Hi Angel,
Root Canal Treatment is a procedure used to save a tooth which has been traumatized (by a knock or by dental decay) which has led to an apical (root) abscess (infection) or pulpitis (If the pulp becomes infected by bacteria from caries or damaged it may inflame causing toothache.) NB. The pulp is the soft tissue within the teeth containing nerve tissue and blood vessels and is commonly called the 'nerve' although it isn't really just a nerve.
Sometimes it is elected to carry out a root treatment on a vital (alive) tooth in order that a post may be placed for example, but in most cases the pulp (nerve) is necrotic (dead) or at least partially necrotic. The infected pulp (nerve) is removed, and the root canals are cleaned and widened with small file instruments. A gutta-percha (rubber points) filling is then placed to seal the canals and prevent re-infection before a filling and possibly eventually a crown will restore the tooth structure. Rubber dam is used whenever possible. (A square sheet of rubber which is held over the mouth with a frame. A hole in the rubber allows isolation of a tooth or teeth from the rest of the mouth. This protects the airway from small instruments, irrigants etc during root canal treatment. It also reduces saliva contamination which is important for root canal treatment).
Root canal can take one, two or sometimes more visits. The amount of time and visits depend upon which tooth is being treated. Generally speaking the incisors (front teeth) have one canal, the premolars/bicuspids have one or two, and the molars/back teeth have three or four canals. So obviously the time taken can vary.
You will usually receive a local anaesthetic injection as you would prior to a filling. Sometimes if the nerve is totally necrotic, no anaesthetic is even needed!
The only time a root treatment can be painful is if the nerve is 'hyperaemic' meaning that it is hypersensitive and still partially alive. It is quite rare, but is the cause of all the horror stories about root canal work. Usually if it does happen, an injection into the pulp itself will get it numb enough to carry on (although this can be a bit uncomfortable itself). If there is any doubt, I would usually place a steroid/antibiotic dressing which would help settle the nerve so that it will be painless to continue at the next visit. So don't painic, if it is sore, just tell the dentist that you don't want him to continue. Sometimes things will feel a bit tender afterwards. I usually suggest that somone having root canal should take an anti-inflammatory preferably something containing ibuprofen prior to or immediately after the procedure.
In conclusion, root canal treatment usually would take 1 or 2 visits of up to an hour each and 99 times out of 100 it is totally painless. It is just a bit boring having to stare at the ceiling all that time while the dentist fiddles around with little files!
A Crown (cap) is a laboratory-made restoration which fits over and covers most of the natural crown of a tooth. These can be gold or white (porcelain or porcelain bonded to metal) for posterior teeth, and are always white for anterior (front) teeth. Basically, the dentist has to create a collar around the tooth by shaping it into a kind of top-hat shape. An impression is taken and sent to a lab where it is made. A temporary crown will be fitted by the dentist in order that the tooth is protected and so that the teeth do not change position. It can take 1 to 2 weeks for the crown to come back from the lab. The lab-made crown is then cemented over the prepared tooth. If the tooth has had root canal, all this can be done without any injections as there is no nerve. A crown prep (preparation) can take up to an hour to do. As with root canal, this is not because of there being a lot of drilling, more that it is intricate and precise.
A crown prep should not feel that different from having a filling except that it takes longer and there are impressions (moulds).
I hope that this starts to explain these procedures and makes you feel a bit better about them now you know what is involved!
Regards,
Mike Gow BDS
( I'm from Kuala Lumpur,Malaysia ) Usually,the dentist is interested in getting the job done and that's it,end of story.
