes be restored with just a filling if there's sufficient healthy tooth structure remaining, but crowns provide better long-term protection. Dr. Preston will evaluate your specific case and recommend the best restoration. Delaying crown placement can lead to tooth fracture, which might require extraction.

You can eat after a root canal, but wait until the anesthesia completely wears off to avoid accidentally biting your tongue or cheek. For the first few days:

• Stick to soft foods and avoid chewing on the treated tooth
• Good options include: yogurt, soup, pasta, mashed potatoes, and smoothies
• Avoid: very hot or cold foods if you experience sensitivity
• Stay away from: hard, crunchy, or sticky foods that could damage the temporary filling

You can gradually return to your normal diet as healing progresses, typically within a few days. Once the permanent crown is placed, you can eat normally.

The main alternative to root canal treatment is tooth extraction, but this creates additional challenges. After extraction, the missing tooth should be replaced to prevent problems with chewing, speech, and tooth shifting.

Replacement options include:

• Dental implants
• Bridges
• Partial dentures

All of these are typically more expensive than root canal treatment. In some cases, pulp capping might work for minor pulp exposure, but this is only viable when caught very early. For most infected or severely damaged teeth, root canal treatment offers the best chance to save the natural tooth.

While root canals have high success rates, they can occasionally fail due to several factors:

• Incomplete removal of infected tissue
• Undetected cracks in the tooth
• Complex root anatomy that's difficult to clean completely
• New decay that allows bacteria to re-enter the tooth
• Delayed placement of the final restoration

Signs of root canal failure include return of pain, swelling, sensitivity, or infection visible on X-rays. Failed root canals can often be retreated by an endodontist, or in some cases, apicoectomy (root tip surgery) may be needed. Most failures occur within the first few years after treatment.

Caring for your tooth after a root canal involves:

• Maintaining excellent oral hygiene with regular brushing and flossing
• Being gentle around the treated tooth initially
• Avoiding hard or sticky foods until the permanent restoration is placed
• Taking prescribed antibiotics if given
• Attending all follow-up appointments

Once healed, treat the tooth like your other natural teeth, but be mindful that it may be more prone to fracture without a crown. Regular dental checkups are important to monitor the treated tooth and surrounding tissues. Don't delay getting the recommended crown, as this protects the tooth from fracture and ensures long-term success.

Root canal treatment saves your natural tooth by removing infected pulp and sealing the tooth, while extraction removes the entire tooth.

Root canal advantages:

• Keeps your natural tooth structure
• Maintains proper chewing function
• Preserves jawbone density
• Usually less expensive overall when considering tooth replacement costs
• Maintains your natural smile and bite alignment

Extraction is faster initially but creates a gap that should be filled with an implant, bridge, or denture to prevent problems. Recovery time is similar for both procedures.

Yes, children can have root canal treatment, though the procedure differs for baby teeth versus permanent teeth:

For baby teeth: A pulpotomy (partial root canal) is often performed, removing infected pulp from the crown portion while leaving healthy pulp in the roots. This allows the baby tooth to remain until it naturally falls out.

For children's permanent teeth: Full root canal treatment is performed similar to adults.

Pediatric endodontists specialize in treating children and use techniques to make the experience comfortable. Saving infected baby teeth is important for proper speech development, chewing function, and maintaining space for permanent teeth.

Prevent the need for root canal treatment by:

• Maintaining excellent oral hygiene: brush twice daily with fluoride toothpaste
• Floss daily to remove plaque between teeth
• Use antimicrobial mouthwash if recommended
• Attend regular dental checkups and cleanings to catch problems early
• Avoid chewing hard objects like ice, pencils, or hard candies that can crack teeth
• Wear a mouth