If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.

When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.

If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.

If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.

When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.

Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.

Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”

Test yourself on your knowledge of this dental procedure.

1. A root canal is
1. A canal shaped structure in the root of your tooth
2. A blood vessel carrying blood from your gum to your tooth
3. An instrument used by your dentist in performing dental surgery
2. Which of these are symptoms of root canal infection?
1. Sharp, acute and intense pain, which is difficult to pinpoint
2. Sharp pain when biting down on your tooth or on food
3. Lingering pain after eating hot or cold foods
4. Dull ache and pressure
5. Tenderness (accompanied by swelling) in the nearby gums
6. All the above
3. If you don't feel any pain you do not have a root canal infection.
1. True
2. False
4. Root canal treatment is a very painful experience.
1. True
2. False
5. Root canal treatment is called endodontic therapy. What does this word mean?
1. Bringing the end of your problems
2. Inside your tooth
3. Fighting gum disease
6. You need root canal treatment if
1. The inside or pulp of your tooth becomes inflamed or infected
2. Your tooth needs to be gently moved in order to correct your bite
3. Acid erosion is damaging your tooth
7. During root canal treatment the canals in your teeth are cleaned out and sealed off.
1. True
2. False
8. Who is qualified to perform root canal treatment?
1. General dentists
2. Endodontists
3. Both of the above

1. a. A root canal is a canal shaped space within the root of a tooth that holds the tooth's pulp — which contains the tooth's nerves and blood vessels.
2. f. — all of the above
3. False. It is possible to have an infection that has stopped hurting but is still present and causing damage.
4. False. Root canal treatment doesn't cause pain, it relieves it.
5. b. The word comes from roots meaning “inside” and “tooth.”
6. a.
7. True. A small opening is made in the chewing surface of your tooth to gain access to the pulp. Dead and dying tissue is removed and the pulp is cleaned and disinfected. The canals are shaped and then sealed with filling materials to prevent future infection.
8. c. All general dentists have received training in endodontic treatment and can perform most endodontic procedures. They often refer people needing complicated root canal treatment to endodontists, who have had specialized training in endodontic diagnosis and treatment.

For generations, root canal treatment has received a bad rap. Thought to cause pain, it is actually just the reverse. The truth is that root canal treatment does not cause pain but actually relieves it. Not only does root canal treatment relieve pain, it literally saves the affected tooth or teeth from further damage and/or loss.

To get started, let's define this procedure. A root canal treatment is a procedure in which the diseased pulpal tissue in the root canals are removed, disinfected, cleaned, and sealed. This is usually necessary following inflammation and infection of the pulp — which is the cause of your pain — as a result of severe decay or in a very heavily filled or damaged tooth.

However, if left untreated, an infected tooth can spread into the bone and even cause an abscess — and that can be more painful and impact your overall general health. The good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, it can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our offices as soon as you feel you have a problem with a tooth.

If you are having pain from a tooth or several teeth, you may need a root canal treatment. Please contact us today to schedule an appointment before it gets worse. To learn more about the signs, symptoms, and treatment for a root canal, read the article “Common Concerns About Root Canal Treatment.”

Hearing the news that you need a root canal often causes anxiety for most people given all the bad press this procedure has received (e.g., “I'd rather have a root canal than...”). However, the truth is that root canal treatment relieves pain; it doesn't cause it. And it is typically highly successful. The real pain occurs for most people when decay is left untreated or the nerve in a tooth under a very large filling becomes infected and dies.

For these reasons, we have put together the following list of questions you should consider asking prior to having a root canal or endodontic (“endo” – inside: “dontic” – tooth) treatment.

• Am I a good candidate for root canal treatment?
• Does it hurt to have a root canal?
• What can I expect if I do not have a root canal treatment?
• Are there any other treatment options for me given my situation? If so, what are they?
• Do you do root canal treatment or should I see a specialist?
• How long will the entire process take from my first appointment until my root canal treatment has healed?
• Will the pain I am in immediately subside after a root canal or will it take some time?
• Will I need or receive any type of sedation while having the treatment?
• Are there any risks associated with root canal treatment? If so, what are they?
• How long can I expect my natural tooth to last after root canal treatment?
• What could happen to cause a root canal to require a second treatment?
• How much will my root canal cost?
• Will my insurance cover all or a portion of the cost?
• Will the tooth be as strong after root canal treatment, or will it need a crown?
• Will there be any special maintenance required on an ongoing basis after I have a root canal?

To learn more about root canals, continue reading the Dear Doctor article, “I'd Rather Have A Root Canal.” Or if you feel you may need a root canal or other dental procedure, contact us today to schedule a consultation.

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.