If a root canal fails, does the tooth need to be extracted?

Not at all. The success rate of a root canal is about 85%, which means in most cases a root canal last for a lifetime. There are circumstances where a tooth with a root canal becomes infected again which might cause pain to the patient. In that situation the root canal can be retreated.

What is a retreatment? It’s a procedure of redoing the root canal by re-cleaning the inside of the roots, disinfecting and obturating each canal. Some teeth may require an apectomy instead, which is a microsurgery used to remove the infected tip of the root. Modern techniques of restatements and apectomy work well.

In rare cases where a tooth is fractured all the way to the root, extraction is the only thing that can be done. A dental implant, a bridge or a partial can later replace the tooth.

Links

• 10 myths and facts about root canals
• Si un traitement de canal échoue, est-ce que la dent doit être extraite?

Do root canals require long and frequent appointments?

Not anymore. Years before a root canal was done by hand with small instruments that the dentist had to carefully manipulate. Sometimes the technique was so long that the dental assistant fell asleep!

Nowadays, with mechanically rotary instruments, root canal treatment may take between one and two hours in one single appointment. The length of an appointment depends on the condition of the tooth and the number of canals it has. Nevertheless if there are complications, additional appointments might be needed.

In cases where we have severe infection, your dentist or endodontist might chose to place a drug inside your tooth to help disinfect the interior of the roots, and then finish the root canal treatment a few days later. But if there is no infection or no complications, the procedure can be completed in one single appointment.

Links

• 10 myths and facts about root canals
• Est-ce qu’un traitement de canal nécessite des rendez-vous longs et fréquents?

What is periodontal disease?

Periodontitis, or periodontal disease, is the inflammation and infection of the tissues that surround teeth. Those tissues are mainly the gums, the supporting bone, the periodontal ligament and the cementum, which together are called the periodontium.

If the inflammation has only affected the gums, it is called gingivitis and it can normally be treated with good oral hygiene. But when inflammation reaches deeper tissues like the bone, the disease is then called periodontitis. This condition is diagnosed by the detecting with a probe the presence of pockets around teeth (spaces between gums and teeth) and by the loss of bone level seen on dental x-rays.

Periodontitis is more difficult to treat than gingivitis. Improved oral hygiene at home is not enough. Curettage and root planning by the dentist or by the periodontist (gum specialist) is needed, and sometimes-even surgery depending on how aggressive the disease is. If periodontitis is not treated, teeth eventually become loose and fall out.

It’s important to note that gingivitis is the first stage of periodontal disease, and if not taken care of with proper oral care, it can quickly lead to periodontitis.

Links

• Periodontitis, Studio Dentaire
• Qu’est-ce que c’est la maladie parodontale?

 

Fact: saliva

Saliva has many functions, including the one that helps digestion, and has also a role in disinfection. Saliva is a liquid that moistens foods when ingested by the mouth, making them softer to swallow. Moreover saliva is a natural cleanser of the mouth that removes food debris and disinfects teeth and gums. It does not of course replace brushing and flossing.

Related articles

• Fact: saliva
• Fact: chewing force
• Fact: neonatal teeth
• Fact: dentition
• Fact: lost baby tooth

Links

• Beaglehole R, Benzian H, Crail J, Mackay J, The Oral Health Atlas, 2009
• Saliva, Studio Dentaire
• Fait: salive, Conseils dentaires

Does a tooth with a root canal need a crown?

Some people might say that a root canal is very costly, and to have a crown on top is even more expensive! But in order to make sure a tooth treated with a root canal to sustain chewing forces and to last a long time without fracturing, it is important put a crown on it.

A dental crown serves to make a tooth more solid and maintain its integrity after it has suffered destruction, either from tooth decay or from a trauma. A tooth that must get a root canal probably already had a very large cavity that had reached the pulp chamber where the nerve is located. After the dentist had properly cleaned the tooth from all decay and that the root canal treatment is completed, there usually doesn’t remain sufficient healthy tooth material to restore the tooth with a filling. It is then necessary to complete the treatment by a post and a crown to ensure that the tooth will not break eventually.

