Tooth pain is a common cause of dental visits, and one of the main culprits behind that pain is infection. More specifically, the infection that happens when bacteria invade the pulp inside of your tooth. This can happen as a result of infected gums (gingivitis), cracked teeth, a deep cavity, or damage due to trauma. When it does, the solution is simple: you may need a root canal.
Root canal treatment is often the only way to save an infected tooth and avoid removing it, while at the same time stopping the pain of infection. And while a root canal was once notorious for being painful and messy, that reputation is now a thing of the past due to new, more effective technology, more comfortable anesthesia, and advances in the field of endodontistry (root canal specialization). Thanks to these factors, root canals are safer and more common than ever.
Periodontal Disease: Where Infection Starts
A common cause of infection in your mouth is periodontal disease, or the inflammation and infection of the gums and tissue surrounding your teeth. This issue is fairly common, experienced by nearly half of adults over 30. If left untreated, the infection can reach the tooth’s pulp, developing into pulpitis.
Pulpitis And Root Canals
If infection reaches your tooth’s pulp, it will cause inflammation. This is called “pulpitis”, and according to the CDC, around 1 in 4 adults have untreated cavities that can lead to it. Depending on a patient’s sensitivity, pain levels, and the results of an electric pulp test (EPT), the pulpitis will be diagnosed as either reversible or irreversible. Reversible pulpitis can be treated by drilling and filling, while irreversible pulpitis is most commonly treated by extraction, or — much more often — by root canal therapy.
Root Canals Are Popular
Many people aren’t a fan of root canals — in fact, 59% of adults would rather speak in public than undergo one! Still, root canals are one of the most common dental procedures in modern life, and are performed regularly by both dentists and endodontists (root canal specialists). How regularly? Well, over 15 million root canals are performed each year, meaning around 41,000 are performed every single day.
Root Canals Are Safe
Unfortunately, a few big myths surrounding root canals gained popularity over the past century, leading to some serious misinformation. Like, for example, that a root canal could cause heart disease or arthritis (a conclusion long since disproven).
The truth, of course, is that root canals are incredibly safe, and that the alternative — doing nothing or putting off the procedure — is much more unsafe. Leaving an infected tooth untreated can lead to tooth loss, infection reaching the jaw or facial bones, and bacteria in the bloodstream, also known as blood poisoning or septicemia. Considering the substantial amount of pain and health risks caused by inaction, undergoing a root canal is certainly the safer option long-term.
Root Canals Are Effective
When it comes to the effectiveness of root canal treatment, the facts are overwhelmingly favorable. For example, a study conducted in 2004 by a dental insurance database measured the results of over 1.4 million root canals and found that 8 years later, 97% of the treated teeth were still retained.
A similar study found that 90% of treated teeth were still retained over a similar time period, and that of the teeth experiencing root canal failure, another 3% were saved by a further endodontic procedure.
Generally, root canal failure occurs more often in teeth with a more complicated root structure or those requiring multiple canals, such as molars. A study conducted over 338,000 failed root canals found that around half of them occurred in molars.
Apicoectomy vs. Root Canals: What’s the Difference?
A common dental procedure that’s sometimes necessary after a root canal is an apicoectomy. Unlike a root canal, an apicoectomy focuses on removing any inflamed tissue and the very end of a tooth’s root, or the apex. Also sometimes called a “root-end resection”, this procedure is most often needed because of reinfection after a root canal. If you do need one, don’t worry: apicoectomies are remarkably effective.
Endodontic Care For You
What’s the difference between a dentist and an endodontist? It mostly comes down to training: endodontists undergo an extra 2-3 year period of advanced specialty education after dental school, during which they study diseases of dental pulp and how to treat them. So while all endodontists are dentists, only 3% of dentists are endodontists. Perhaps this is why most root canals (around 70%) are still performed by dentists.
Crowns After A Root Canal: What Do I Need to Know?
Not all root canals require crowns after completion. However, if the treated tooth is needed for chewing (teeth toward the back of the mouth like molars or premolars), a crown may need to be installed to protect the tooth’s enamel.
Dentists use a variety of materials for crowns, most commonly porcelain or metal. Both are exceptionally durable, outlasting composite restorations post-root canal. In fact, a recent study associated crowns of both materials with better tooth survival.