What is a Root Canal?
A root canal is the dental treatment used to save a tooth that has been infected or is severely decayed, and is performed on the soft center of the tooth, known as the dental pulp.
The pulp consists of nerves, blood vessels and connective tissue. When the dental pulp is damaged, bacteria can start to multiply inside the tooth, ultimately leading to infection, and rotting of the tooth. Reasons leading to infection or inflammation of the pulp vary. It could be due to extensive caries damage, repeated dental procedures, poor restorations or a tooth fracture. Injury to a tooth can also damage the pulp, even if there are no signs of tooth decay.
Why Root Canal Treatment Is Important
The purpose of root canal treatment is the removal of the diseased, infected or dead pulp, and the airtight blockage of the root canal, so that germs do not grow inside the tooth. Leaving the infected tooth untreated may cause damage to the tooth and the surrounding bone, with the ultimate consequence of tooth loss, the expansion of bone destruction and the contamination of adjacent teeth and tissues.
The most common signs you may need root canal treatment are:
- Severe pain while chewing
- Persistent pimples on the gums
- A chipped / cracked tooth or an evident hole in the tooth
- Temperature sensitivity, even after the sensation has been removed
- Swollen gums
- Swelling around the face and neck
Root canal treatment usually takes several appointments to complete. First the dentist will take an x-ray in order to diagnose the lesion, and the patient is informed about the type of treatment and the procedure that needs to be followed, based on the specifics of each case.
The tooth is then anesthetized locally and isolated from saliva and bacteria, and the root canals are properly cleaned and shaped.
An opening is made through the crown of the tooth in order to reach the infected pulp chamber. Using a dental file, the root canals are then cleaned and shaped, and ready to be filled. The root canal is disinfected with antimicrobial solutions or the use of a diode laser, and the pulp chamber is enclosed with a special inlaid material (gutta-percha). In some cases of extensive microbial infection, antibiotics need to be taken in conjunction with root canal treatment.
During treatment the tooth is sensitive. It is therefore recommended that you avoid chewing on that side until the treatment is complete. Also, tell your doctor if the temporary seal is gone. It is possible to experience discomfort after the procedure that may be due to irritation of the area around the tooth due to the treatment, or to a relapse of an old infection which existed before, but was in remission with pain or swelling. In this case you should contact your doctor to give you the appropriate instructions and possible medication until the next appointment.
The success rate of root canal treatment can reach 90%. It depends on the anatomical morphology of the tooth roots, the ability of the dentist (endodontist) to properly prepare the root canals and remove germs, and the degree of destruction of the tooth by germs or previous unsuccessful endodontic treatment.
Tooth restoration can be done with a simple seal, a resin or porcelain insert or a porcelain wreath and an intramuscular shaft. The type of permanent restoration depends on how damaged the tooth was before treatment, but also on the position of the tooth in the mouth. In the posterior teeth (molars) it is usually recommended to restore with porcelain crowns and axes, always aiming at the long-term preservation of the integrity and functionality of the teeth.
Alternatives to Root Canal
The only real alternative to root canal treatment is tooth extraction, followed by the construction of a bridge or the placement of a dental implant. These alternatives are not only more expensive overall than a root canal, but they also take much longer, especially in the case of an implant.
Root canal treatment is the only way to save a tooth with an infected pulp or abscess, and is the most economical treatment. It has a very high success rate, and the tooth can be preserved for many years after the treatment. Even after a failed treatment, there are still options with very good success rates, such as repeat treatment and endodontic surgery on the root by a dentist. It is always best to try and keep your natural teeth.
All in all, the procedure is generally comfortable. Apart from managing to save the natural tooth, it also reduces the need for more extensive dental interventions. Proper treatment leads to complete and long-term recovery of the health of the affected area, and also reduces the need for more extensive dental interventions.