Endodontics

Root Canal Treatment

Root canal treatment, also known as endodontic treatment is a dental procedure in which the diseased pulp tissue is removed and the inside of the tooth is cleaned and sealed with a special filling material.

To understand about root canal treatment, you need to know the basic structure of the tooth. A tooth has two main parts: a crown portion and a root portion. Crown is the part of the tooth which is seen in the mouth and root is the part of the tooth which is inside the jaw bone. Inside the crown and root there is a soft core of tissue known as pulp that contains blood vessels and nerves. In the crown, the pulp is present within a chamber called the pulp chamber and it travels down the length of the root to the tip (or apex) called the root canal.

When tooth decay has progressed far enough into the pulp you may have severe toothache, sensitivity to heat or cold, pain with biting or pressure, tooth discoloration, and swelling around the affected tooth. These symptoms may indicate the need for a root canal treatment where the pulp of a tooth is treated in an effort to maintain a healthy tooth. The aim of root canal treatment is to save a tooth that is severely damaged due to decay or injury.

Indications

The most common indications for root canal treatment include:

• Trauma to the tooth that exposes the nerve
• Severe tooth decay that extends into the pulp
• Infected pulp that causes an abscess (an accumulation of pus in the teeth or gum tissue).
• Break or crack in the tooth that extends into the nerve of the tooth
• To save the dying tooth due to aging or previous trauma

Procedure

Root canal therapy can be performed in one or more appointments. It is performed in a dental clinic under local anaesthesia. For an infected or abscessed tooth, antibiotics are started before completing the root canal.

The first step in the procedure is to take an X-ray that displays the entire tooth to see the shape of the root canals.

Next, to keep the area dry and free of saliva during treatment, a rubber dam is placed around the tooth. The rubber dam is a sheet of latex or non-latex material. The main function is to isolate the tooth being treated and also to keep the different chemical solutions from falling to the back of the throat.

Using a dental drill, an opening is created in the tooth to reach the infected pulp area.

Then, the infected contents of the pulp chamber are carefully removed using root canal files. A series of root canal files of increasing diameter are subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. It is necessary to remove the entire nerve in order to prevent re-infection and toothache after the procedure.

Frequent irrigation of the root canals is done using sodium hypochlorite to flush away the debris.

Once the entire tooth is completely cleaned, it is dried with tiny absorbent paper points.

After the canals have been dried, they are filled with a rubber like substance called gutta percha. The purpose of this filling material is to seal the canals inside the tooth.

The tooth is then restored with a permanent filling material.

Root canal treated teeth tend to become brittle and can break because the blood supply to the tooth is removed during the procedure. Therefore, after a root canal treatment the tooth should be protected with a crown. The purpose of the crown is to prevent the tooth from breaking in future.

After the Procedure

After the completion of the root canal procedure you may have some discomfort for a few days which can be controlled by over-the-counter pain medications. Brush and floss regularly, avoid chewing hard foods with the treated tooth, and see your dentist regularly. It is advised to minimize chewing on the tooth under treatment until the procedure is completed to avoid recontamination and also to prevent a fragile tooth from breaking.

Complications

As with most dental procedures, complications can occur. After root canal treatment new infections may occur from:

• An undetected crack in the root of the tooth
• Defective dental restorations
• A missed root canal (leaving one of them uncleaned)
• Breakdown of the inner sealing material over a period of time

All these causes can result in failure of root canal treatment.

Summary

Your natural teeth allow you to eat a wide range of foods that are required to maintain proper nutrition. For a severely damaged tooth, a root canal procedure is the treatment of choice to save the tooth that would otherwise be lost. Root canal treatment is a highly successful procedure and many teeth fixed with a root canal can last a lifetime with proper care.