If the pulp inside the tooth becomes infected or decayed, root canal therapy is used to treat the problem. The pulp is the soft tissue in the center portion of the tooth which consists of blood vessels and nerves. The pulp extends from the middle of the tooth down to the root canals. It gets infected when the bacteria attack the pulp. This is usually the result of a deep cavity which has let bacteria enter the tooth through a weakness in the enamel and dentin. A fracture or a blow to the tooth can damage it enough to let bacteria in as well. An infected tooth frequently causes sensitivity to hot or cold, pain when biting, spontaneous pain, swelling, and possibly a bad taste in the mouth. However, in some cases, it might not cause any symptoms. If left untreated, the infection can travel to the tips of the roots and into the jawbone. This can cause a painful abscess to form.
Root canal procedures start with numbing the tooth and surrounding area with a local anesthetic. If restorations such as crowns or fillings have been used, they are removed prior to treatment. The pulp is then accessed through the top of the tooth. Then, the decayed or damaged pulp is cleaned out with special tools. The canal is then sealed up and filled with a rubber-like substance to prevent future infection. An impression is made of the tooth and sent to a lab where a crown is made. A temporary crown is used to protect the tooth while the permanent crown is being fabricated. During the final visit, the permanent crown is attached to the tooth with a strong dental adhesive.
There are times that the tooth doesn’t completely heal after root canal therapy. There are many reasons why the tooth may have not entirely healed. It could have very narrow canals or branched or curved canals which can make them very hard to clean. One or more root canals could have been missed the first time as well. Or the tooth decay or fracture could expose the filling material to a new infection.
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