Years ago, diseased or damaged teeth were removed. Today, modern dental techniques are able to save your teeth. One of the most common approaches to saving teeth is called Root Canal Therapy or in dental terminology, Endodontic Treatment.
Endodontics means inside (endo) the tooth (dontia). the dental pulp is the tissue (composed of nerves, blood vessels, etc.) that is contained inside the tooth. It's primary function is (a) the development of the tooth and (b) the sensation or feeling in the tooth. the specialty of endodontics is devoted to the biology, physiology, pathology and treatment of the human dental pulp.
Root canal therapy is generally necessary when the pulp, which contains the nerves and blood supply of the tooth, is diseased or damaged. The disease or damage may be caused by a number of situations. For example, bacteria from a deep cavity can enter the pulp and cause infection. Or, the tooth may be injured in such a way that the blood supply is ruptured or the nerve damaged. A third possibility is a fracture of the tooth itself which exposes the pulp to bacteria normally found in the mouth. A fourth possibility would be gum (periodontal) disease so severe that it causes infection of the pulp, too.
The most common reasons a tooth develops infections are:
Dental decay (large deep cavities)
Accumulative effects of placing several filling over time
Restorative insults to teeth (drilling, heat and desiccation)
Traumatic injury (accident)
All of these conditions can cause severe toothaches. Or, deterioration of the pulp may happen so gradually that it is nearly painless. In any event, when these situations exist, the tooth should be treated by root canal therapy, or it will be lost.
What is involved in root canal therapy?
The first step taken will be to remove the pulp tissue and carefully clean the pulp chamber and root canals. This is done through a small opening in the crown of the tooth. (If you are experiencing severe pain from the tooth, this will usually provide dramatic relief.) Once the tooth has been cleaned, medicine is then placed in the tooth and it is temporarily sealed. However, if severe infection is present, we may leave the tooth open for a few days to promote drainage. We may at times prescribe an antibiotic to help control the infection.
If a cyst or large area of infection is present at the tip of the root, it may be necessary to remove it surgically. This is called periapical surgery (or an apicoectomy) and is done through the gum.
The treatment program generally will be finished in one to five appointments depending on the tooth and its condition. When we are sure the tooth is free of infection, we will fill the inside of the tooth and canals with gutta-percha, a rubber-like material, to prevent bacteria from entering the tooth. Once this is completed, the tooth should be restored and strengthened with a crown.
The reason you need a root canal can be placed into two broad categories of infection:
1. Vital infection:
The dental pulp has become diseased and inflamed yet the tissue is still alive and vital. the damage (most often indicated by unusual sensitivity to temperature changes or a sever toothache) is so advanced that the condition of the pulp tissue is not expected to get better. This irreversible problem requires removal of the dental pulp, hence a root canal.
2. Non-vital infection
The dental pulp has already become dead tissue. This tooth will no longer respond to temperature changes and sweets. The dead pulp tissue, debris and bacteria on the inside of the tooth affect the bone and cause infection outside the tooth at the tip of the root(s). Symptoms most commonly associated with non-vital infection are a tooth that hurts to bite on, becomes sore to touch or occurs. An x-ray will help in the diagnosis of this problem, but only when the infection is so advanced as to cause an abscess of the bon around the root tip of the tooth.
The treatment of either of those tow categories of infection is largely the same in routine cases. The treatment options are toot canal therapy or extraction of the offending tooth. Root canal therapy is the treatment of the inside of the tooth so that the source of the infection, or the source of inflammation causing the dental pain can be removed. The tooth is then protected from the problem recurring in the future.
The goal of root canal therapy is to create an environment inside the tooth to allow the infection to heal and remain symptom free. This environment should be as sterile as possible, removing all tissue debris and bacteria to the tip of the root. The space must then be filled with an inert material to maintain this clean space.
Will the treatment be painful?
Many of the treatments can even be done without local anesthesia. However, if we anticipate any discomfort, a local anesthetic will be given. Sometimes there may be temporary irritation of the tissues surrounding the tooth following treatment. You will be advised of medication to control this. Should you develop any severe swelling, or increasing pain, you should contact us.
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