I’m sure most of my readers have already heard of the term root canal treatment. What is it? Why are people so scared and apprehensive at the idea of getting one?… I’ll get to that later!
Root canal treatment consists of treating an inflamed pulp tissue of a diseased or infected tooth.
This pulp tissue is found in the narrow space in the center of the root(s) of the tooth. This space is also known as the canal of a single-rooted tooth, such as a central incisor, or canals of a multi-rooted tooth, such as a molar. Most molars have at least three canals and some can have four or more!
When the pulpal tissue becomes irritated or damaged as a result of prolonged caries activity or a blow or traumatic injury, an infection of the pulp usually results. This infection can be acute or chronic,
One of the most common causes of dental nerve damage is trauma. The traumatized tooth may initially become loose, painful, and eventually tighten, but become discolored (darker).
Traumatized teeth can remain dormant and chronic for years without causing pain and therefore do not require any type of treatment immediately. While other traumatized teeth can lead to an acute situation where root canal treatment is needed as soon as possible.
Then there are teeth that lose their vitality due to long-term carious injury that goes untreated and causes the nerve tissue to become inflamed or infected. These types of neglected teeth can initially become chronic with little to no pain and eventually become acute, followed by swelling and significant pain.
The chronically infected devitalized tooth may have no symptoms other than obvious discoloration. Prior to initiation of treatment, an X-ray of the affected tooth(s) is ALWAYS indicated.
It is important to treat devitalized teeth as soon as possible to prevent the infection from reaching the surrounding bone tissue and causing additional problems.
Root canal therapy molar is usually performed in a single appointment, but depending on the individual situation, a series of appointments may be needed to complete the treatment.
Due to the many variations in root shapes, sizes, and tooth positions, not all teeth that require root canal treatment can be successfully treated. Successful root canal treatment is usually possible when all canals are located, accessible for instrumentation, sterilized, obturated, and hermetically sealed.
Endodontic fees vary based on the number of roots involved. The more roots and canals a tooth has, the more it will cost to treat.
Root canal therapy is very successful for the most part. Probably in the 90 to 95% range. Most root canals are done easily and without pain or consequences. That said, there are situations where root canal treatment is very painful and undesirable.
While this rarely happens, this is the situation most people will remember and tell everyone about the horrible root canal they went through. Most people never talk about the easy or delicate root canal treatments that are usually performed.
When teeth are due for root canal treatment, it is important to realize that the tooth in question will not be as strong as before. It will dry out and become brittle. Therefore, it is more prone to breakage. Consequently, most endodontically treated teeth will require full crown coverage to protect against future fractures.
Many people have to undergo root canal treatment due to the death of the nerve, which is located in the hollow interior part of the tooth. The tooth is hollow when it erupts and contains nerve tissue, blood vessels, and cells that deposit calcium within the pulp chamber and in the extension of the pulp chamber along the roots. A tooth can die for various reasons. One is deep caries, which is potentially the most serious, as it can lead to infection and requires immediate treatment, combined with antibiotics, to fight the infection.
A tooth that is badly knocked down can die as a result, it is not infected, but the body sends white blood cells to remove dead or dying tissue from the tooth. The root end will fill with blood, creating a painful abscess. In this case, the use of antibiotics is not usually necessary, since there is no bacterial involvement. Deep fillings can in many cases cause calcification of the pulp chamber. This can lead to narrowing of the tooth’s blood vessels, leading to loss of vitality of the tooth’s soft tissues. This again results in an increase in white blood cells at the root tips.
These white blood cells also remove dead tissue. When a patient presents with a painful tooth, the dentist must ensure that a correct diagnosis is made. A sore tooth may not mean a root canal is needed. Some teeth are sensitive to cold due to receding gums, exposing the roots of the teeth. Often a desensitization of the root areas will solve the problems. If a tooth begins with a sensitivity to cold and then progresses to severe pain when heat is applied to the tooth, then it is probably a root canal. Another test is to gently tap on several teeth. If one is particularly sensitive to light percussion, that is another symptom that indicates the need for a root canal. All this is done after taking the necessary x-rays.
An x-ray usually shows a dark area around the root structure when a tooth needs a root canal. The patient is given a strong local anesthetic (freezing) and we can continue with the treatment. A rubber dam is used to prevent saliva from entering the tooth and to prevent problems if an instrument is dropped. The treatment begins as if it were a regular filling. A small access opening is made in the top of the tooth to expose the nerve tissue. There are specific tools called endodontic files that are used to remove internal tissues. They have a standardized size. We take x-rays on the way.
The goal is to file the canals along the roots to within 0.5mm of the root tip. Front teeth usually have one root, premolars two, and molars three. In some cases, a tooth may have an extra canal that goes beyond normal. When we start cutting the tissue, we take the necessary x-rays to determine how close we are to the top of the roots. The files are available in carefully standardized formats. They are randomly classified in 08, 10, 15 etc up to size 55. As we progress we enlarge the canals to remove all the soft tissue.
I am using a file system that resides on a handpiece. It is an addition to the use of hand files. It removes tissue while cleaning the inner aspect of the pulp chamber and canals. Once we are satisfied that we have cleaned the canal to the ideal length and width, we use a material called gutta-percha, which is also a standardized material in terms of dimensions. A 30 gutta-percha material is equivalent to a number 30 file.
We close (fill) the canal to the top or end of the root. Then we fill the channel three-dimensionally so that the oval channel is completely filled. A tooth treated with a root canal can become weak. We use a strong filler material for several months.
Root canal treatment is a proven and effective way to preserve your dentition in circumstances where the loss of a tooth would be undesirable. If you have questions ask your family dentist.
This is done to allow us to retire a channel in the event of an unexpected response. This is a rare event. After 6 months we recommend a crown (cap) to keep the tooth intact as it is prone to fracture. Root canal treatment is a proven and effective way to preserve your teeth in circumstances where the loss of a tooth would not be desirable. If you have any questions, ask your family dentist.
We use a strong filling material for several months. This is done to enable us to retreat a canal in case it has an unexpected reaction. This is a rare occurrence. After 6 months we suggest a crown ( Cap) to help keep the tooth intact as they may be prone to fracture. Root canal treatment is a proven and effective way to preserve your dentition in circumstances where the loss of a tooth would be undesirable. If you have questions ask your family dentist.