A painful, infected root canal is most often the result of one of several unfortunate conditions: trauma, a fracture, or a deep cavity that penetrates through the tooth’s enamel and dentin layers into the pulp layer (where we find arteries, veins, and nerves). An infected root canal is not going to go away without treatment by the dentist. Untreated infection can progress into the bone, causing an abscess that can be extremely painful. These infections are extremely serious (even life-threatening) and must be treated as quickly as possible. The risk to other parts of your body is very real!
The pain can be extreme and is caused by the infection and damage inside the tooth and the bone surrounding the tooth. The treatment is the relief of the pain, and is successful in 95% of cases. It is very important to trust the treatment of root canal problems to a qualified dentist. Dr. Berbari is experienced, trained, qualified, and certified to treat an infected root canal. The treatment proceeds in stages, and requires several visits:
In about 5% of root canal infections, complications interfere with the success of the treatment. In the event of complications, further treatment may be required. Some of the factors that can affect the success of the treatment are related to the bone around the teeth, to your overall state of health, to the shape and condition of the root and nerve canal(s), or to fracture lines (often not visible).
Where a canal has calcified or is sharply bent, or in the event of a long-standing or substantial infection in the bone around the tooth, or if a metal file separates while we are working inside the canal, the tooth can remain sensitive. Resolving the cause may require surgical intervention.
Possible alternatives to the conventional root canal treatment include doing nothing, and extracting the tooth (and possibly filling the space with an implant, bridge or partial denture).
Most often, when we treat a root canal, the nerve is dead, but there are conditions where we will treat a tooth with the nerve intact. In the case where a fracture or a large filling causes a tooth to need major reconstruction, the root canal treatment allows the dentist to insert a post into the root to make the area strong enough to be used to anchor a crown.
Fracture is a common cause of failure of a root canal treatment. In some cases, and unfortunately, a fracture can extend from crown to root, and be either invisible or difficult to detect. Several events can cause a fracture of this type: biting on a hard object; grinding teeth; clenching teeth; normal wear; and a traumatic injury. A fracture of this type, before the root canal or after, may require extraction of the tooth.
Extraction can cause surrounding teeth to shift, unless the extracted tooth is replaced. Ask Dr. Berbari about options for replacing extracted teeth.
Teeth that have been treated for root canal infection become more brittle, leaving them more susceptible to breaking, cracking, and other injury. Talk to Dr. Berbari about a crown to prevent damage, especially if the tooth is a bicuspid or molar.
After a root canal, the nerve is gone, and so if any decay occurs in the future, you will feel no pain. Pay attention to these teeth, as with other teeth. Keep up regular dental check-ups, pay attention to diet and daily dental hygiene.
Following a root canal treatment, the teeth can remain sensitive for several weeks.