Root canal treatment in Iran: Procedure and recovery

Root canal treatment is the removal of the nerve and blood vessels of a tooth for the purpose of trying to save the tooth from extraction. A simple analogy is removing the wick from a candle. The void where the wick was is cleaned and smoothed and then dentist will place a rubber type material into the cleaned out space to seal the canal. Avoiding needed root canal therapy will only make the problem worse, so contact clinical team right away to schedule a root canal treatment if you need it!

When Do I need A Root Canal Treatment?

The pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from within the crown of the tooth (that portion of the tooth that is visible) to the tip of the root in the bone of the jaws.

When the pulp is diseased or injured and can't repair itself, it dies. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth.

If left untreated, the infection can lead to the following:

• An abscess (pus-filled swelling) forming around the root of the tooth.
• Destruction of bone surrounding the root of the tooth. This may allow the abscess to burst through the weakened bone to drain pus into the mouth through the gums.
• Severe pain

Root canal treatment in Iran aims to stop this infectious process taking place within the root canal system and to eliminate pain. This will allow you to keep the tooth instead of extracting it.

After root canal treatment, the tooth becomes very brittle and weak. It may crack or fracture more easily when you chew on it. Protecting the biting surface with a crown or an onlay will help to prevent an irreparable fracture from occurring soon after root canal treatment is completed. This protection is mandatory for all root canal treated teeth that are subjected to high biting forces.

Steps Of Root Canal Treatment In Iran

Step 1: Consultation

During the first visit, dentist will examine your teeth carefully to identify the source of the toothache/infection.

Clinical tests and dental X-rays are taken to pinpoint the offending tooth. A 3D CBCT scan of the root canal space may be taken for complex cases involving multiple roots, and to look for hidden root curvatures, root resorption, and canal blockages among other issues that can complicate treatment. The potential risks and complications involved as well as the long term prognosis for the tooth will then be discussed with you.

In some cases, it may be determined that your tooth is so badly damaged or infected that it may not survive for very long afterwards.  In such cases, it may then be better to have the tooth removed and replaced with a dental implant, for example, for a higher chance of long term success.

Occasionally, you may be referred to a root canal specialist (endodontist) if your case has a high level of difficulty.

Here are some factors that would make root canal treatment difficult to perform :

• severely curved or twisted root canals
• blocked root canals
• root resorption
• cracks within the tooth or root
• previous root canal treatment
• presence of root canal posts and crowns
• patients with very limited mouth opening
• claustrophobic patients

Step 2: Root Canal Treatment Procedure

Before the procedure begins, your tooth will always be numbed with local anaesthetic.

The tooth to be treated is then isolated with a perforated rubber sheet clamped on to the tooth (rubber dam). This is MANDATORY to ensure a clean, dry working field, to shield your throat and soft tissues from any disinfectant used and to prevent you from inhaling or swallowing tiny root canal instruments. Intra-Venous sedation or oral sedatives can be helpful to ensure an anxiety-free procedure, if you are very anxious or claustrophobic.

Dentist will then gain access to the root canal system by drilling an opening into the tooth. Existing decay, old leaking fillings and defective crowns are usually removed as well. The root canals are then cleaned and shaped, flushed with disinfectant and sealed with a rubber sealant called gutta-percha. A filling is then placed to cover the access cavity and seal it off from any further bacteria ingress.

Taking Care Of Root Canal-Treated Teeth

A tooth that is root canal-treated has a greater tendency to fracture, so patients are advised to not chew on hard foods before the tooth can be crowned or restored. Otherwise, the tooth should be maintained with brushing and flossing in the same way as the other teeth to prevent tooth decay or gum disease.

Complications Of Root Canal Treatment 

Sometimes, even when the treatment has been carried out correctly, the patient may find that the tooth is sensitive to touch. This may be the result of complications in the procedure due to unusual structure of the teeth, such as:

• Calcification of the root canal space
• Very curved canals
• A premature tooth or tooth with a limited tooth structure that may fracture during treatment

When such complications occur, the success rate may be affected and other follow-up treatment may be required.

