Dental Questions: Why do I need a root canal if my tooth doesn't hurt?

Has a dentist ever looked at an x-ray of your teeth and recommended a root canal? You probably know that root canals are performed to remove aggravated (and painful) tooth nerves. Why would a dentist want to do this procedure on a tooth that has never bothered you? The truth is that root canals are often used to protect teeth with "dead" nerves from future pain and infection. Take a look!

A root canal is a dental procedure where the nerve of the tooth is removed and the resulting empty nerve canal is filled with a sealing material. They are performed on teeth with some type of irreversible nerve damage. This typically stems from bacteria, trauma or deep/extensive dental work. Patients may complain of a painful tooth that throbs or has an exaggerated reaction to cold foods/drinks. These can be clues that the nerve has become so severely agitated that it will eventually wither out and die. Conversely, a patient can indicate that the gums around the tooth are swollen, the tooth is sensitive to biting or that there is a bump or pimple on the gums above a tooth. These types of findings suggest the nerve in the tooth has already died, and is now fueling a localized bacterial infection called an abscess. Either way, these types of teeth will eventually need root canals to solve their issues. 

Why might you need a root canal on a tooth that has never bothered you? A certain portion of the population will have the nerve in a tooth die in response to bacteria or trauma without pain or swelling. These teeth are usually discovered incidentally at a dental exam by visualizing an abscess on an x-ray. In most instances, this does not pose an emergency or cause for immediate concern. However, leaving the problem long term can lead to swelling, pain or the spread of infection.

Dental treatment recommendations can be difficult to understand, particularly when they involve root canals, crowns, implants or other complex procedures. At Thousand Oaks Family Dentistry, we are here to walk you through any difficult or confusing dental situations.  If you would like to know more about root canals, crowns or types of dental plain, please give our office a call!

Dental Anesthetics

For many patients, the dreaded "shot" is the worst part of any dental procedure. Although you may find needles objectionable, local anesthesia makes modern dentistry comfortable, convenient and safe. Read on to learn how this quick and easy step is crucial to your dental care!

For starters, we use local anesthetics to block the sensation of pain in areas of the mouth that will be come irritated during dental treatment. Dental enamel, root canal treated teeth and implant crowns do not have direct connections to live nerve fibers, and thus do not benefit from anesthesia. This is why placing sealants on children does not require a shot- only the enamel and sealant material are affected during the procedure.

While you may picture Novocain when you think of dental anesthetics, this product hasn't been used in mainstream practice for years. Modern formulations such as Lidocaine and Articaine are easier to control and much safer for the patient (lower toxicity). These medications block pain and touch sensation for two to four before wearing off back to normal. However, they cannot block the nerves that conduct vibration and pressure sensation. These fibers have a different lining that requires much more medication to anesthetize. 

At our office, we deliver anesthesia with the Wand system. Here, a single-use syringe and vial are computer controlled to deliver the medication under constant pressure. This gives the dentist greater power over the location and amount of anesthesia used, while increasing patient comfort. If you would like to know more about local anesthesia and how we use it in modern dentistry, please give our office a call!

Endodontists we work with

At Thousand Oaks Family Dentistry, we take our patient's individual needs very seriously. With this in mind, we have cultivated a network of highly skilled dental specialists to address any and every concern. For our patient who require root canals and other endodontic services, we are proud to work with Conejo-Simi Endodontics and Southern California Endodontic Group.

You may be referred to an endodontis' office to diagnose and treat certain types of tooth pain or resolve an infection. Specialists like Conejo-Simi Endo and So-Cal Endo have technology like microscopes and cone-beam CT scanners that can better visualize cracks, abscesses and root fractures on teeth. If the tooth in question is savable, an endodontist can then perform a root canal to remove infection or stop tooth pain. Their technical expertise shines in treating posterior teeth, where root anatomy can become complicated and difficult to visualize. Nevertheless, our specialists have years of experience and will always strive for the best treatments possible!

We typically refer to out to endodontists following an exam and X-rays. However, certain types of pain will clue us in to your need for a specialist even before looking in the mouth. Our office is positive that you will have a great experience at Conejo-Simi Endodontics or Southern California Endodontic Group. If you would like to know more about the specialists we refer to or why we use them, please give us a call!

Dental Questions: What is a root canal?

Before and after X-rays of a completed root canal (rightmost tooth). Notice how the roots have whiter centers once the procedure was finished. 

In today's article, we are going to shed some light on a common (and commonly misunderstood) dental procedure: the root canal. Many patients fear and dread these treatments when in actuality they are painless and routine. We hope you find this information helpful!

Root canals fall under the dental field of endodontics. These procedures may be carried out by a general dentist or at a specialist's office. Then end goal of any root canal treatment is to remove the nerve tissue from the inner tooth, desensitize it and eliminate any bacteria or infection. This process allows us to save and treat many teeth that would otherwise need to be extracted. 

The first step in root canal treatment is to get the tooth in question completely numb. These procedures can be time consuming, so complete anesthesia is absolutely crucial. Contrary to popular belief, modern root canal therapy is virtually painless, with the many patient leaving the office with much less pain than they were in before!

Once the patient is numb and comfortable, a small opening is made in the top of the tooth to access the innermost layer called the pulp chamber. Here, the nerve endings that cause symptoms such as pain and cold sensitivity are cleaned out from the tooth.  This step is continued down the roots of the teeth, where a series of small files are used to clean and shape the root system. Once the pulp chamber and roots are completely cleaned, the tooth is filled with a thick, rubbery material called gutta percha. This step is crucial as it creates a plug against bacteria and recurrent infection.

After the treatment is complete, the top of the tooth is filled and restored, typically with a tooth-colored material. In many instances, teeth that receive root canals will need crowns for optimal strength. This is something the treating dentist will discuss with you and plan ahead of time. 

As with many dental treatments, this article is a general guideline and doesn't cover all aspects of endodontic therapy. If you have been told you need a root canal or want to know more about this type of procedure, please give our office a call. We will be more than happy to ease your mind and point you in the right direction!