Before the advent of endodontic treatment, the only method for managing fractured, contaminated, or abscessed teeth was extraction. Thankfully, root canal therapy will now readily and conveniently cure any of these illnesses or injuries.
A root canal, also known as endodontic treatment, is the procedure of removing contaminated, damaged, or dead pulp from your tooth.
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What is dental pulp?
Pulp is a connective tissue mass that lies under the dentin layer in the middle of the tooth. The pulp contains blood vessels, nerves, fibers, and connective tissue, and it connects the underlying tissues and extends from the crown of the tooth to the tip of the roots.
Copyright: Bruce Blaus.
On the other hand, the root canal is the part of the pulp cavity that stretches from the canal orifice to the apical foramen, and its configuration varies depending on the size, shape, and number of roots in each tooth.
How does pulp become damaged?
The pulp can be damaged in a variety of ways that include tooth decay, gum disease, and injury to the tooth by accident.
Root Canal Procedure
First, the dentist will take an X-ray to see the shape of the root canals and see if there is evidence of inflammation in the surrounding bone. If endodontic treatment is indicated, the endodontist will administer a local anesthetic to numb the region.
After that, to separate the tooth, a rubber sheet is wrapped around the tooth. The pulp chamber and root canals are then cleaned using very small tools from an opening made in the crown of the tooth. Root canals are filled with a rubber-like substance called gutta-percha after they have been thoroughly cleaned and shaped. This prevents bacteria from entering this space again. Finally, after endodontic treatment is completed, the endodontist installs a crown or other restoration on the tooth to return it to full function.
Root Canal, Image Courtesy of Jeremy Kemp
What are the Complications of a Root canal?
During root canal therapy, as in any other area of dentistry, a clinician can encounter undesirable situations that may impair the prognosis of endodontic treatment. Endodontic mishaps are the collective name for these technical errors.
Procedural defects include the following:
- Inadequately cleaned and shaped root canal system
- Instrument separation
- Deviation from normal canal anatomy
- Inadequate canal preparation
- Perforations
- Post space perforations
- Obturation related
- Vertical root fracture
- Instrument aspiration
Endodontic failures can result from procedural errors at any point of the root canal procedure. However, to solve the issue, an endodontist will perform endodontic retreatment.
Who performs endodontic therapy?
Endodontic treatment is generally taught to all dentists, but endodontic therapy is ideally performed by an endodontist.
An endodontist is a dentist who has received further expertise in diagnosing and handling issues involving the inside of the teeth. They conduct regular, complicated, and extremely complex endodontic techniques, such as retreatment of previously unhealed root canals and endodontic surgery.
What are the signs that pulp is infected?
The pulp can be infected when there is inflammation and which causes pain when eating or drinking hot or cold foods. It can also cause spontaneous discomfort, pain when chewing, or lying down.
What is the purpose of root canal therapy?
Since the tooth is unable to recover on its own, the infection will spread across the tissues, destroying bone and supporting tissue. As a consequence, the tooth would fall out. In general, root canal therapy involves thoroughly cleaning and shaping the root canal structure after filling it with gutta-percha (rubber-like) material to avoid recontamination of the tooth.
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How many visits will it take to complete a root canal treatment?
Many treatments will now be done with as few as two visits. However, depending on the state of the tooth, the treatment period can vary.
Will I feel pain during or after treatment?
When the pulp becomes compromised, blood supply and cellular activity rise, and pressure within the tooth cannot be relieved; it could be painful. Also, without inflicting significant pain, the pulp will die.
Unlike, nowadays, thanks to improved treatments and greater knowledge of anesthesia, the majority of patients are at ease during the procedure. However, you could experience the sensation for the first few days after therapy, particularly if pain and infection were present before the operation. Medication may help to alleviate the discomfort. Consult the endodontist if persistent, extreme pain or pressure persists.
Would the tooth need any extra attention or intervention after endodontic treatment?
You should avoid chewing or biting on the treated tooth before the dentist has restored it. Since an unrestored tooth is prone to cracking, you should see your dentist as soon as possible for a complete reconstruction. Otherwise, proper oral hygiene, such as brushing, flossing, and routine check-ups and cleanings, is all that is needed.
Can all teeth be treated endodontically?
Endodontic treatment is an option for the majority of teeth. However, it can be difficult to manage a tooth endodontically where root canals are not accessible, the root is seriously fractured, the tooth cannot be restored, or the tooth lacks enough bone support.
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What are alternatives to root canal therapy?
If a tooth has been severely injured and its support has been compromised, extraction is the only option.
What are the causes of endodontic failures?
The majority of root canal failures are caused by bacteria in the root canal system, either directly or indirectly. Despite strict adherence to the basic therapeutic standards, treatment errors may occur. Many factors influence the effectiveness or failure of endodontic treatment. However, some are typical in all situations for success or failure, and in some cases, success or failure is exclusive to that particular case.
Some potential factors that influence the effectiveness or failure of endodontic therapy are the anatomy of the tooth and root canal system, the therapy regimen’s asepsis, the quality and apical seal, post-endodontic restoration quality, and the dentist’s ability.
Is root canal the best treatment in my case?
Your dentist will suggest the most effective treatment plan based on their expert judgment after evaluating the injured or infected tooth. Discuss any doubts you have about your dentist’s advice with them.
How to prevent a root canal?
It’s important to maintain the same oral hygiene practices that help reduce cavities and other tooth complications to avoid a root canal. Try to make a habit of taking these steps to keep your teeth healthy:
- At least once a day, floss between the teeth.
- At least twice a day, brush your teeth.
- Every six months, visit your dentist for a checkup.
- At least once a year, have your teeth professionally cleaned by your dentist.
- Use fluoride toothpaste or a fluoride rinse and keep your teeth and gums healthy.
- Limit the use of sugary foods and refined carbohydrates.
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Bibliography
American Association of Endodontists. (n.d.). What is a root canal? https://www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/
Garg, N., & Garg, A. (2010). Textbook of endodontics (2nd ed., pp. 3-6,322,342). Jaypee Brothers Medical Publishers.
