If there is inflammation and swelling, the DENTAL SURGEON/ ENDODONTIST may prescribe an antibiotic or/and anti-inflammatory medicine for some days before starting the root canal procedure. The purpose is to control the infection and to ease the swelling which can make the anesthetic less effective.
If the condition is painful, the patient will have to take an over the counter or prescription analgesic to relieve the tooth pain until the procedure. The next step in the procedure is to take an X-ray to check the shape of the root canals and determine if there are any signs of infection in the surrounding bone
At the center of a tooth is a hollow area that houses soft tissue, known as pulp. This hollow area contains a relatively wide space towards the chewing surface of the tooth called the pulp chamber. This chamber is connected to the tip of the root of the tooth via thin hollow pipe-like canals—hence, the term "root canal". Human teeth normally have one to four canals, with teeth toward the back of the mouth having the most. These canals run through the center of the roots like pencil lead runs through the length of a pencil. The tooth receives nutrition through the blood vessels and nerves traversing these canals.
For patients, root canal therapy is one of the most feared procedures in all of dentistry; however, dental professionals assert that modern root canal treatment is relatively painless because the pain can be controlled. Lidocaine is a commonly used local anaesthetic. Pain control medication may be used either before or after treatment. However, in some cases it may be very difficult to achieve pain control before performing a root canal. For example, if a patient has an abscessed tooth, with a swollen area or "fluid-filled gum blister" next to the tooth, the pus in the abscess may contain acids that inactivate any anaesthetic injected around the tooth. In this case, it is best for the DOCTOR to drain the abscess by cutting it to let the pus drain out. Releasing the pus releases pressure built up around the tooth; this pressure causes much pain. The DENTAL SURGEON then prescribes a week of antibiotics such as penicillin, which will reduce the infection and pus, making it easier to anaesthetise the tooth when the patient returns one week later. The DENTAL SURGEON could also open up the tooth and let the pus drain through the tooth, and could leave the tooth open for a few days to help relieve pressure.
Steps of the Root Canal Procedure
Root canal procedure'
1. Preparation for a root canal treatment
2. Anesthesia
3. Isolating the tooth
4. Gaining access to the dental pulp
5. Removal of PULP TISSUE
6. Measuring
7. Cleaning the root canals
8. Filling the root canals
Lower right first molar (center) after root canal therapy; the pulp chamber and root canals have been cleaned of debris, decontaminated and filled with gutta percha.
9.Restoring the Tooth After Root Canal
PULPECTOMY "pulpectomy" Sometimes the DENTAL SURGEON performs preliminary treatment of the tooth by removing all of the infected pulp of the tooth and applying a dressing and temporary filling to the tooth.
PULPOTOMY "pulpotomy" The DENTAL SURGEON may also remove just the coronal portion of the dental pulp, which contains 90% of the nerve tissue, and leave intact the pulp in the canals. This procedure, called a "pulpotomy", tends to essentially eliminate all the pain .
The pulpectomy and pulpotomy procedures eliminate almost all pain until the follow-up visit for finishing the root canal. But if the pain returns, it means any of three things: the patient is biting into the tooth, there is still a significant amount of sensitive nerve material left in the tooth, or there is still more pus building up inside and around the infected tooth; all of these cause pain
Systemic issues
An infected tooth may endanger other parts of the body. People with special vulnerabilities, such as prosthetic joint replacement or mitral valve prolapse, may need to take antibiotics to protect from infection spreading during dental procedures. Both endodontic therapy and tooth extraction can lead to subsequent jaw bone infection. The American Dental Association (ADA) asserts that any risks can be adequately controlled. There is no scientific evidence that root canal therapy has any adverse affects on the overall health of the individual. Effective root canal therapy performed by adequately trained clinicians results in very high success rates with no systemic relationship to the patient's overall health.
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