If you’ve been told you need a root canal or are scheduled for one soon, you’re in the right place. This is your guide to everything you should know before getting a root canal as well as what to expect during the procedure. By the end of this post, you’ll know:

– Exactly what questions to ask your dentist

– What to expect during the procedure

– What to expect in terms of pain

– Everything that should be discussed with your dentist before you agree to a root canal


Before You Go – What Is Root Canal Therapy?

Root canal treatment or therapy is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

The doctor removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Having a root canal done makes the tooth brittle and prone to fracture. The inside of the tooth has been scraped out, leaving the outer shell of the tooth dry, brittle, and prone to breakage. That’s why a root canal procedure requires a second procedure shortly afterwards: A crown.

A root canaled tooth needs protection because you’ve carved out the tissue inside it. Enter: the crown, which is a rigid covering that is stronger than enamel that preserves the structural integrity of the tooth and prevents it from breaking.  After restoration, the tooth continues to function like any other tooth.


What to Ask Before Agreeing to Treatment

– Is a root canal absolutely necessary?

– Is it possible the tooth will recover and not need the root canal?

– Why did the pulp die?

– What are my options?

– What if I don’t do the root canal?

– Should I skip the root canal and go right to the implant?

– Will my infection spread to other teeth or to my bone?

– How predictable is the treatment?

– And perhaps most important: Should I have this done by specialist or can you do as good of a job as a specialist can?


How Does My Dentist Know I Need a Root Canal?

Diagnosing whether you need a root canal does have a scientific basis but it can be a bit of an art form to find out how diseased the pulp of the tooth is. This is why you really need someone who is experienced. A practitioner who rushes this process could choose the wrong treatment of the tooth.

To diagnose whether or not you need a root canal, your dentist will need to determine if the pulp inside the tooth is dead or dying or if it’s possible that the pulp could recover.

Data Points Your Dentist Uses to Decide If You Need a Root Canal

Lingering pain: Your dentist will ask you about how your tooth responds to hot and cold. When you drink cold water, does your tooth get sensitive? How long does the pain last? This is a way of figuring out if you have “lingering” or “non-lingering” pain. “Lingering” means the pain sticks around. Non-lingering pain goes away. If the pain goes away, the pulp inside your tooth might be alive enough to recover from the hot and cold, indicating that the tissue could potentially recover. If you drink cold water and you’re sensitive for the next hour or more, that’s “lingering” pulpitis (infection of the pulp) which means your tooth isn’t recovering and the nerve is likely dead.

Positional pain: Does your pain get worse when you lie down or stand up suddenly or run in place? This can be the sign of an abscess and, likely, a dead tooth.

Spontaneous pain: If pain is brought on by a stimulus like a hot or cold drink, it’s possible that the pulpitis is reversible, but if you’re sitting there doing nothing and get a wave of pain, that’s probably a dead tooth.

Fistula on the gum: A fistula is a little white, yellow, or red pimple-looking thing that shows up your gum. What this tells your dentist is that there is an infection because there is pus, blood, and infectious materials trying to get out and the body is trying to vent it. The problem is that it doesn’t always go alongside the tooth that is infected — a fistula can mislead the dentist as to which tooth it is.

Abscess: An abscess is typically seen on an x-ray. It is essentially a hole in the jawbone that shows up as a dark spot on the x-ray because the bone doesn’t want to grow in that area. Bone won’t grow in the area around an infection and an infection typically comes from the tip of the root, which is where everything is spilling out from the dead tissue inside of the tooth.

Referred pain: If the pain is not only in your tooth but also referring to another part of the body, like your jaw, ear, or surrounding teeth, this could mean you have an abscess.


How Long Can I Wait Before I Get My Root Canal Done?

Once you find out you need a root canal, time is of the essence, because the infection will continually get worse. You’ll get more pressure and more swelling if you wait. You might get a bad taste in your mouth or might start to go numb. The infection could spread to more vulnerable tissues, like your heart. This is why people used to die of tooth infections hundreds of years ago.

Your dentist will prescribe you antibiotics for the infection. Once you start taking antibiotics, you’ve bought yourself four or five weeks. If you get on the antibiotics before the root canal is done, you’ll have less pain during the procedure because this will make it easier to get you numb.


Should I Get a Root Canal Or an Implant?

A big question now in dentistry is: do you go right to the implant because it’s more predictable than a root canal?

To make this decision, you need to ask your dentist about the predictability of success of a root canal. This is something that you and your dentist have to decide together, after you consider all the options for your unique case.

People who are proponents of implants say with an implant, you’ve removed the source of the infection completely — there are no sealing or removal issues and you’re placing something sterile into the jawbone.

This is why, if you decide to get a root canal, it’s essential your dentist is very skilled, because the procedure is so technique-sensitive, and that your dentist has assessed there’s a good chance of success of the root canal.


A Word on DUI (Deciding Under the Influence)

A lot of the time, people are in a lot of pain when they have to make the decision about whether to get a root canal. When you’re in pain and you’re desperate (making decisions under the influence of pain) you’ll do anything to get rid of that pain.

Here’s where it’s important to still be wary. Make sure your dentist has your best interest at heart and is helping you make the right decision.


What to Expect After You Go Home

You shouldn’t bite or chew on the treated tooth until you have had it restored with a crown by your dentist. A tooth treated with root canal therapy is prone to fracture, so you’ll need to get the crown as soon as possible. Until you’re able to come in to get the crown done, practice good oral hygiene and brush and floss normally. Avoid biting on the tooth or chewing food on it.


Pain and Soreness After a Root Canal

You might expect some pain, but don’t be surprised if there is no pain. No pain can happen and is not unusual.

If you do have pain, it usually peaks 17 to 24 hours after the procedure and it’s best to keep your head elevated while sleeping for the first one or two nights. If need be, take whatever pain medication that your dentist recommends.

Feeling soreness after a root canal is unusual, but it happens often enough to discuss. Your tooth can be sore and tender, but not necessarily painful, but sore and tender to percussion and chewing for up to six months, even after you’ve gotten the crown. The concept or theory here is that the infection was so great inside of the tooth that it affected the surrounding areas in the jaw bone and that the body has to fix those areas and that takes time.

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