A Root Canal is a microsurgery, where the nerve and the blood supply of a tooth is amputated and removed, the canals that previously held the nerves and blood vessels are shaped properly with a series of endodontic files, then those newly cleaned and shaped canals are disinfected with a series of medicinal rinses.
Finally, the ideally shaped canals are dried and a rubber-type material called Gutta Percha is used to obturate, or seal, the canals from re-contamination.
In order to access the pulp chamber of the tooth, a small hole will be made directly in the center of your tooth's crown. The access can be made either through an existing prosthetic crown, or "cap", or will be done directly through your natural tooth. Once the root canal is completed, there will either be a temporary filling placed into the accessed area, or a final build-up will be placed.
While it is perfectly acceptable, and even sometimes advantageous, to access the pulp chamber and canals through an existing prosthodontic crown, or "cap", it should be understood that crown has now been compromised, and should be replaced in approximately 30-days from the date of the root canal. Leakage, or contamination, is almost assured in these types of access situations. Since a root canal is not a cheap procedure, due to the level of difficulty and skill required to perform these procedures correctly, it is highly advisable to protect that investment with a new build-up and a new crown, to properly seal the root canal and tooth. This will guarantee the longest life expectancy for your root canal, and tooth overall, increasing the prognosis.
Root canals do not hurt while being performed.
Local anesthesia is given to put your tooth to "sleep". Patients many times state "It feels as if you are working on someone else's mouth." In fact, we have had many patients who actually fall completely asleep while we are performing the procedure and have to wake them up, in order to have them move their head for the Doctor. At patient request, and at Dr. Hoffman's discretion, medications may be indicated to keep anxious or fearful patients comfortable. If interested, please inquire about this option, as it is not routine, but easily accommodated, in most cases.
After the root canal is completed and the anesthesia has worn-off, there may be SLIGHT discomfort...not pain. The possibility of discomfort does come from the nature of microsurgery being performed, and the nerve and blood supply being amputated. This discomfort, if measured on a scale of 0-10, with 0 being asleep and 10 being the worst pain imaginable; most patients report discomfort from a level of 0-3, that may last for up to 48-72 hours maximum. Most patients will receive NSAIDs immediately after treatment to keep discomfort extremely tolerable, to non-noticeable, provided you medical history allows these medicines.