There are however certain situations where a tooth’s nerve is irritated after a trauma and not because of a destructive dental cavity. If the tooth that had the trauma is not broken or cracked, and if it did not already have a big filling, then some dentists believe that it’s possible to do a root canal without a crown. In this case, a filling (with or without a post) is enough to restore such a tooth.

Links

• 10 myths and facts about root canals
• Est-ce qu’une dent qui a un traitement de canal a besoin d’une couronne?

Fact: chewing force

Can you imagine 200 kg per square centimetre? That’s like the weight of three adults on a very small surface! That’s how strong the human jaw is, and this should also convince people to stay away from lions.

Not only the jaw is strong but also the enamel (outer layer of teeth) is the strongest substance in the human body, even strong than bone! I would still not recommend to chew anything with your teeth as some metallic objects can fracture the enamel.

Fact: neonatal teeth

A neonatal tooth is a tooth that is present in the baby’s mouth the day he or she is born. Not all neonatal teeth are actual baby teeth. Some are just pre-baby teeth that fall out before the actual deciduous dentition starts erupting.

Is it necessary to take powerful painkillers after a root canal?

Root canals are often associated with pain. Sometimes intense pain, but that is not caused by the root canal itself, but by the infection or inflammation of the pulp (inside) of the tooth before the procedure is done.

When someone goes to the dentist for a root canal, they are completely numb under local anaesthetics and no pain is felt during the procedure.

There could be however some pain felt after a root canal and it is usually caused by remaining inflammation around the roots that slowly heals. This pain only lasts for a temporary amount of time, from a few days, rarely up to a few weeks. This type of pain can be relieved with common painkillers like anti-inflammatory drugs such as ibuprofen (Advil, Motrin), or with acetaminophen (Tylenol).

In case of more severe pain that persists months after the root canal procedure has been done, it is recommended to consult your dentist or your endodontist to verify if there were any complications.

Links

• 10 myths and facts about root canals
• Est-il nécessaire de prendre des analgésiques puissants après un traitement de canal?

Fact: dentition

Does a root canal kill a tooth?

If you search the web, you will find many websites that describe the root canal as a procedure that kills a tooth. But when you understand the science behind it, it can influence your opinion.

The pulp chamber, or inside of a tooth, has nerves and blood vessels which were there initially to help the tooth develop, grow and erupt in the mouth of a child or a teenager. Later in life the nerves can cause pain, helping a person knowing that there is something wrong going on with the tooth.

A root canal is done when the pulp chamber is infected. The dentist removes what’s inside the pulp, cleans, disinfects and fills each canal. The tooth will no longer have nerves or blood vessels.

In my opinion, a tooth is not “killed” after undergoing a root canal. It is simply allowed to heal properly after being decayed or infected, and will continue allowing a person to use it while eating and chewing.

Links

• 10 myths and facts about root canals
• Est-ce qu’un traitement de canal tue une dent?

Fact: lost baby tooth

Is it normal for a tooth that had a root canal to remain sensitive?

The whole reason why a tooth undergoes a root canal procedure is to remove the nerve and not to have pain anymore. Mild pain can be felt on a tooth but only for a few weeks following the procedure. Persistent pain months after the treatment is not normal.

Sometimes a minor adjustment on the filling or the crown is needed to eliminate the pain. Among the reasons why there is persistent pain are hidden canals that were not cleaned during the procedure, or the root of the tooth itself that is fractured.

In rare cases where pain is still present months after the procedure and all proper adjustments were done, your dentist might refer you to a specialist for root canals called endodontist. The specialist will find the proper diagnosis and have the tooth treated when possible. But in cases where the root itself is broken, no treatment can be done to save the tooth and unfortunately it would have to be extracted.

Links

• 10 myths and facts about root canals
• Est-il normal pour une dent qui a eu un traitement de canal de rester sensible?