When Further Treatment Is Necessary

Root canal treatments usually have good success rates but depend on the pre-existing condition of the tooth. When the treatment fails, there is usually persistent inflammation of the bone and sometimes swelling and pus discharge. Some of the reasons why root canal treatment fails are:

• Persistent or recurrent root canal infection, which can occur even when a good root canal treatment has been performed. The assessment of re-treatment will be based on the quality of the root canal filling, the status of the disease and the nature of the signs and symptoms
• A defective restoration that may compromise the seal of the root canal fillings from bacteria in the mouth

 Is Root Canal Treatment Painful?

Few treatments in the dental world have a reputation as bad as the root canal. Because of the pain associated with root canals, mainly patients unfairly fear or avoid their necessary root canals—without realizing that a root canal actually relieves pain instead of causing it!

When a tooth is infected or broken to the point of needing root canal treatment, that tooth is almost always symptomatic and incredibly painful. Once a dentist performs root canal treatment to save the tooth, however, the pain goes away. Unfortunately, the thing people tend to remember most about their root canal is the pain they felt beforehand, which leads them to associate root canals with pain.

Being afraid of root canals, however, poses a threat to your oral health. If you need a root canal but become so scared of the pain that you refuse to get treatment, you put your health and safety on the line. An infected tooth not only puts the rest of your smile at risk, but it can also compromise your jaw health and the health of your sinus. Ignoring your need for a root canal means you’ll most likely need more expensive and more invasive dental treatments later, including extraction, a dental bridge, or a dental implant. Root canal problems will not go away if you ignore them!

If the pulp in the tooth is dead there are no nerves, so you shouldn’t feel anything. If the pulp is still alive, you will need a local anesthesia to help with the pain management. dentists also offer dental treatment under sedation if you are concerned about pain or have anxiety towards the procedure.

Faq

Should I Get A Root Canal Or Extraction?

Some may wonder if the tooth will recover on its own or if they should just get an extraction and dental implant. Only your dentist will know if a root canal is necessary and if there are root canal alternatives available based on the severity of the infected tooth and your medical history.

Do I Need To See A Root Canal Specialist?

Depending on the severity of the root canal, your dentist may refer you to an endodontist who specializes in root canal treatment. Endodontists are dentists with additional years of training that focuses on diagnosing tooth pain and performing root canals and other procedures inside the tooth.

How Much Does A Root Canal Treatment In Iran Cost?

The financial implication of a root canal is almost always a top concern for patients. The cost of a root canal depends on the complexity of the surgery and if your health insurance policy will help cover part of the procedure.

Is Pain After Root Canal Normal?

It is normal to feel tenderness in the area for several days after your root canal, as well as some soreness in your jaw after keeping it open for the entire procedure. Pain will usually peak 17 to 24 hours after the procedure. Over-the-counter pain medications can help alleviate post root canal pain along with keeping your head elevated when sleeping the first few nights. Any severe pain or pressure that lasts for more than a few days should be reported to your endodontist.

How Long Does A Root Canal Take?

Depending on your endodontist and the severity of your root canal, the dental procedure will usually take between 30 and 90 minutes. Some endodontists prefer to perform the entire root canal in one visit, while other endodontists prefer to do the root canal in several appointments in order to let the tooth dry and be able to disinfect a second time before filling. The number of root canal appointments will also affect the total length of the procedure.

At the end, an x-ray is taken to double-check the root filling.

At Elite Dental, most root canal treatments are completed in a single visit. Occasionally, this may not be possible and a temporary antiseptic dressing is placed inside the tooth before you leave.

We will then prescribe you with painkillers and occasionally antibiotics to aid with the healing process.

Step 3: Preparing The Root Treated Tooth For A Dental Crown

After root canal treatment, the remaining tooth structure becomes very brittle and can crack easily when chewed on. Covering the biting surface with a dental onlay or crown as soon as possible can prevent the tooth from breaking. We view crowning as mandatory and an essential part of finishing the treatment.

The tooth needs to be trimmed and shaped to accommodate the crown. A mould or digital scan of the prepared tooth is then made and transferred to the dental laboratory, where the crown is made. A temporary crown is then fitted to protect the tooth in the meantime.

Step 4: Fitting Of The Crown

Once the new crown is ready, the temporary crown is then removed. The fit, colour, shape and bite of your new crown will then be checked with your input, before it is finally cemented onto your tooth. After the crown has been fitted, your tooth still needs to be treated with care, since biting into very hard things like bones, ice, shellfish or opening bottles/cans with your teeth may damage the crown in the long run.