Root canal treatment (endodontic treatment) typically involves the repair of a tooth that is infected or has a dying nerve, with the aim of saving it. It is usually a straightforward procedure that can also help relieve dental pain. In the traditional clinical setting, root canal procedures were painful but in the modern day setting, technological advances in the dental field ensure that a majority of people experience minimal or no pain at all with the procedure.
A root canal treatment is performed to relieve inflammation and infection in the root of a tooth. In the procedure, the nerve (pulp) is extracted and the dentist then cleans the inside of the tooth, disinfects it and fills it up. Usually 2 or 3 visits are required to complete the treatment. It is important to note that failure to treat such teeth often results in the tooth getting an abscess.
What Causes Infection?
Infection in the tooth is usually a result of the bacteria already present in the mouth. Decay reaching the nerve, damage to teeth due to trauma (e.g. a cracked tooth), or leaky fillings are the main reasons for root canal treatment being required.
Structure of the Tooth
Before understanding what the root canal procedure entails, it is imperative to gain an understanding of the tooth structure. A tooth is usually composed of two parts: the crown is the part usually visible in the mouth, and the root is a section that fuses into bone acting like an anchor for the tooth, thus, keeping it in position. Teeth also have:
- Enamel which is the tough outer coating
- Cementum which is the hard outer coating of the surface of the root
- Dentine which is a softer material supporting the enamel and usually forms most of the tooth
- Dental pulp which is typically the soft tissue at the core of the tooth
Where is The Root Canal?
The root canal is a natural cavity at the centre of a tooth. The pulp housed within the pulp chamber is characterised by a soft section within the root canal which has nerves, connective tissue, and blood vessels. The nerve of the tooth is not considered critical to the function and health of a tooth that has already emerged through the gums. Typically, the nerve’s function is to sense cold or heat. Therefore, living without a tooth nerve does not interfere with the everyday quality of life.
How to Know if Treatment is Needed
The most common warning sign that it is time for a root canal is a toothache. Dentists can further determine the need for root canal treatment through x-rays. If x-rays can show that the pulp has been damaged due to infection by bacteria, then a root canal is recommended. There are certain symptoms of pulp infection when the tooth is alive including pain when consuming hot or cold drinks or food, pain during chewing or biting, and a loose tooth. Most people tend to think that a tooth has healed after some time because such symptoms dissipate when the pulp dies.
However, the infection subtly begins to spread to the root canal. It is then that the individual can get a relapse of the symptoms including pus, facial swelling, and the tooth becoming dark in colour. Also, the individual may experience swelling of gums near the infected tooth, loosening of teeth, and unprovoked and spontaneous pain.
It is vital to see a dentist if one develops a toothache because an infected tooth and pulp, do not heal on their own. Leaving the infected tooth can make it difficult for the root canal treatment to work. Further, the use of antibiotics does not treat root canal infections permanently.
How the Procedure is Done
The entire procedure is performed while the patient is under a local anaesthetic. Consequently, it is not painful. The first step involves the dentist administering local anaesthesia. The dentist then accesses the inside of the tooth using a miniature drill with the aim of accessing the infected area.
To treat infections in the root canal, the bacteria are first removed using small files to clear damaged and diseased pulp. The files are then used to shape the inner chamber of the tooth and irrigants are used to get rid of remaining pulp debris. Antimicrobial solutions are then used to destroy any remaining bacteria. Finally the root canal is filled using a rubber like material.
The open chamber is then filled and the tooth is prepared for a permanent crown after a few weeks. The crown can be made of gold, porcelain mixed with metal, or porcelain. Usually, the crowns formed from porcelain can be customised to match the colour of the other teeth. The inflamed tissue heals naturally and the restored tooth can last a lifetime.
Even though tooth removal is not advisable, it is at times performed. However, the recommended form of treatment is the one that aims to preserve as many natural teeth as possible. Therefore, tooth extraction is the last resort.
Why Treatment is Vital
Following the damage of the pulp or nerve, a tooth typically begins to break down, subsequently, leading to a proliferation of bacteria that rapidly multiply in the pulp chamber. What follows is that the bacteria and decayed debris result in an abscessed tooth.
The abscess is a pocket filled with pus that forms at the end of the tooth roots resulting in an infection that spreads beyond the roots of a tooth. Usually, the abscess results in bone loss at the root tips, and swelling that can spread to the head, neck, and face. Therefore, root canal treatment is not just about treating pain but it also helps preserve the health of the mouth.
Personal Care After Treatment
Although root canal treatments involve removal of nerves, it is imperative to note that the tooth still has nerve endings that could easily be irritated and inflamed after treatment. It is advisable to chew food on the opposite side of the mouth until the affected area is completely healed. Good oral hygiene and regular checkups are also vital to maintaining a healthy mouth and teeth after such procedures.