Root Canal Treatment in Johns Creek, GA

A root canal has a worse reputation than it deserves. The pain people associate with it usually comes from the infected tooth, not the treatment. With the tooth numbed, most patients find it feels about like getting a filling, and some soreness afterward is the usual extent of it. The alternative is often losing the tooth.

What is a root canal, exactly?

Inside every tooth is a soft core of nerve and blood vessels called the pulp. When it's damaged, by deep decay, a crack, a broken filling or a hard knock to the tooth, the pulp becomes inflamed and often infected. Mild inflammation can sometimes settle, but once the pulp is infected or too damaged to recover it can't heal, because it's sealed inside hard tooth structure. Left alone, the infection works down through the root and into the bone, where it forms an abscess.

A root canal removes the pulp that's infected or too damaged to recover, cleans and shapes the hollow canals inside the root, and seals them. The outside of the tooth stays. You keep your tooth, and it keeps doing its job.

How do I know if I need one?

The classic signs:

  • A toothache that's severe, or that keeps you up at night
  • A tooth that hurts when you bite or chew
  • Sensitivity to hot or cold that lingers after the food or drink is gone
  • A pimple-like bump on the gum near the tooth, sometimes with a bad taste
  • Swelling or tenderness in the gum or jaw
  • A tooth that's turned gray or dark

And sometimes there are no symptoms at all, and we find the problem on an X-ray at a routine checkup. That's one of the better reasons not to skip them.

What happens during the procedure?

It usually takes one to three visits. We start with X-rays to see the shape of the roots and how far the infection has gone. Then we numb the tooth thoroughly and place a rubber dam, a small sheet that isolates the tooth and keeps it dry.

Through a small opening in the top of the tooth, we remove the pulp and any decay with a series of fine instruments, then clean and shape each canal. The canals are filled with gutta-percha, a rubbery material that seals them, and the opening is closed with a filling. If the tooth needs time to settle or an infection needs to calm down first, we'll place a temporary filling and finish on the next visit.

The tooth may be tender for a few days afterward as the inflammation settles. Over-the-counter pain relief usually handles it.

Why does the tooth need a crown afterward?

Because a tooth that's had a root canal is weaker than it was. Decay, cracks and the treatment itself all take structure away, and back teeth especially take a lot of chewing force. A crown covers and holds the tooth together so it doesn't fracture. Which restoration is right depends on the tooth and how much sound structure is left, but for molars it's nearly always a crown, and getting it done promptly is what protects the work.

Can't I just have the tooth pulled instead?

You can, and sometimes that's the right call, when a tooth is too far gone to save. But pulling a tooth that could have been treated usually costs more in the long run. The teeth on either side drift into the gap, the bite changes, and you're then looking at an implant or a bridge to replace what was removed. If a root canal can save the tooth, that's nearly always the better deal.

What about a cracked tooth?

Cracks are common, especially in people who grind or clench, chew ice, or have large old fillings. The tell-tale symptom is a sharp pain when you bite down or when you release the bite, often with sensitivity to temperature and trouble pointing to exactly which tooth hurts. The crack opens slightly under pressure and irritates the pulp, then closes.

How we treat it depends on where the crack runs:

  • Craze lines are tiny surface cracks in the enamel. Nearly everyone has them and they don't need treatment.
  • Cracks confined to the crown of the tooth can usually be fixed with a filling or a crown.
  • Cracks that reach the pulp need a root canal and a crown to save the tooth.
  • Cracks that extend below the gumline or split the root often can't be saved, and the tooth has to be removed and replaced.

The earlier a crack is treated, the more options there are. If biting on something has started to hurt, don't wait for it to get worse.

A tooth got knocked out. What do I do?

This applies to adult teeth only. Never put a baby tooth back in; call a dentist instead. For a permanent tooth: pick it up by the crown, not the root. Rinse it gently with water if it's dirty, don't scrub it, and if you can, put it back in the socket and hold it there. If you can't, keep it in milk or a tooth-preservation solution from a pharmacy. Get to a dentist immediately, ideally within half an hour. Call us; if we can't see you right away or we're closed, go to the nearest emergency dentist rather than waiting. A tooth that's replanted quickly can often be splinted and saved with a root canal.

Tooth hurting now?

Call (770) 609-1281 or text us. We're on Medlock Bridge Road in Johns Creek, next to Starbucks, and we'll get you seen as soon as we can.