Teeth are composed of three hard layers
Nowadays, dentists believe that it is better to keep natural teeth. That’s why they combine efforts to preserve your teeth. A successful root canal is a great way to achieve this. When this solution proves impossible, you have no choice but to extract it. By keeping your natural teeth, you prevent other teeth from losing their alignment and problems with the jaw or gum disease. This way, you will avoid having to replace them with a bridge or an implant.
Teeth are composed of three hard layers
- the cement
The space inside these layers is called the channel. The latter is filled with a tissue: the dental pulp. It is a soft tissue that encloses the nerves and blood vessels allowing the tooth to develop. Once the tooth has finished growing, it can survive without pulp. If the pulp is infected, it must be removed. The treatment is called root canal therapy or endodontic treatment.
When is a root canal needed?
The dental pulp can be damaged by an enamel crack, deep decay or accident. Bacteria can penetrate the tooth and infect the pulp, which can cause pain or inflammation. Now it happens that the pulp can become infected or die without pain.
Your dentist may notice changes in :
- The color of the tooth
- The appearance of the gums
- The bone or the root of the tooth (during the x-ray)
Through examination and X-rays, the dentist sometimes concludes that the tooth may not survive when it is badly damaged.
In many cases, root canal treatment can reduce or even counteract the onset of symptoms to preserve the tooth.
A member of the dental team will place a dyke around the tooth to protect it from bacteria in the saliva during treatment.
Your dentist or endodontist may perform local anesthesia to help you avoid pain.
This makes a slight opening in the tooth to access the damaged canal and pulp.
It removes the pulp, cleans and widens the canal with precision instruments.
Then, it fills and seals the channel with a material that looks like rubber (called gutta-percha). A shutter is used that pre-sets the temperature of the instrument to melt the rubber and make it a better sealant.
Finally, it closes the opening of the tooth with a temporary or permanent sealant.
Points to consider
The root canal can take one or more visits depending on the complexity of the anatomy of the canal and the extent of damage to the pulp.
Sometimes, if the infection has spread from the tooth to the bone – causing an abscess – the infection must be drained before the canal is closed.
Your tooth will probably remain sensitive for 1 to 2 weeks after treatment. It is rare, however, that you experience severe pain or inflammation. If so, you must call your dentist or endodontist as soon as possible.
To look and work, as much as possible, as a natural tooth, your tooth must then be restored with a filling or a crown. The type of restoration will depend on the strength of the other parts of the treated tooth. A posterior tooth will probably receive a crown since a lot of pressure is exerted on these teeth when you chew. If the intact natural tooth portion is deficient, your dentist will then be able to use a pivot to help hold the crown in place. A discolored tooth may be either bleached or covered with a crown or facet
Second treatment and root surgery
Although root canal treatment is successful in most cases, a second treatment may be required. The filling material is removed and the channel again cleaned, prepared and closed.
A dentist or endodontist may resort to surgery if a conventional canal treatment can not be done or has not been successful. Surgery serves to :
- Check the end of the channel to make sure there are no cracks (or fractures).
- Remove any parts of the canal that could not be cleaned during conventional treatment.
- Eliminate an infection that has not healed after conventional treatment.
- Eliminate an unhealed infection after conventional treatment.
All dentists learn to do root canal treatments during their studies. On the other hand, in some complex cases of surgery or treatment, your dentist may refer you to an endodontist.
Most of the time, an endodontically treated tooth can be preserved. However, sometimes all attempts fail and there is no choice but to extract the tooth.