When a tooth has undergone heavy damage from decay and bacteria has infected the tooth, a root canal treatment is performed to remove the bacteria infection and save the tooth, as opposed to removing the whole tooth. This article explains everything you need to know about root canal treatment.
What is a root canal treatment and when is it performed?
The root canal system is the network of canals within a tooth that contains the pulp. A root canal treatment, also known as endodontic treatment, is a dental procedure that involves removing the inflamed or infected pulp from the inside of a tooth. The pulp contains nerves blood vessels and connective tissue, which can become infected due to deep decay, repeated dental procedures, or a cracked tooth. A root canal treatment is a complex procedure performed to remove inflamed or infected dental nerve tissue from the inside of a tooth, thereby stopping any pain.
The dental pulp is the innermost layer of a tooth and it contains the nerves and blood vessels. On the outside, our teeth are protected by a hard, mineralized layer known as the enamel. Between the enamel and the pulp is the softer dentin, which contains nerve endings originating in the pulp.
When a tooth has extensive cavities or if it gets damaged as a result of an accident, the nerves and blood vessels in the dentin and pulp become exposed to the oral environment, which may cause sensitivity to cold or hot. This problem, if it is superficial, can be treated by simply restoring the tooth with a filling.
However, if this situation persists, damage to the tooth continues and ultimately the pulp tissue becomes inflamed. When this happens, there tends to be severe, continuous pain which does not go away, even after taking pain medication. At this stage, to save the tooth from extraction, an option would be to perform a root canal treatment.
What are the signs that you need a root canal treatment?
The following symptoms may indicate a dental infection, if an infection is left untreated, it can lead to severe complications, including the need for a root canal treatment.
- Pain – The pain associated with inflammation of the pulp tissue is severe and continuous. In most cases, the pain is so severe that forces the patients to visit their dentists in an emergency.
- Chewing Pain – In advanced cases, patients may feel severe pain whenever they bite on food with the affected tooth.
- Swelling – Inflammation of the pulp tissue can also lead to swelling of the soft tissues around the affected tooth.
- Pus – In some cases, pus can be seen oozing out of the soft tissues surrounding the damaged 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.
- Tooth Sensitivity - Prolonged sensitivity to hot or cold temperatures.
If you feel that you are suffering from some of the above-mentioned problems, then it is important to see your dentist immediately to avoid permanent damage to the tooth. Regular dental exams can help identify potential problems early on, which may prevent the need for a root canal treatment.
How is Root Canal Treatment Performed?
Root canal infection treatment is usually performed in 2-3 appointments of 1 hour each. Some of the steps involved in root canal treatment include the following.
1) Imaging and Treatment Planning
First, your dentist will perform a clinical examination and test the tooth as well as the neighbouring teeth to rule out any other issues.
X-ray images of your teeth may be taken to visualise the extent of the infection as well as the shape and number of the roots of the affected tooth.
During the first stage of root canal treatment, the infected pulp is removed from the tooth's pulp chamber under local anesthesia. At this point, we will put an antibacterial medicament inside the tooth, followed by placing a temporary filling or crown to seal the area while the medication takes effect.
During the next appointment, we will remove the temporary filling or crown and the medicament to assess the healing. We will also use special instruments to remove the infected pulp from the
tooth crown and root canals, which will then be thoroughly cleaned and disinfected to remove any remaining bacteria and prevent future infection.
After thoroughly washing and disinfecting the tooth's interior, we will seal the root canals with a material called gutta percha. If required, our dentists will place the medicament again to ensure proper healing.
Once sufficient healing has taken place, we will thoroughly clean and dry the tooth’s interior, and then seal it up with an inert material. This is done to prevent future chances of infection.
Finally, when the surgical site has healed completely, our dentists will restore the tooth with a permanent core buildup which serves as a foundation for the final crown restoration. A post may be necessary if the tooth is badly broken down, and it is used to support the core.
This can be done at the same time as the obturation visit of the root canal treatment. We usually recommend a ceramic or zirconia crown as they preserve more of the tooth structure compared to metal ceramic crowns. Read more on
dental crowns at Dental Designs Clinic.
Related Articles
Misconceptions About Root Canal Treatment
- Root Canal Treatment is Painful - Modern techniques and anaesthesia make root canal procedures relatively pain-free.
- It's Better to Extract the Tooth - Preserving the natural tooth is always preferable to extraction, which can lead to other dental issues.
- Root Canal Treated Teeth are Fragile - With a proper restoration like a dental crown, treated teeth can last a lifetime.
Reinforcing the Tooth
Teeth that require root canal treatment tend to have very little tooth structure remaining, due to the previous decay or damage. Therefore, they must be reinforced by using a crown, which covers the entire top and sides of the tooth. Reinforcing the teeth with crowns becomes even more important for the back teeth, which undergo very high chewing forces. Otherwise, weakened teeth may fracture as a normal filling is not strong enough to protect the tooth.
If the tooth fractures and exposes the root canal filling, the whole root canal may need to be redone as infection may have penetrated the tooth. Therefore, we always recommend that the crown be done immediately after the root canal treatment to protect the tooth.
At Dental Designs Clinic, we make every attempt to save each tooth from extraction, so that you may continue to use your teeth. In some cases, if the tooth is too badly broken down, extraction or tooth removal may be necessary. We can help with the replacement of the tooth by using a dental bridge, or a dental implant.
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References
- Segura‐Egea, J. J., Cisneros‐Cabello, R., Llamas‐Carreras, J. M., & Velasco‐Ortega, E. (2009). Pain associated with root canal treatment. International endodontic journal, 42(7), 614-620.
- Matsumoto, T., Nagai, T., Ida, K., Ito, M., Kawai, Y., Horiba, N., ... & Nakamura, H. (1987). Factors affecting successful prognosis of root canal treatment. Journal of endodontics, 13(5), 239-242.