Root Canal Treatment
Root Canal Treatment, also called endodontic treatment, is commonly referred to as “nerve kill”.
To understand endodontic treatment, it helps to know that inside the tooth, under the white enamel and a hard layer called the dentin, there is a soft tissue called the pulp. Most people would probably refer to a tooth's pulp tissue as its "nerve." As tooth decay (caries) approaches this chamber, the pulp tissue becomes inflamed. By this time (but not always) the patient usually experiences toothache. If unheeded, the pulp eventually becomes irreversibly inflamed and dies (point of no return). As a result, toxins are released from the dead pulp out the opening of the root tip and into the surrounding jaw bone. This leads to bone inflammation sometimes acutely manifested as dental abscess.
The prompt removal of this pulp tissue at this "point of no return" is then required to save the tooth and the surrounding bone.
The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numbed, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure (otherwise it would be contaminated by bacteria from the saliva and the entire treatment could fail).
Patient with rubber dam in place
Fine endodontic files are used to clean and shape the inside of the microscopic canals, making sure all bacteria and toxins are removed. By doing this the endodontist (dentist specialised in RCT) not only relieves the pain, but more important, assures the permanence of one’s own healthy tooth for the rest of the patient’s life.
After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible sealing material. In most cases, a temporary filling is placed to close the opening. In the final treatment session, the temporary filling will be removed by the dentist . The tooth is reconstructed and restored its healthy natural shape and function by a crown or some other restorative work.
An important final issue is the need to asses the success of the treatment. For it the endodontic specialist will schedule the patient for check-ups, and will do X-ray exams to make sure the bone around the treated root has healed.
RCT is a highly specialised treatment, because of the complex system of very fine spaces and canals within the tooth, which the endodontist is trained to detect and to treat thoroughly. A correctly RCT treated tooth is a reliable tooth, and assures that any future treatment needed “on top of it”, as a bridge, a crown or aesthetic procedure is not liable to fail becoming a waste of money. That’s why RCT is the most important specialised dental treatment even if the results are not visible as the treatment is performed completely inside the tooth.
Why could a root canal treatment fail?
RCT is a very delicate treatment, requiring highly specialised training,. If a non specialised dentist fail to find, clean and correctly fill all of the root canals within a diseased tooth, the treatment will probably fail. With it all the rest of the future work sustained by that particular tooth will also be lost with the corresponding loss of time, health and money. That’s why one should look for a trained endodontist.
If ones tooth has not healed or has developed new problems, the RCT specialist can offer it a second chance. Another procedure, called endodontic retreatment, may be able to save it.
With proper care, most teeth having had root canal (endodontic) treatment can last as long as other natural teeth. In the last ten years, there have been great innovations in the art and science of root canal therapy. The latest state of the art endodontic techniques we use in our clinic allow us to perform efficient and painless endodontic treatments. |
