Root canal treatment (also referred to as endodontic therapy) is a dental procedure where a damaged nerve is removed from the internal aspect of the tooth. The remaining nerve chamber and canals are then sterilized and sealed. Following root canal treatment it is prudent to place a crown on the tooth to restore its strength and protect its longevity. The only alternative treatment when a nerve is irreversibly damaged is to extract the tooth. A dental implant or fixed bridge are excellent alternatives for replacement.
There are many reasons that a root canal may be required. The most common is extensive decay in a tooth which allows the bacteria to infect the nerve. The nerve may be damaged due to trauma from a blow to a tooth, especially front teeth. Back teeth commonly suffer nerve damage from a deep fracture within the tooth. This is especially common in teeth with large silver-mercury fillings. Repeated dental work over the years can lead to a nerve which develops symptoms and requires endodontic therapy. In rare situations, the immune system can malfunction and a tooth will start to have resorption for no apparent reason. Root canal treatment may be required to halt the resorptive process.
How can you tell if a tooth needs a root canal? Occasionally, no symptoms may exist especially if the nerve has died. Dental X-rays and vitality tests can normally detect such abscessed teeth. But in most cases, signs and symptoms (see chart) will be present. These can include sensitivity to cold and hot, spontaneous aching or pain, tenderness to chewing, or a bump or swelling in the area of the tooth. Tooth bleaching can cause transient sensitivity to cold during the bleaching process but has not been shown to cause nerve damage. Cosmetic dentistry procedures such as Mac veneers, Durathin veneers, or crowns can cause a tooth to suffer nerve damage but it is a very small percentage due to the conservative nature of the restorations. Durathin veneers and cosmetic dental bonding require no tooth preparation and thus there is no effect on the nerve.