Whose knees do not quake at the thought of a "root canal?" Pain and cost spring to mind. But how many of us even know what a "root canal" is?
Root canal therapy, also known as endodontic therapy, is a dental treatment for removing infection from inside a tooth. It can also protect the tooth from future infections.
It is carried out in the pulp of the tooth, which is the root canal.
Contents of this article:
- What is a root canal?
- What is root canal treatment?
- How painful is root canal therapy?
- What is a tooth made up of?
- When is root canal treatment needed?
- Root canal therapy, extraction or implant?
- What are the steps?
- What is the cost?
- Root canal therapy complications
- How to avoid needing invasive dental treatment
What is a root canal?
A "root canal" is not really a treatment, but part of a tooth. It is the hollow part inside a tooth that contains the nerve tissue, blood vessels, and other cells.
Toothache can be extremely painful, but root canal treatment can relieve the pain.
The name of the dental procedure is actually endodontic therapy, which means "inside the tooth."
However, the term "root canal" has come to be commonly used to talk about the procedure.
What is root canal treatment?
Root canal therapy involves removing everything that is inside the root canal.
The dentist then cleans, shapes and decontaminates the hollow area, using tiny files and irrigation solutions.
Next, the dentist fills the tooth with a rubber-like material and a special cement which seals all the canals.
After root canal therapy, the tooth is dead. The patient will no longer feel any pain in that tooth because the nerve tissue has been removed, and the infection has been eliminated. Once the root canal is completed, a permanent filling or crown is needed to protect the tooth.
How painful is root canal therapy?
One of the great fears about this kind of treatment is that it will be painful, but if the treatment is carried out by a trained dental surgeon, it should be relatively painless.
The pain that is felt comes from the infection and not from the treatment. The treatment does not cause pain; it helps to alleviate it.
The dental surgeon will relieve the pain of the procedure by numbing the tooth and surrounding area with local anesthesia.
After the treatment, some tenderness is normal. It is temporary, and over-the-counter (OTC) pain medication may be enough to relieve it. If needed, prescription drugs, such as codeine, are available.
The dentist may prescribe an antibiotic to treat or prevent infection.
What is a tooth made up of?
A tooth consists of a crown and roots.
The root canal forms the pulpy core of a tooth.
The crown is mainly above the gum, while the roots are below it. The roots attach the tooth to the jawbone.
Inside the crown and the root, or the root canal, is the pulp. The pulp contains soft tissue with nerves and blood vessels. It nourishes the tooth and provides moisture to the surrounding material. The nerves in the pulp sense hot and cold temperatures as pain.
Enamel coats the outer layer of the crown. Enamel is the hardest substance in the human body, with the highest proportion of minerals, being 96 percent mineral. The other 4 percent of the enamel is organic matter and water. Enamel is translucent.
Dentin supports the enamel. Dentin is yellow in color, and it affects the color of the teeth. It is less brittle than the enamel, and it is 70 percent mineral.
When is root canal treatment needed?
If the pulp becomes injured or diseased, it cannot repair itself, and the tissue dies.
If a person has a deep cavity, a cracked tooth, or a loose filling, bacteria can enter the pulp.
The bacteria will eventually destroy the pulp. If the bacteria penetrate through the root openings, this can cause an infection in the bone.
An infection will weaken the bone and break it down. The ligaments around the tooth will swell, and the tooth will become loose.
A pulp injury will make the tooth very sensitive to high and low temperatures. There may be pain when chewing, and some people have a continuous, throbbing pain.
Root canal therapy, extraction or implant?
Without treatment, the infection will spread. Eventually, the tooth will become loose and need extracting.
Some patients may prefer to have the tooth pulled out, especially if it hurts a lot or if the tooth cannot be restored. This can happen if there is large decay, trauma, or loss of bone due to periodontal, or gum, disease.
However, removing a tooth may mean that the surrounding teeth start to move and become crooked. This not only looks unsightly, but can make it hard to have a good bite.
Root canal therapy will usually save the tooth and eliminate the pain.
If the tooth cannot be saved, the next best option is an implant, but it is better to save the natural tooth if possible, because nothing functions as well as a natural tooth.
What are the steps?
Root canal therapy takes between one and three sessions to complete.
Root canal therapy involves a number of steps.
It can be carried out by a dentist who specializes in problems of the pulp, known as an endodontist, or by a dental surgeon.
During the first visit, under local anesthesia, the surgeon makes a small access hole on the surface of the tooth, and removes the diseased and dead pulp tissue with very small files.
The next step is to disinfect the canals and fill them with a rubber-like material with an adhesive cement to seal the canals completely.
Treatment can often be completed in one appointment, but if there are curved canals, multi-canals, or large infections, this could take one or two additional appointments.
Adding a crown or filling
Following the root canal treatment, the tooth will be more fragile than a normal tooth.
After the pulp tissue is removed, the tooth receives its nourishment from the periodontal membrane, or ligament, which attaches the tooth to the bone.
The membrane is living, so the tooth can still function without the pulp tissue. But in time, teeth become more brittle, and especially the back molar teeth that have the most biting force.
This is why a crown or filling is needed, to protect it. Until this is done, the patient should not chew or bite on the tooth.
After this, the person can use the tooth just as before.
What is the cost?
Cost of dental treatment varies widely, but saving the tooth with a root canal is relatively cost-efficient.
The other option is extraction, and the cost of an implant or bridge to replace the tooth afterward is usually more expensive.
Extracting a tooth can also lead to malocclusion, or misaligned teeth, and difficulty chewing.
Root canal therapy complications
As with any surgery, sometimes complications can occur.
One problem is when the dentist only finds three root canals in a tooth that has four of them. If one canal remains untreated, the infection might continue and spread into the bone.
The dentist must also make sure the filling material goes far enough into the canal, to fill it up. If the root canal is not properly sealed, the infection could return.
During the procedure, the root of the tooth may crack, or the instruments can break in the canal or perforate the canal. This makes it hard to fill the tooth effectively.
If complications occur, a specialist can try to correct the problem and complete the root canal.
To avoid complications, patients should always follow the dentist's instructions. If an antibiotic is needed, it is important to finish the entire prescription.
It is essential to have a permanent restoration, such as a crown, placed once the root canal therapy is complete.
How to avoid needing invasive dental treatment
To prevent infections, tooth decay and gum disease, dentists recommend:
- Brushing teeth last thing at bedtime and at least one other time each day
- Using a toothpaste that contains fluoride
- Using a suitable toothbrush and replacing it regularly
- Attending regular dental checkups and cleanings
- Flossing to clean between the teeth and prevent the buildup of plaque
- Avoiding sugary drinks and foods, and following a healthy diet.
Dental sealants can also prevent decay.