Root Canal Treatment
What is meant by root canal treatment?
Known as an endodontic therapy or root canal treatment is a procedure where the dead pulp is taken out from the tooth with this process being done by an endodontist as a specialist in the field of Endodontics which is a branch of dentistry. With years of experience and knowledge, an endodontist has the expertise to treat a root canal problem so that the original tooth can be restored. The dental pulp is found in the centre of the tooth as a soft tissue which contains the lymph and blood vessels including the nerves. If the pulp is affected by disease, injury, a deep cavity or a fracture, it results in exposure to bacteria and dies. The inflamed pulp is removed by the endodontist who cleans shapes and sterilizes the area besides filling the empty cavity with gutta-percha and a dental sealer to avoid further infection. In some cases, a restoration which is complex is done or a crown is placed that protects the tooth.
How does dental pulp get infected?
Bacteria is commonly present in the mouth but when it enters a tooth or teeth through filling that is old and broken down, decay, a gap and/or a fracture, it becomes pathologic or diseased in nature. In some cases, the condition deteriorates quickly and in others it is slow to manifest. An endodontist or a general dentist will clean, fill and seal the chamber of the tooth after removing the infected pulp.
What is the process of a root canal procedure?
The endodontist would numb the tooth area and place a rubber dam. An opening would be made through the crown of the tooth and the pulp would be removed. The canal or canals would be cleaned with files or small dental instruments that would be alternated with irrigants using hand-held or mechanical instruments. The canal would be shaped to the desired size and filled with an endodontic sealer and gutta-percha. The cavity would be filled with a temporary filling that may contain medications to heal the tooth and left open for the infected liquid to drain. The dentist would prescribe antibiotics to help in preventing infection. The next visit would involve removal of the temporary filling and replaced by a permanent one along with placement of a porcelain or gold crown according to preferences.
Why is gutta-percha used?
As the nerve system is removed along with the pulp in the tooth during the process of root canal treatment, the cavity is cleaned, shaped and filled with a dental sealer and gutta-percha. Gutta-percha is the milky juice extracted from the Malaysian trees that is purified and transformed into a thick rubber-like substance that is ADA certified and approved material that can be used as a dental filling for root canals.
Does a tooth or teeth that have undergone root canal treatment need to be recapped?
Yes, it is very necessary as the root canal treatment renders the tooth as dead or cannot be used to its full capacity as was the case earlier. So this in turn makes the tooth brittle and prone to discolouration with the ability to fracture faster which would lead to complications. In order to enhance the appearance of the tooth and restore its contour and shape, the tooth or teeth that have gone through the root canal treatment have to be capped to prevent fracturing and to help to better the patient's bite and the capability to chew normally.
Who are the candidates for endodontic therapy or root canal treatment?
Patients who have a root canal problem have a flash of pain in their tooth, pain when biting or chewing food, an ache in the tooth that is dull and a sudden pain that wakes one up at night. People who have root canal symptoms are sensitive to hot or cold foods or beverages that last for some time, a tooth that shakes or is loose, a lasting pain that extends over four to six weeks after replacement of a filling or after a filling and a tooth or teeth that is particularly more sensitive than the others. Patients who have a continuous pressure or chronic pain that is spread over the ear, neck and eye. In some cases, there may be a pimple or a bubble on the gum which when pressed may let out blood or pus and may not be particularly painful or if the dentist has diagnosed and recommended root canal treatment after examining a X-ray or by a clinical exam.
What is the benefit of root canal therapy and why is it better than extraction?
It is important to retain one's teeth as the loss of a tooth may lead to other dental problems. Root canal therapy has the benefit of helping to retain or keep one's teeth or tooth intact while extraction of a tooth or teeth results in TMJ pain, teeth that drift or move, bite problems and dental treatment of adjacent teeth which were originally normal in nature.