Root Canal Treatment

What is root canal treatment?

Endodontics is the field that deals with the living tissue inside the tooth (the pulp) and the root canals. When this tissue becomes inflamed because of a deep cavity or an injury, root canal treatment cleans, shapes and fills the root canals.

In children and teens, the roots of permanent teeth keep developing for a while after the teeth come in. In young permanent teeth whose roots haven't finished forming, we may choose special techniques that help the root continue to develop.

Two situations most often lead to root canal treatment in children and teens: deep cavities that go unnoticed for a long time, and injuries such as falls or bumps. In both cases, early care greatly improves the chances of saving the tooth. That's why it's important to come in for a checkup right away if you notice lingering sensitivity, pain that starts on its own, or a change in the color of a tooth.

Which signs matter?

• Sensitivity that lingers after something hot or cold
• Pain that starts on its own or gets worse at night
• Swelling or an abscess in the gums
• A tooth that darkens or changes color
• After an injury such as a fall or a bump

How does it work?

1. Diagnosis: We check the condition of the tooth and how far the root has developed with an exam and an X-ray.
2. Numbing and isolation: We numb the area and isolate the tooth with a thin rubber sheet to keep it dry and away from saliva.
3. Cleaning: We clean, shape and disinfect the root canals.
4. Filling and restoration: We fill the canals and restore the top of the tooth with a filling or a crown.

A different approach for young permanent teeth

After permanent teeth come in, their roots keep developing for several more years. When the nerve is affected in a tooth whose root hasn't finished forming, our first goal, whenever possible, is to keep the tooth alive and let the root continue to develop.

That's why, in young permanent teeth, we may choose vital pulp therapies that remove only the affected part of the tissue and preserve the rest. If the tissue has lost its vitality completely, we use special techniques that help close the tip of the root. Which method is right depends on the X-ray, the condition of the tooth and your child's age.

Root canal treatment after dental injuries

After a fall or a bump, the tissue inside the tooth may be affected not right away, but weeks or even months later. A tooth turning gray, swelling in the gums or pain that starts on its own can be signs of this. That's why we check injured teeth at regular intervals and, if needed, plan root canal treatment in time.

After treatment

• The tooth may feel slightly tender when chewing for the first few days; this usually fades on its own.
• Once the root canal is finished, it's very important to cover the top of the tooth with a permanent filling or crown; don't wait too long with a temporary filling.
• We follow the success of the treatment with checkup visits and, when needed, X-rays.
• A tooth with a root canal can still get cavities like any other tooth, so keep up with brushing and flossing.

Comfort during root canal treatment

The words "root canal" often cause unnecessary fear. In reality, the procedure is done under local anesthesia, and your child won't feel pain during treatment. Before we begin, we explain each step in words that fit your child's age, and if a longer visit is needed, we take breaks.

Isolating the tooth with a thin rubber sheet both improves the success of the treatment and keeps water and tiny bits from getting into your child's mouth. Most children are surprised to find that the treatment isn't nearly as hard as they expected.

Are antibiotics always needed?

No. In root canal treatment, the real treatment is cleaning out the infected tissue. Antibiotics are prescribed only after the dentist's evaluation, if there's facial swelling, fever or other signs that the infection is spreading. Avoiding unnecessary antibiotics is also important for your child's overall health.

How we explain it to your child

“We're going on a tiny cleaning adventure down to your tooth's roots! And we'll give your tooth a little raincoat so it stays nice and dry the whole time.”