Most people fear the idea of a root canal and would worry if a dentist told them that their child needs one. In spite of the negative ideas about root canals, they can actually improve the health of your mouth and preserve your tooth structure and alignment. Additionally, most patients report that the discomfort is comparable to that of getting a filling and some even say their root canal was painless! Like any other dental procedure, the level of discomfort is directly tied to the skill of the dentist performing it. This is why it is helpful to bring your child to a pediatric dentist skilled in calming fear and minimizing discomfort associated with any dental procedure.
When is a root canal necessary?
A root canal may be necessary when your tooth’s pulp becomes infected or damaged. In the center of each tooth lies one or more root canals which contain the pulp, the living part of your tooth. The pulp is made up of nerves and blood vessels which travel into your jawbone. When the pulp becomes infected, it often causes severe pain and can lead to an abscess, which is a puss-filled pocket at the end of the tooth’s root.
Pulp damage can be caused by a deep cavity, a chipped or cracked tooth, or trauma to the tooth. Even when an injury isn’t visible on the outside of the tooth, it can still harm the pulp. When damaged, the pulp may break down, allowing bacteria to multiply and cause an infection or an abscess.
When chewing or biting causes severe pain, a tooth is chipped or cracked, gums are swollen or painful, the gum area below a tooth is very dark or has pimples, or hot or cold cause sensitivity that lingers, you should schedule a dental appointment right away. Like any other infection in your body, an infection in your tooth needs to be treated promptly. Untreated infections can spread to other parts of your body and even cause diseases like infective endocarditis.
Can I just get the tooth pulled?
A root canal preserves much of the structure of your original tooth. A fully developed tooth can survive without the pulp because the surrounding tissues will help nourish the tooth. Fixing damage and removing bacteria helps your entire mouth function better and stay healthy. Saving your natural tooth maintains the appearance of your smile and preserves your alignment for the most efficient biting and chewing. It also protects other teeth from excessive wear and strain.
While it may seem easier and cheaper to get the tooth pulled, this often is not the case. If you need an implant it will often cost more, and many patients report that an extraction is more uncomfortable than a root canal. In fact, with modern techniques and anesthesia, many patients report that their root canal was painless!
If you do not get an implant to replace an extracted tooth, it can negatively impact speech and chewing, and your other teeth will shift which impacts your alignment. Poor alignment can result in unnecessary wearing down of other teeth, jaw pain, grinding, headaches and other problems. In some cases, the original tooth cannot be saved and will need to be extracted, but otherwise, saving as much of your natural tooth as possible is usually the healthiest choice for your mouth.
What if a root canal is recommended for a child’s baby tooth?
You may think that the baby tooth is going to fall out anyway, so why not just leave it or get it pulled? It is important to treat the infection, in order to preserve the health of supporting gum tissue, bone, and developing adult teeth.
It is best not to just pull the tooth because baby teeth actually have many important functions. In addition to being necessary for efficient biting and chewing, and helping your child learn how to correctly form words, primary teeth act as a guide for permanent teeth. They shape the mouth, smile, and face, and even impact the formation of your child’s palate and nasal cavities. When baby teeth are missing, permanent teeth often grow in crooked and may need orthodontic care to correct.
What happens during a root canal?
Every child is different, and while some will be fine having a root canal with dental anesthesia, others may require dental sedation. Our goal is to help your child feel safe and comfortable, so dental treatment is a positive experience. Children who feel strong anxiety about dental visits or who have had frightening experiences in the past often benefit from sedation. We will take as much time as needed to discuss options with you to make the best choice for your child.
Unless you have opted for your child to be sedated during the procedure, the first step is administering the local anesthetic. Once the tooth is numb, we place a dental dam which is a sheet of rubber, over the area to keep the tooth clean and saliva free. Next, we make an opening in the crown of the tooth and clean out the infected pulp, bacteria and any debris from the root canals. If necessary, we will place medicine in the root canal to treat the infection and schedule another appointment to finish the procedure.
Once the root canal is cleaned and infection free, we disinfect it, then fill it with a biocompatible material which is secured with adhesive cement. This seals the canals, preventing further infection. If a baby tooth receives a root canal, we use a filling material that can be dissolved by the body. This allows the root of the primary tooth to be absorbed like the natural root would, so the permanent tooth eruption can proceed as normal.
Depending on the situation, a temporary or permanent filling will be placed on the tooth to seal the hole to keep out bacteria, saliva, and food. If a follow-up appointment is needed, we will remove the temporary filling and restore the tooth to full function with a permanent filling or crown. The follow-up appointment should not require anesthesia.
Why would a crown be needed? If a cavity covered a large portion of the tooth, a crown may be necessary to restore the tooth structure. Molars and premolars need to withstand more force from chewing, and a crown helps strengthen the tooth so it doesn’t crack or break.
What happens after a root canal?
The area will probably be numb for a few hours, and it is best to wait to eat until the numbness is completely gone so you don’t bite your tongue or cheek. The tooth and area may be sensitive or swollen for a few days, but over the counter medication should help. Be sure to follow all dosing instructions, especially for children. It will also help to eat soft foods and avoid very hot or very cold food and drinks during this time.
If there is a temporary filling on the tooth, do not bite or chew with the tooth until it has been fully restored. Temporary fillings are not as strong as permanent fillings and could break. Follow any instructions you were given and brush and floss as normal. If your child is younger than eight, continue helping them brush twice a day and floss once a day, to keep their mouth healthy and avoid cavities. If you practice good oral hygiene, a tooth that has been treated with a root canal could last the rest of your life.
How can a root canal be prevented?
There are many steps you can take to try to prevent the necessity of a root canal. The first step is good oral hygiene, which includes brushing twice a day, flossing once a day, and regular cleanings and checkups. Dr. Culp focuses on education and prevention rather than treatment, partnering with you to keep your children’s teeth healthy. We believe that a well-informed family has a much better chance of reducing the risk of dental disease and spend a lot of time educating you and your kids on proper dental hygiene. At home, teach your children the best ways to brush and take care of their teeth.
You can protect teeth from trauma while playing sports with a well-fitted mouth guard. As your child grows and their mouth changes, be sure to replace it as needed. A poorly fitted mouth guard doesn’t protect their teeth and mouth nearly as well.
If your child does need a root canal, we will do all we can to help you and your child feel safe and comfortable. Please, schedule an appointment as soon as you notice a problem with your child’s teeth. Any dental problem is treated far more easily when caught early!
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At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist.