Root canal treatment (RCT) is a treatment done to repair and preserve a badly damaged or infected tooth instead of removing it. Most people have little if any pain during a root canal, as it is done under local anesthetics. In fact, it's probably more painful living with a decayed tooth. Root canal alternatives include extracting the damaged tooth, no further treatment, or replacing the natural tooth with prosthesis like a dental implant, bridge or removable partial denture.
Why you may need a root canal
Teeth have a soft core called dental pulp. The pulp extends from the crown — the visible part of the tooth — to the tip of the tooth's root in the jawbone. The pulp contains nerves, blood vessels and connective tissue. When a tooth is cracked or chipped or has a deep cavity, bacteria can enter the pulp. Injury to the tooth also can cause pulp damage and inflammation. Left untreated, bacteria and decaying material can cause a serious infection or a tooth abscess, leading to pulp death, bone loss and loss of the tooth itself. Signs and symptoms may include swelling around your face and neck, a hole in your tooth, toothache or tooth pain, gum swelling, and sensitivity to hot, cold and sweets.
Getting started on root canal treatment
A root canal is usually done by an endodontist (Dentist with specialization on root canal treatment). The root canal treatment can be done is either single visit or may take multiple visits, additional visits are required sometimes because some teeth prove difficult to treat. First, you have dental X-rays to check the extent of damage and see possibility of saving the tooth. You also receive a local anesthetic to control pain during the procedure. Decay is removed, and an opening is made through the crown of the tooth to gain access to the pulp chamber. Using small dental instruments, the infected or diseased pulp is removed.
Clearing up root canal infection
After the diseased pulp is removed, the pulp chamber and root canals are flushed and cleaned. The root canals may be reshaped and enlarged to allow better access for filling. Before permanently filling the root canals, they are cleaned of all infection and dried. Medication is sometimes put into the pulp chamber and root canals to clear any infection. If infection has spread you may need a prescription of antibiotics. After root canal therapy, a temporary filling is placed in the crown to protect the tooth and keep out debris and saliva. Avoid biting or chewing on the tooth until it's been permanently treated and restored.
Filling the root canals
After cleaning and drying, it's time to fill the interior of the tooth — the empty pulp chamber and root canals. You may not need additional anesthetic for this step. If you had a temporary filling, it will be removed to allow access to the inside of the tooth. A sealer paste and rubber compound is used to fill the tooth, followed by a dental filling to make sure the root canals are protected from saliva.
Final stage of a root canal
The final stage of the root canal is restoring your tooth. Because the tooth typically has a large filling or is weakened from extensive decay, it needs to be protected from future damage and returned to normal function. This is usually done by placing a crown — a realistic-looking artificial tooth — over your tooth. A crown is typically made of metal, porcelain or porcelain fused to metal, but other materials may be used. Crowns made of porcelain or porcelain fused to metal can be tinted to match the color of your other teeth. Sometimes, a metal or fiber post must first be inserted in the tooth for structural support and to keep the crown in place if there is significant tooth structure missing. You can ask your endodontist about other restoration options.
After your root canal
After your root canal, your restored tooth with the new crown should work like a natural tooth and look cosmetically pleasing. If you follow good dental and oral hygiene, your restored tooth could last a lifetime. The first few days after your root canal, the tooth may be sensitive and mild pain can occur for few days which may need some analgesics and anti-inflammatory agents. If pain, swelling or pressure lasts more than a few days, be sure to talk to your endodontist.
DR. ADARSH KHANAL (ENDODONTIST)
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