I’ve been seeing this question reoccurring in twitter so I’ve decided to make this the 1st in a long line of “Ask Dr. Pierson” blogs. The question was “why did my dentist give me a partial root canal”?
First I’m assuming a partial root canal is an incomplete root canal. With that assumption, there are several clinical reasons why you would receive a partial root canal, but the number one reason as to why a partial root canal: INFECTION!
Let’s begin with what is a root canal? A root canal removes the nerve(s), arteries, veins, and infection from a tooth. Most patients’ missinterpute a root canal as removing the root from a tooth, but the root actually remains, just without nerves in it. During the root canal process, the canals are reshaped, cleansed, and filled with a replacement material called gutta percha. Gutta percha is the predominant material used to fill the empty space inside the root of a tooth after it has undergone endodontic therapy (root canal therapy).
Why can’t this procedure be completed in one visit? The number one reason is tooth infection. Usually an infected tooth is extremely difficult to numb, thus making the root canal more uncomfortable. Why is an infected tooth so difficult to numb? The human body during its healthy state has a pH of 7. Dental anesthetic is set to work at pH 7. When there is an infection present, depending on the level of infection, the pH shifts away from pH7. The further away from pH7, the more infected you are. Therefore, the more infected you are, the less the anesthesia will work. In these cases, a patient will need to take antibiotics. Antibiotics, will “kill the infection” and bring the pH back to normal (pH 7).This is why an infected tooth usually can’t be completed with one visit.
After removing the nerve, and canal reshaping, we dry the tooth with a white, canal shaped instrument. If this instrument goes into the canal and comes out of the canal with its color white, the tooth is now ready to receive the gutta percha filling material and complete the root canal. However, if the instrument does not come out white, the canal is still infected and therefore cannot be completed in one visit. At this point, a temporary filling material is placed in the tooth, and the patient is usually given a regiment of antibiotics.
Here is another common misconception regarding root canals. When your dentist completes the root canal, and says “Your root canal is now finished”, the actual restoration of the tooth is not complete. Once a root canal is completed it is imperative, that you receive permanent restoration on that tooth. A root canaled tooth is very fragile and highly susceptible to breakage or fracture. The permanent restoration (usually a crown or an onlay) is needed to preserve and protect the tooth. Depending on your dentist, the permanent restoration may be done while you wait, or may require two visits. If your dentist uses Cerac, these restorations can be made in a little more than an hour while the patient waits. No more temporary crowns, and no more unpleasant tasting impressions. To find out more about what CERAC restorations click here.