Root Canal or Tooth Extraction by our Boston Endodontists
When a tooth becomes decayed or cracked, the damage can be too extensive to save the tooth. For instance, the damage has spread to the pulp or nerve of the tooth. Removing the cavity or damage and filling the tooth is no longer an option. A dentist has two options: root canals or extractions.
What is a Root Canal?
Many patients often hear the words “root canal” and instantly think of all the horror stories they’ve ever heard about the procedure. A root canal is a dental procedure to remove all the damaged area of the pulp tooth. The tooth is then cleaned, disinfected, filled and sealed. It is a common procedure for a tooth that is cracked, decayed or damaged.
The reason it is called a root canal is because the dentist cleans the canals located inside the tooth’s root.
The entire procedure takes approximately 30 minutes to 2 hours depending on the type of damage to the tooth and where it is located. The process requires four steps:
X-Ray: A dentist will take an X-ray of the affected tooth to determine if there is actually decay or damage. Once the treatment option is picked, the patient undergoes the procedure.
Anesthesia is Administered: Local anesthesia is inserted into the affected tooth using a needle. The sedation numbs the tooth, so a patient won’t experience pain during the procedure. It is common to experience a pinch sensation in the gum area where the needle is inserted.
Patient Undergoes a Pulpectomy: The dentist makes an opening in the affected tooth to remove the pulp inside it. The opening is made using a small dental drill on the top of the tooth. They must use another small tool called a file to remove any of the diseased or damaged pulp from inside the affected tooth.
The file is also used to shape the inner chamber of the root and tooth. The dentist may irrigate the chamber with water too. This is done to wash away any remaining pulp they didn’t or weren’t able to remove. Sometimes a dentist will also use a antimicrobial solution inside the tooth. This solution is to kill any type of bacteria in the affected tooth. It also reduces any risks of a patient developing another or worsening dental infection.
Filling: During the procedure, the roots of the tooth were opened to remove the diseased pulp. The dentist must fill the tooth with material called gutta-percha. This material replaces the pulp. Filling is inserted inside the tooth to close it. This is only a temporary filling. The last part of the filling process is to seal the tooth with dental cement.
Pain of a root canal is the same as having a filing. In about three weeks, a patient returns to their dentist to complete their treatment. It is the restoration process. A permanent dental crown is placed on top of the affected tooth.
A dentist may need to place a small post inside the root chamber to make the crown more stable. It depends on the condition of the patient’s natural tooth. A patient’s dentist may require an additional visit to X-ray the treated tooth again. This time it is to make sure there’s no sign of a dental infection.
A Damaged Tooth Treated with a Root Canal Can Last a Lifetime
With proper care, the treated tooth can last a lifetime. Root canal treatments have a high success rate. However, it is important that a patient take proper care of their teeth after undergoing a root canal. For instance, practice good oral hygiene. Good oral hygiene involves brushing teeth twice a day and flossing once a week. Go to all dentist appointments. Cleanings and examinations are required to keep teeth healthy. Don’t chew on hard foods such as ice and candy. This can cause harm to root canals and breath teeth.
What is a Tooth Extraction?
The second treatment option for an affected tooth is a tooth extraction. An extraction is the ideal solution for a damaged or broken tooth. The damage is too extensive to repair with a filling or dental crown. A tooth extraction involves removing the affected tooth from its socket. The socket is located inside the jawbone.
A Patient Undergoes One of Two Types of Tooth Extractions
A dentist will determine what type tooth extraction is best to remove the affected tooth. A simple extraction is a dental procedure that loosens the tooth from the socket with a dental instrument called an elevator. The dentist then uses forceps to remove the affected tooth.
If the affected tooth is more complicated to remove, a patient undergoes a surgical extraction. A surgical extraction is for an affected tooth that hasn’t fully erupted or is broken at the gum. A tooth that hasn’t fully erupted means it is partially still inside the gum. Surgical extraction is also for a wisdom tooth that is impacted.
Tooth Extraction Procedure
Prior to a tooth extraction procedure, a X-ray is made of the affected area of the tooth. The X-ray will determine the best way to remove the patient’s tooth. A patient should give their entire dental and medical history and list of medications they are currently taking during this step in the process. This will provide the dentist with enough information to choose the best treatment.
The dentist may prescribe antibiotics to their patient prior to the surgical tooth extraction. Antibiotics are for patients who have a weakened immune system, infection at the time of the tooth extraction procedure or a specific medical condition. They may also be prescribed if the dentist anticipates a long tooth extraction procedure.
Patients are advised not to smoke prior to the procedure. Smoking increases the risk of developing dry socket. A dry socket, also called an alveolar osteitis, is a painful dental condition where a blood clot doesn’t form at the site at the tooth extraction. It may dissolve or dislodge prior to the gum healing. This causes intense pain and additional dental treatment.
They are also advised never to drink out of a straw, spit or smoke immediately following the procedure. This will cause the blot clot to dislodge and also cause dry socket.
During a surgical extraction, an oral surgeon makes a small incision on a patient’s gum. The damaged tooth is then removed from the bone of the tooth. After the procedure, the patient is required to bite on gauze for about 30 minutes to help the blood clot. The incision may lightly bleed for the next day or so. It’ll stop after that because a blood clot has formed in the area. Ice packs are another part of the follow-up procedure.
For instance, a patient can place ice packs on their face for 20 minutes at a time to reduce any swelling. The jaw becomes stiff or sore after the swelling decreases, place a warm compress on to decrease the stiffness. Also, they want to rise with warm salt water after the surgery for 24 hours. This will keep the area clean. Soft foods and cold foods are required for three days following a surgical tooth extraction. A patient can include hard foods and warm foods as the pain decreases.
A surgical tooth extraction does hurt more than a simple tooth extraction procedure. The patient’s dentist may prescribe pain medication for the first couple days after the dental procedure. It takes about two to three weeks to fully heal. A patient may return for a follow-up visit if they need to remove stitches from the incision site. Most dentists use stitches that dissolve on their own.
The Goal of a Root Canal or Tooth Extraction is to Prevent Further Damage to the Tooth
Both treatment options remove the damage tooth. It also seeks to keep the teeth around the tooth functioning properly. A tooth extraction is generally the most affordable solution to removing a damaged tooth. We always recommend the root canal option if it is possible. Saving your natural tooth is better than getting an artificial tooth. An artificial tooth may fail. It costs additional money to replace the tooth. Removing a tooth can also lead to other dental problems such as TMJ discomfort, shifting of a patient’s teeth or issues with their bite. Tooth extraction may cause the root to break down over time.