When the nerve of a tooth is compromised either by decay or trauma it may be necessary to remove the nerve(s) from the tooth in a root canal procedure. The compromised nerve may manifest as a “toothache” and in some cases is only determined by a periapical x-ray showing a radiolucency (dark area) in the bone at the tip of the root. Pain is not always present with an infected tooth.
The root canal procedure removes the dying or dead (necrotic) nerve tissue from the root(s) of the tooth, disinfects the root canal(s) and then seals them to prevent bacteria from traveling through the canal(s) and into the bone.
- Front teeth (from canine to canine) usually only have one canal.
- Premolars (also known as bicuspids) typically have one or two canals
- Molars most often have three or four canals.
After the tooth is treated with a root canal, it may be tender for a few days to a couple of weeks while the affected/infected area heals. When a patient presents with acute pain in a tooth requiring a root canal, it may be necessary to place the patient on an antibiotic in order to get the infection controlled prior to root canal treatment. Root canaling a tooth with an uncontrolled infection may make it difficult to anesthetize the tooth (get the tooth numb) due to the acidic environment created by the infection which neutralizes anesthetic.
After a root canal is completed, the tooth may be missing a lot of structure due to removal of extensive decay, the tooth may become brittle (since it is not being nourished by the blood-vessels that were in the canals) and the tooth usually becomes dark in color. It is therefore recommended that a crown be placed on a root canaled tooth in a timely manner to prevent fracture, to replace missing tooth structure and to conceal the dark shade of the tooth underneath.