Why do I need Root Canal Treatment?
The Anatomy of a Tooth
A tooth comprises of a crown and a root. The crown is the part that you can see in your mouth (above the gum). The root is under the gum and anchors the tooth in the jaw. More or less in the middle of the tooth, is the pulp chamber containing nerves and blood vessels.
Why do I need and when should I have Root Canal Treatment?
The most common reasons are:
- Dental decay
- Accumulative effects of placing several fillings over time
- Traumatic injury
When the pulp becomes irreversible damaged due to bacterial infection or injury, it will die and will need to be removed. The main symptom of a dying pulp is severe toothache made worse by contact with hot things.
However, dead teeth will no longer respond to temperature changes. The dead pulp tissue and bacteria inside the tooth adversely affects the surrounding bone by forming an abscess. The main symptoms; the tooth is sore to touch and hurts when bitten on, there may also be some swelling.
What choices do I have?
Once the nerve and blood vessels are irreversibly damaged, there’s only two choices:
- Root canal treatment
Extracting a tooth is a “quick fix”. The pain stops and the abscess soon heals. The consequences of extraction are:
- A decrease in your ability to chew your food
- If you don’t fill the empty space the other teeth may drift, causing; a) gaps to appear between the remaining teeth where food can get caught. This results in further decay and gum disease. b) The opposing tooth may grow up (or down) into the resulting space, which may cause chewing difficulties over a period of time. c) The relationship between the upper and lower teeth may change which could ultimately cause problems with your jaw joints later in life.
If you do decide to have the tooth extracted, you should seriously consider the options for replacing the missing tooth, which are:
· Removable partial denture
· Bridge: the teeth either side would be used to anchor a false tooth in the middle
· Implant: a precision metal post surgically screwed into the jawbone.
Root Canal Treatment
The treatment can be done in one or several visits that can vary from 30 minutes to two hours, pending on the specific tooth and the nature of the damage.
Step 1 – Opening of the crown of the tooth and removing the upper part of the infected pulp
Step 2 – Locating the canal (any number – between one and five) in each of the roots
Step 3 – Determining the length of the canals
Step 4 – Removal of pulp remnants, cleaning and shaping of the individual canals
Step 5 – Filling of the canals from the crown down to the tip of the root
Step 6 – Repairing the crown of the tooth with either a filling or a laboratory made crown.
Normally a root treated tooth becomes brittle thus the final, ideal permanent restoration on all back teeth is a crown. A crown covers the entire tooth to protect it from breaking or chipping, and protects the root canal from becoming contaminated. Contamination may lead to early failure and thus it is important to avoid.
For previously crowned teeth, or for some front teeth, a permanent filling may be all that is needed. In some cases the tooth needs to “settle” for a period of time before a crown can be fitted.
Frequently Asked Questions
- I have had root canal treatment on my tooth, but it still hurts.
The degree and type of pain you experience after root canal treatment depends upon a number of factors. These include the original cause of pulp damage, the amount of pain you had prior to treatment, the amount of manipulation necessary to work on the tooth and your unique reaction to dental trauma and treatment.
Anti-inflammatory painkillers, such as Ibuprofen or Aspirin, may be required after treatment and should be taken as directed. The tooth can be expected to be sore for from a couple of days up to a few weeks.
To help diminish this discomfort, the height of the tooth is often trimmed to reduce the force you can place on the tooth when chewing. You will be asked to avoid chewing on that side of your mouth until it is comfortable again.
- How long can I delay having a root canal treatment ?
Ones a tooth is “opened” and the nerves are exposed, there is no turning back (except to have the tooth out). It depends on the severity of the problem or infection to how long one should leave between visits. It is reasonably safe to move on to the next step once the pain has disappeared. Between visits the tooth will be dressed with a temporary filling. There is a chance of re-infection due to possible leakage of the temporary filling, therefore one should not leave a root canal uncompleted for too long.
- Are there any risks involved?
Root Canal Treatment still remains one of the most effective ways to treat and restore a tooth after a pulpal infection. Due to the fact that we work in a biological zone, results vary and even with the best preparation and filling material, failure still occurs, resulting in extraction. Root Canal Treatment is a very delicate procedure and the instruments used specialized. Instrument fracture sometimes occurs and depending on the position of the fracture and stage of procedure, treatment may be altered.
- Will antibiotics cure a root canal infection?
Absolutely not! Antibiotics are useful in treating root canal infections to help relieve the symptoms in the short term, and is indicated where there is swelling , a temperature , or other systemic signs of infection. In a dead tooth there is no blood supply to carry the antibiotics to the source of the infection inside the tooth. Antibiotics only treat the infection in the surrounding bone. Although the pain may go after a course of antibiotics, the infection will reoccur later because bacteria are still present within the untreated dead tooth.
- Does root canal treatment hurt?
In reality the process of doing a root canal should not hurt. You should be numb and the tooth should have no feeling. For some teeth, profound local anaesthesia may be difficult to achieve due to the infection. What really hurts is the reason a root filling is needed in the first place; the patient is already in pain before the root canal is started. In some cases where the tooth has died already, a patient may not experience any pain or discomfort. He/she may not even be aware of the problem.
There is nothing routine about root canal treatment. Every tooth is unique just as every person is unique. The value of root canal therapy is not what it costs, but the value of knowing you have done everything possible to save your natural teeth, a non-replaceable commodity.
No one expects to get the performance and quality of a luxury car for the price of a bicycle. In life you generally get what you pay for, advanced dental treatment such as root canal treatment, is no different.
You are welcome to call us for more information concerning Root Canal Treatment