Root Canal Treatment
Root canal treatment (endodontic treatment) is required when you have a
tooth infection. When
you have an infection, your body sends white blood cells and antibodies to
the infected area to kill the bacteria. The tissue becomes red and swells.
When you have an infection in your tooth, there is no room in the
canal space for extra antibodies or white blood cells. When the tissue
attempts to swell, it chokes itself and dies, and then it becomes a
perpetual source of infection, called a tooth abscess, spilling into the bone tissue around the end
of the tooth.
In endodontic treatment, the dentist removes this dead or diseased
tissue, cleans the inside of the tooth thoroughly, and then places a
sealer material inside the tooth. It's important that the tooth be filled
to the very end of the apex of the tooth.
This treatment is generally not difficult for the
patient, and pain after root canal is often not a large
issue, in spite of its
reputation. In my experience as a dentist, a
tooth extraction appointment
was the most traumatic for the patient, by far. Many of these appointments
were very easy, and with some, we didn't even need novocain to keep the patient
comfortable because the tooth was dead and had no feeling in it. Yet some people
are so afraid of endodontic treatment that they choose to have a tooth extracted
instead, which ends up being much more stressful for them than if they had the dentist save
the tooth.
Other information related to root canal treatment:
An explanation of some root canal treatment terminology
The tissue inside your tooth is called the pulp. The pulp tissue is
responsible for most of the formation of your tooth. It is present well
before the tooth erupts in your mouth. The tooth actually grows from the
outside in. As the tooth grows, your pulp tissue shrinks.
Once your tooth is fully formed and has erupted, the pulp tissue
remains and performs a sensory function. If your tooth becomes irritated,
it is the pulp tissue that senses this. Even a small cavity can sometimes
cause inflammation in the pulp. The larger the cavity, the more the
irritation. You may have sensitivity to cold or
to air. It's a warning system that something is wrong.
If the pulp tissue becomes infected, the toothache can become severe and
constant.
There are two parts to this pulp tissue. One part is in the crown or the
visible part of your tooth. This pulp is in what is called the pulp
chamber. This pulp tissue extends into narrow passageways in the roots of the
tooth. These passageways are the root canals. At the end of the root is an
opening to the bone. A blood vessel and a nerve come from the bone and
into the tooth and supply the tooth with sensation and nourishment. The
very tip of the tooth is called the apex.
These endodontic treatments do not need any maintenance and they are very
durable. Once it is successful, it will never wear out or need any further
attention. It could last you the rest of your life.
Problems with root canal treatments are caused by the dentist's inability to either
completely clean out the inside of the tooth all the way to the apex,
because of obstructions or curves, or an inability to completely seal the
apex of the tooth, thus allowing leaking of living material into the tooth
that can become a further source of infection. If this
happens, it is called a failed root canal.
A failure can be treated with root canal surgery, or the tooth can be
extracted. An apicoectomy is the most common
surgery. Fortunately, failures don't happen very often. Maybe 10% of
these treatments are failures.
Endodontic
treatment is more difficult with back teeth than with front teeth. A
root canal on a front tooth is
the simplest. A front tooth has only one root, where back teeth can have
up to four. The root is generally straight, as opposed to curved roots on
back teeth. And the access and visibility for a front tooth is much
easier. Problems with endodontic treatment usually occur with back teeth.
Read Dr. Hall's blog posts about
root canals, where he
answers questions from visitors.
