A root canal, also called endodontic treatment, is a procedure carried out inside of the tooth because of pulp inflammation or infection. There are different causes for this, such as deep tooth decay, faulty crown installation, cracking or chipping in teeth and trauma among others. If pulp inflammation is left too long, an abscess can result, and this is more painful and more difficult to treat.
During a root canal, the dentist removes the inflamed/infected pulp and then cleans and disinfects the tooth before filling it with gutta-percha, a rubber-like material. A crown may be placed to protect the tooth if the enamel was severely eroded. If not, a simple filling will do. If you dentist suggests that you need a root canal, the following are some questions to ask so that you can understand the treatment better.
1. Where does the pain come from?
Most often, pain will be the first sign that something's wrong in your tooth. However, there are many sources of pain, not all of which can be cured by endodontic treatment. For instance, sinus-related pain, a hypersensitive dentin or occlusal trauma from tooth grinding and clenching won't be helped by root canal.
There are several diagnostic procedures the dentist will perform to ascertain the origin of pain. Endodontic-related pain is usually signified by prolonged pain on exposure to hot or cold substances and little response to pulp tests and apical pathology (infection of tooth nerve/nerves beyond the tooth to the surrounding bone).
You can expect the dentist to carry out a cold test using hygienic endo-ice to observe tooth response. He/she will also examine the occlusal (chewing) surface for wear and palpate the tooth to find any tenseness or tenderness in the masticatory muscles. You should then be informed about the source of pain and whether a root canal will fix it.
2. Can the tooth be saved?
There are instances in which the tooth cannot be saved following root canal treatment. Root canals should only be performed on teeth that can be restored to full function. For instance, if the pain comes from a wisdom tooth which serves little function in chewing or the tooth is significantly fractured/decayed, removal will be cheaper and less painful.
A tooth worth treating is one with sufficient structure to hold a restoration. For example if you have a vertical fracture, it may be very difficult to save the tooth. This is especially true if the fracture extends up to the pulp. You should ask yourself whether you can afford the post-treatment restoration. Sometimes the procedures needed to restore a tooth may be more expensive and extensive than you can afford.