What Is Root Canal Treatment?

Root canal treatment, often referred to as a root canal, is a dental procedure designed to treat inflamed or infected pulp within the tooth. This treatment is essential for preserving natural teeth that might otherwise need to be extracted due to severe decay or infection. Discover the ins and outs of root canal treatment and how it can save your natural teeth.

Understanding the anatomy of the tooth

The tooth comprises three crucial elements:

• Enamel, the resilient outer layer
• Dentin, the softer middle layer
• The dental pulp
  

Enamel acts as the tooth's armour, offering robust protection as the most rigid layer. With its high mineral content, decay progresses slowly through this shield, providing significant defence against damage.

Dentin, located in the tooth's middle layer, is softer and more susceptible to decay due to its lower mineral content. Nerve endings connected to the pulp can make the tooth sensitive to hot or cold sensations, signaling potential issues. In some instances, a decayed tooth can be saved through filling procedures. 

Dental pulp, nestled at the tooth's core, houses the nerve and blood vessels in a canal-like structure. This essential component provides the tooth with vital nutrients and a blood supply and keeps it alive!  

What is a root canal treatment?

Root canal treatment or endodontic procedure is an advanced dental procedure performed to remove the inflamed or necrotic pulp (infected pulp tissue from the pulp chamber) from a severely decayed or infected tooth. The root canals are then cleaned, disinfected and filled with a special material to prevent further infection.

When an infection is left untreated, it can lead to serious issues like pulp inflammation or infection within the tooth. The pulp, located beneath the white enamel and crown of the tooth, can become damaged, often requiring treatment. If the pulp damage progresses, the infected pulp is removed to save the tooth and prevent further complications. 

The tooth pulp consists of blood vessels, nerves and connective tissue that can become inflamed or infected due to deep decay, repeated dental procedures or dental trauma. If the decay is superficial, tooth-filling material such as composite can be used to restore it.

Recognising the significance of root canal treatment is crucial as it not only relieves pain but also preserves your natural teeth, preventing the need for tooth removal. This procedure boasts a remarkable success rate, making it a highly effective solution for dental issues.

What are the signs that I might need a root canal treatment?

Several signs may indicate the need for root canal treatment. Recognising these signs and seeking dental attention immediately is essential to prevent further damage to the tooth and surrounding tissues.  

Pain

The severe toothache or pain associated with an inflamed pulp may be throbbing or sharp. In most cases, the intensity of the pain may be so severe that it requires immediate attention and emergency treatment. 

Swelling

In some cases, when the infection has spread to the surrounding tissues, a pimple-like bump is seen on the gums near the tooth. Some even experience a foul taste or odour in the mouth. These symptoms may indicate that the tooth's pulp is infected or damaged and can also be associated with tooth discolouration! 

Pus

As infection builds up in the soft tissue, it may ooze out as pus discharge from the pimple-like swelling near the teeth of the affected tooth.

Loose tooth

When the infection from the pulp travels to the structures surrounding the damaged tooth, the periodontal tissue, which anchors the tooth to the bone, gets destroyed. As a result, the tooth becomes loose and may ultimately fall off if treatment is not sought promptly.

If you notice any of these signs, it is essential to schedule an appointment with your dentist before your teeth suffer from further permanent damage.  

The Process of Root Canal Treatment

The root canal treatment process involves several steps and may require around 2-3 visits of 1 hour or more each, depending upon the case's complexity. 

1) X-ray imaging and treatment planning

First, the dentist will perform a thorough clinical examination, which may include a few tests such as dental x-rays to determine the extent of the infection to determine whether the tooth is alive. The dentists might follow up by radiographically assessing the tooth through different imaging modalities to rule out other possibilities and visualise the extent of the infection and the shape and number of the roots of the affected tooth.

2) First coot canal visit

After numbing the tooth, the dentist will access the pulp chamber to remove the pulp. At this point, an antibacterial medicament is placed inside the tooth, and the access is sealed with a temporary filling while the medication takes effect.

3) Second stage of RCT: Cleaning, shaping and filling the canals

In the second appointment, the temporary filling and medicaments are removed to assess the healing. The root canals are then shaped further with special instruments and cleaned using a root canal disinfectant solution to prepare them for filling.

Once the canals are shaped, they are filled with a rubber-like biocompatible material called gutta-percha. This material seals the canals and prevents bacteria from re-entering. Sometimes, a temporary filling is placed to seal the opening until a permanent crown can be placed.

4) Permanent restoration and crown placement

The final step of the process is restoring the tooth with a crown or permanent restoration such as filling. This strengthens the tooth and protect it from further damage. This can be done at the same time as the root canal filling visit.

Root canal treatment may require multiple visits but it is a remarkably effective method to preserve a tooth that might otherwise have to be removed.

How do I care for my root canal treated tooth?

The success of root canal treatment depends on how well you take care of it after the treatment is completed. Here are some aftercare tips:

• Practicing good oral hygiene, such as brushing and flossing daily, is crucial in preventing infections and maintaining healthy teeth. Regular care helps protect the crown of the tooth and prevents the need for more serious interventions.
• Do be careful in chewing on hard or sticky foods. Avoid chewing on the treated tooth until it is fully restored with a permanent crown.
• Schedule regular dental check-ups: Visit your dentist regularly for check-ups and professional cleanings. This will help monitor your treated tooth's health and identify any potential issues early on.
  

By following these aftercare advise can help make sure your root canal treatment is successful and helps assure longevity.

FAQS

How do I know if I need root canal treatment?

Ans: If your teeth are severely decayed or damaged and the pain does not resolve after taking over-the-counter painkillers, root canal treatment can be done to save the tooth instead of removing the teeth. For more information, check out our other article on Why you need Root Canal Treatment. 

Can I eat after root canal treatment?

Ans: You can eat soft food that requires less chewing like soft bread, eggs or fish. It is advised to avoid hard, chewy and hot food after the treatment as you may bite on your lips, which may be numb due to local anaesthesia.

Do I need to crown my teeth after Root Canal Treatment?

Ans: Removing the inflamed dental pulp and filling the root canal can make the tooth more fragile, increasing the risk of chipping or breaking with excessive biting force. The position of the tooth also plays a crucial role in this especially in the posterior region, like premolars or molars. These teeth are essential for chewing and may be more prone to damage when biting into hard foods. This risk is less common in teeth located in the anterior region.

What happens if you do not get root canal treatment?

Ans: This could spread the infection from the tooth to the surrounding soft tissues, potentially causing facial swelling and leading to serious health complications.

Is it better to have root canal treatment or extraction of the tooth?

Ans: Preserving natural teeth rather than extracting them is highly recommended. However, the decision also depends on the patient's preference for treatment and financial considerations. Patients should be aware of the possible consequences of not replacing a tooth after extraction.

References 

1. Treatment Outcome and Root Canal Preparation Techniques: 5-Year Follow-Up | 
   John O Makanjuola , Olabisi H Oderinu , Donna C Umesi  
   https://pubmed.ncbi.nlm.nih.gov/36153168/

2. Theory and practice of minimally invasive endodontics
   H W Jiang 
   https://doi.org/10.3760/cma.j.issn.1002-0098.2016.08.004

3. Endodontic management of badly broken down teeth using the canal projection system: two case reports |A S Bhomavat, R K Manjunatha, R N Rao, K H Kidiyoor
   https://doi.org/10.1111/j.1365-2591.2008.01465.x