ROOT CANAL TREATMENT

Root canal treatment (RCT) is a dental procedure involving removal of injured, inflamed, infected or dead pulp from the tooth. The pulp is the soft tissue inside the tooth that includes nerves, blood vessels and connective tissue, which helps the tooth grow and develop. Pulp is not vitally important after the tooth has erupted and root canal treatment allows you to keep the natural tooth by avoiding extraction.

Indications:

Root canal is done when the damage to the pulp is irreversible. Damage to the pulp can be caused by deep dental caries, trauma from repeated dental procedures, fractures or other injuries to teeth, faulty restorations etc. Root canal is also done when the vital pulp needs to be removed prior to some other dental procedures to avoid infection or pain in future.

Pain: Pain due to irreversible pulpitis is one of the main reasons to initiate root canal treatment. The pulp is inflamed to a point that the patient experiences spontaneous and severe pain, which is not localized. There will be prolonged sensitivity to both hot and cold food. Removing the pulp and filling the canals is the only alternative to extraction. If left untreated the infection can progress in to abscess formation.

Abscess: It is the localized bacterial infection characterized by collection of pus near the root of the tooth. It can cause pain and swelling. In some cases a draining fistula is present. There will be sensitivity and swelling in the adjacent facial structures. If not treated the infection can spread to bone and nearby tissues causing cellulitis.

Trauma: Severe physical trauma can cause pulpal damage and death and root canal treatment becomes necessary to save the tooth from extraction. When the tooth is fractured, luxated or avulsed, root canal is performed in most cases. There may not be an infection in such cases but RCT is done to avoid pain and future infections.

Discoloration: Tooth can be discolored due to damaged or dead pulp and RCT is the first step in the treatment.

Pulp vitality tests and X-rays are done to decide whether RCT is necessary. X-rays will also aid in proper treatment because the shape and number of root canals varies with different teeth.

Procedure:

Local anesthesia is given to numb the area to ensure the treatment is pain free. Rubber dam is placed to isolate the area from saliva. Decayed tooth structure is removed if present. An access cavity is made inside the tooth and the pulp is removed from the pulp chamber and the root canals.

The canals are cleaned and shaped using specific instruments to accommodate the filling.

The canals are filled with biocompatible materials like gutta-percha. Adhesive cement is used along with it to ensure complete sealing of the canals. A temporary filling is placed in the tooth cavity. It will be replaced by a permanent filling later.

After root canal treatment a crown is placed to protect the tooth and to restore the function completely. If there is significant loss of tooth material a post may be placed inside the tooth to support the restoration.

Time:

RCT treatments are usually completed in two appointments with a week in between. But in some cases the root canals are cleaned and filled on the same day. Placement of the crown also depends on the condition of the specific tooth. It is important to make sure that the tooth is completely pain free before proceeding to restoration with a crown.

Cost:

The cost of RCT of a single tooth can be $500 and above depending on the tooth condition and number of roots. The cost of the final restoration can vary according to the choice of the material of the crown and also depending on whether a post is required or not.

Facts:

• Root canal treatment has more than 95% success rate and many of them can last a lifetime.
• Permanent restoration with a crown is critical for the success of the RCT as it protects the tooth from fracture.
• RCT is not advised for teeth with insufficient periodontal support or tooth that cannot be made functional nor restored.
• With local anesthesia RCT is not a painful procedure and most of the pain associated with RCT can be treated using simple over the counter pain medications.
• Root canal treatment is always a better treatment option than it’s alternative, tooth extraction.