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Root Canal

dentist showing patient x-ray

Have questions about root canals? Our dentists took some time to share information and answer common patient questions to help educate about root canals and the role they play in your oral health. View the table of contents below to learn more or find your question and get an answer from one of our dentists!

Dr. Mike DesRosiersDr. Sarah Hussain Endodontist

The following content was provided by Dr. Michael DesRosiers, LVIF Certified General Dentist, and Dr. Sarah Hussain, D.M.D. and M.S., and has been medically reviewed for accuracy. Some relevant links have been added to audio transcripts to provide resources for additional information.

What is a root canal?

Answer provided by Dr. Michael DesRosiers. Transcript included below.

Dr. Michael DesRosiers:
So a root canal, it typically arises, the need for a root canal, when you have an infection within your tooth. So there are several different ways that the nerve of the tooth can become compromised. You can have a cavity that’s deep enough to involve the pulp of the tooth, where a bacterial infection starts in the nerve space. You can have a crack in your tooth that will expose the nerve space and it can get infected in that way. Typically, these things are pretty painful, and so, you know when one is coming, but not always. So your tooth will start to ache. It will start to be sensitive when you chew on certain things. You might start to have sensitivity to different temperatures, hot and cold, things like that. So you will be going in and typically asking your dentist to take a look at a specific tooth.

The root canal, what it does is actually remove the infected nerve and pulpal tissue from the tooth. The net effect is as if you were to take the tooth out without removing the tooth. So you remove the only part of the tooth that really can get infected, which is that nerve tissue and pulpal tissue, and then you replace it with something that’s inert. So it’s called gutta percha, and it seals from the very tip of the root up to inside the crown of the tooth, and it prevents the tooth from getting reinfected, achieving a good seal and gets rid of those painful symptoms.

Can I get a root canal on a crowned tooth?

Answer provided by Dr. Michael DesRosiers. Transcript included below.

 
Dr. Michael DesRosiers:
Absolutely. It’s not unusual to have root canals on teeth that have already had crowns. In some cases, the dentist will elect to remove the crown and treat the root canal and then replace it, whether it’s the same crown able to be re-cemented or a new crown needs to be made. In most cases, for teeth that have crowns need root canals, you actually access through the crown, do the root canal procedure, and then you seal it up with a bonded restoration where you made the opening.

How long does a root canal take?

Answer provided by Dr. Sarah Hussain. Transcript included below.

Dr. Sarah Hussain:

Well root canal treatment time varies, depends on the tooth type. If we are treating a front tooth like a central incisor, lateral incisor, it would take an hour. If we are treating a premolar, I would say it takes an hour and 15 minutes, hour and a half. And if we are treating a molar tooth, that’s going to be between an hour and a half to two hours. There are certain cases where we have to split the treatment over two appointments, because there is infection, especially with a chronic infection when there is a bubble or a bump on the gum. Then we have to place some medicine inside the tooth for a few weeks until this heals up. And then the patient come back for treatment completion. So in that situation, we will have to do one hour appointment, then another one hour treatment.

But basically it is like I said, for anterior teeth, it’s different than the back teeth. It’s between one hour to max is two hours. Difficult cases where we have, for example, a blocked canal or like a separated instrument from previous treatment, then we will have to explain that to the patient prior to the treatment that we will need more time for this case.

How do I know if I need a root canal?

Answer provided by Dr. Sarah Hussain. Transcript included below.

Dr. Sarah Hussain:

Okay. So how do we know we need root canal treatment? Number one, if there is a severe sensitivity to cold or heat. Severe sensitivity doesn’t mean that it hurts when you drink the cold and then it goes away when the cold is gone. It means when you drink something cold, it hurts and then lingers afterwards. And then you keep holding your face saying, “Oh, this hurts,” and lingers for about 15 seconds to 30 seconds. This is the one time that you need a root canal treatment. Heat sensitivity is the same. It also indicates the need for the root canal treatment.

Number two, when there’s a tooth ache that wakes you up during the night that … you would take some pain medicine in order to be able to go back to sleep. This is one other indication that you need root canal treatment. Chewing sensitivity. When you chew on your tooth and it hurts, this is the second indication for the need of a root canal treatment, chewing sensitivity. Also sometimes there’s a problem in the tooth and we don’t have any symptoms. But sometimes if you look in the mirror and you see there’s a bump or a small bubble on your gum next to the tooth, this is something that you will need to seek treatment for. That means you may need a root canal treatment.

Does insurance usually cover a root canal?

Answer provided by Dr. Sarah Hussain. Transcript included below.

Dr. Sarah Hussain:

I would say this is a very broad question because there are many dental insurances and the benefits varies. But most dental insurances, they would cover root canal treatment at a certain percentage. It varies. Most of them, they would cover a good amount of root canal treatment. It’s between 50% to 100%. So I would say yes, most dental insurances they do cover most of the fees of the root canal treatment.

What can I expect after a root canal?

Answer provided by Dr. Sarah Hussain. Transcript included below.

Dr. Sarah Hussain:

So for the first few days after the treatment, the tooth might feel sensitive and sore, especially if there was some pain before the treatment starts. So when we go to the endodontist and there’s pain, there was infection, we would expect that this tooth is going to be sore for a few days after the root canal treatment. We would recommend over the counter pain medication like Tylenol. In certain cases, we would prescribe Tylenol or Ibuprofen, 800 milligrams.

In some few cases when there is a large infection or if we are doing a re-do for the root canal treatment, which is [inaudible] treatment. But a small percentage of the patients who would have a flareup as severe symptom with moderate severe pain and swelling in the area. If that happens, we would prescribe antibiotics, and that will take care of the situation. So this is not something to worry about. All of the symptoms or the sensitivity that’s related to the post-op, it’s manageable with either over the counter medication or prescription medicine that we would prescribe. It’s not going to last for too long max. It’s going to last for few days to one week and that’s. In very, very, very, very rare cases, root canal post-op symptoms would last for a week or two.

Does a root canal hurt?

Answer provided by Dr. Sarah Hussain. Transcript included below.

Dr. Sarah Hussain:

Is the treatment going to be painful? Would I feel it? This is the main question I would get every single day. I don’t think we have answered this question. Root canal treatment, supposed to be pain-free. So I rarely have a patient that would feel something or any pain while I do treatment. We give local anesthesia, which is just for that tooth. The patient will be fully numb. If for any reason the patient, they feel something, we can always add more anesthetic. So the treatment itself should be pain-free, except for the needles of course. They would feel the needle, but after that, everything else should be pain-free.

Do you get put to sleep for a root canal?

Answer provided by Dr. Sarah Hussain. Transcript included below.

Dr. Sarah Hussain:

Would you put me to sleep during the treatment? Unfortunately, I do not. I don’t know any endodontist in North Carolina who does put patients to sleep for root canal treatment. It’s different than the surgery for wisdom teeth extraction. They would put patients to sleep. But with root canal treatment, we will need the patient to be awake because we have to have their mouth wide open with the biter block, move that up or down, and putting the other things on their face, like the nitrous oxide. It’s not going to be convenient for the endodontist. And we don’t prefer to put them fully to sleep because we want them to be awake to cooperate with us through the treatment. So this is something that we do not do. And they don’t need it because it will be pain-free.