Treatment
Root Canal Treatment in Mesa, AZ
A tooth has started hurting, someone has said the words root canal, and you would rather it were anything else.
The treatment removes the cause of that pain and keeps the tooth in your mouth, and it is carried out under local anaesthetic in the same way a filling is.
The treatment
What is actually happening inside the tooth
Under the hard outer layers of every tooth there is a soft core, called the pulp, carrying the nerve and the blood supply that fed the tooth while it was forming. Decay, a crack, a deep filling or a knock can let bacteria reach it. Once they do, the pulp becomes inflamed and then infected. Because it sits sealed inside a rigid chamber with nowhere to swell, the pressure has nowhere to go. That is the throb that keeps people awake.
Root canal treatment removes that tissue, cleans and shapes the narrow canals it ran down inside the roots, and seals them so bacteria cannot get back in. Nothing leaves your mouth. The roots stay in the bone, and the part of the tooth you can see goes on biting and goes on showing when you smile.
Why the treatment is the thing that stops the pain
Root canals have a reputation, and it is better to say so than to talk around it. Ask most people what a root canal is and they will describe pain rather than a procedure.
That gets the order backwards. The pain people remember is very often the pain that took them to the dentist in the first place. The treatment is what removes its cause. It is carried out under local anaesthetic, the same as a filling, so you should not feel the work happening. If you do feel something, more anaesthetic can be given. Nobody expects you to sit through it.
None of which means it is nothing. The appointment is longer than a filling and your mouth is open for more of it. A tooth that has been sore for days is often tender to bite on for a few days more. Both are worth knowing in advance, and neither is what the reputation is really about.
If you are dreading it, say so when you book rather than once you are in the chair. It changes how the appointment is paced, and it is an ordinary thing to ask for.
Why a crown usually follows on a back tooth
A root-treated molar has had material removed from the middle of it and no longer has its own blood supply. It is drier and more brittle than it was, and the cusps that do the chewing are left standing with less holding them together, so it becomes more liable to split under a heavy bite. A crown caps it and spreads that load.
A tooth that splits vertically through the root generally cannot be saved, so the crown is protecting the treatment you have just had rather than being an extra sold on top of it. Front teeth take far less chewing force and can sometimes be restored with a filling alone.
Good to know
Treats the nerve inside the tooth, not the outside
Carried out under local anaesthetic
The tooth stays in your mouth
Usually finished with a crown
May take one appointment or two
What to expect
Four stages, spread over a few visits.
01
Working out what is wrong
An examination, an X-ray and a few simple tests on the nerve, to find which tooth is responsible and whether the pulp can still recover.
02
Anaesthetic, then cleaning
The anaesthetic is given time to work properly. A small opening is made, and the canals are cleaned with fine instruments and rinsed.
03
Sealing the canals
The cleaned canals are filled with a rubber-like material and sealed, which is what keeps bacteria from returning to the space.
04
Restoring the tooth
A filling closes the opening. On most back teeth a crown is planned to follow, to spread the load of chewing.
Candidacy
Is a root canal the right answer for your tooth?
It is usually worth doing when the tooth around the infected nerve is otherwise sound. It is a weaker case, and sometimes the wrong case, when there is too little left to rebuild.
Enough solid tooth above the gum to rebuild and hold a crown.
Healthy bone underneath, and a tooth you actually chew on.
Too little tooth left above the gum to hold a crown afterwards.
A crack in the root itself, which the treatment cannot repair.
Advanced gum disease that has already loosened the tooth.
A wisdom tooth you do not chew on, where taking it out is simpler.
“They are so friendly, professional and do not try to push treatments I don't need. I love them!”
Miki Lee · Google review
Common questions
Is a root canal as bad as people say?
The reputation is older than the dentistry. What people tend to remember is the pain that sent them to the dentist in the first place, because an infected nerve is one of the sharper things a body does, and the treatment is what takes that away. The work itself is done under local anaesthetic, in the same way a filling is. Expect the appointment to be longer than a filling, and expect the tooth to be tender to bite on for a few days afterwards.
How do I know whether I actually need one?
The usual signs are a lingering ache, sensitivity to hot or cold that stays after the drink has gone, pain on biting, or a swelling on the gum near the tooth. None of them is proof on its own. It takes an examination, an X-ray and a couple of simple tests on the nerve to tell whether the pulp can still recover. Part of that appointment is ruling a root canal out, because not every painful tooth needs one.
The pain stopped on its own. Can I leave it?
Pain going away is not always good news. When a nerve dies it stops sending signals, so the tooth can go quiet while the infection at the root carries on. That is why a tooth that hurt last month and does not hurt today is still worth looking at. Whether it needs treating now, or can reasonably be watched, is something an X-ray answers and guesswork does not.
Should I just have the tooth taken out instead?
That is a real option and we will discuss it properly rather than talk you out of it. Extraction ends the problem in one appointment. What it leaves you with is a gap, and the teeth either side tend to drift towards it over time, so the decision is usually between treating the tooth now or replacing it later. Sometimes the tooth is too broken down to be worth saving and extraction is plainly the better answer. If that is your situation, we will say so.
Do I really need a crown afterwards?
On a back tooth, usually yes. A molar that has had its pulp removed has also had material taken out of the middle of it, and it no longer has a blood supply, which leaves it more likely to split under a heavy bite. A crown holds it together. Front teeth carry far less chewing load and can sometimes be restored with a filling instead. Which applies to your tooth should be explained before the treatment starts, not after.
How long will the tooth last?
Nobody can put a number on your particular tooth, and you should be wary of anyone who does. What the outcome mostly depends on is how much sound tooth was left to work with, whether it is protected properly afterwards, and how well the gum around it is kept. A treated tooth can still decay at the margins like any other, so it needs the same brushing, flossing and check-ups the rest of your mouth needs.
No obligation
Ask about root canals
Tell us what is going on and we will call you back to arrange a time. If it turns out you need something other than root canals, we will tell you that too.
Prefer to talk now? (480) 547-8034
Not sure what you need?
That's okay.
Many patients come in knowing something isn't right but aren't sure what treatment they need.
We'll start with a conversation and a thorough evaluation. Dr. Sandstrom will explain what he sees, discuss your options, answer your questions, and help you decide what makes sense for you.