Recently a survey was conducted in the UK to find out the most undesirable places to visit. Not surprisingly, dental clinics was at the top of the list with contemporaries like police station, butcheries, etc. Some of my friends in town complain that their dentist unnecessarily advised them for a root canal treatment (RCT). In my opinion it’s very important to know what exactly an RCT is since it’s something you could do better without.
Endodontics is the branch of dentistry that deals with diseases of the tooth’s pulp (nerve and blood supply), which is located in the center of the tooth and in canals (called root canals) within each tooth root. Pulp nourishes the tooth when it first erupts (emerges through the gum). Once the tooth matures, the pulp can be removed safely from the pulp chamber and root canals and the tooth can be maintained. This is because the tooth also is nourished by a blood supply that surrounds the tooth. Removing the pulp is called endodontic treatment, but it is often referred to as root canal treatment or root canal therapy. Many people refer to this as “having a root canal.” Root canal treatments are quite common. They save an estimated 24 million teeth each year in the United States.
Why Would You Need Root Canal Treatment?
RCT is needed for two reasons: infection or irreversible damage to the pulp. An untreated cavity is a common cause of pulp infection. The decay erodes the tooth until it opens into the root canal system, allowing bacteria to infect the pulp. Infections inside teeth don’t respond to antibiotic treatment. The reduced blood supply also limits the pulp’s ability to heal itself.
The pulp also can become damaged from trauma, a fracture or extensive restorative work, such as several fillings placed over a period of time. Sometimes, a common dental procedure can cause the pulp to become inflamed. For example, preparing a tooth for a crown sometimes leads to the need for root canal treatment.
In many cases, when the pulp is inflamed, but not infected, it will heal and return to normal. Your dentist may want to monitor the tooth to see if this happens before doing root canal treatment. Sometimes, though, the pulp remains inflamed, which can cause pain and may lead to infection.
Once the pulp becomes infected, the infection can affect the bone around the tooth, causing an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty canals with an inert material. If root canal treatment is not done, the tooth may have to be extracted.
Signs and Symptoms
Some indications that a tooth may need a root canal are:
- A tooth that hurts significantly when you bite down on it, touch it or push on it
- Sensitivity to heat
- Sensitivity to cold that lasts longer than a couple of seconds
- Swelling near the affected tooth
- A discolored tooth, with or without pain
- A broken tooth
To determine whether your tooth needs root canal treatment, your dentist will place hot or cold substances against the tooth, feel surrounding tissues and gently tap on the tooth. He or she also will take X-rays. If the condition of the pulp isn’t clear from these tests, your dentist may use an electric pulp tester.
Length of Treatment
Root canal treatment can be done in one or more visits, depending on the situation. An infected tooth will need several appointments to make sure that the infection is eliminated. Some teeth may be more difficult to treat because of the position of the tooth, because they have many and curved root canals that are difficult to locate, or for other reasons. An uncomplicated root canal treatment often can be completed in one visit. Once the root canal treatment is finished, you will need to see your general dentist to have the tooth restored with a crown or filling.
After Root Canal Treatment
Your tooth will be sore for two to three days after the procedure. The worse the infection and inflammation was prior to root canal treatment, the sorer the tooth will be after treatment. You can take over-the-counter pain relievers to ease the pain.
As with most invasive medical or dental procedures, complications that still manages to arise are:
- Sometimes when a root canal is opened for treatment, the oxygen in the air will trigger some bacteria to start growing, causing inflammation and pain.
- Bacteria may get pushed out through the tips of the roots. If this happens, the surrounding tissue will become inflamed and possibly infected. This can be treated with painkillers, and sometimes antibiotics, but the site could be painful until it clears up.
- A root canal treatment can puncture the side of the tooth. This can happen if the canal is curved or if the canal cannot be located.
- A root canal may be missed or an entire canal may not be fully cleaned out. Occasionally, root canals have branches that are not accessible to traditional treatment.
- An instrument may break. Usually it’s possible to leave the piece in the tooth and finish the root canal. But if the cleaning of the canal has not been finished, the file piece may have to be removed.
I often hear this: “my teeth have never given me any problem and I have never visited a dentist”. People in this category are waiting for a major pain or swelling to occur before they visit a dentist. They are inviting dental pain which is one of the most severe. With such state of mind, you are looking for trouble. Moreover, I would like to avoid RCT as much as possible since it is not one of the best experiences you will have with your dentist.