A root canal therapy is a treatment of the dental pulp of the tooth that is inflamed, infected, or dead. The dental pulp is a soft vascular tissue in the center of the tooth that consists of the nerve, blood vessels, and connective tissue.
The pulp chamber is a hollow space in the center of the tooth that contains the pulp, and it continues down canals that extend through the roots of teeth and into the surrounding bone.
Some tooth roots have more than one canal, but all have at least one canal.
Root canal treatment (RCT) is the more correct term for a procedure that treats the nerve of the tooth. Endodontics is a specialty of dental science that deals especially with the tooth pulp and tissues surrounding the root of the tooth.
A root canal treatment may be done by a general dentist or by an endodontist. An endodontist is a dentist who has gone to three years of specialized training after general dentistry to focus exclusively on root canal treatments.
General dental practitioners are qualified enough to perform root canal treatment but may refer a patient to a specialist (endodontist) if the tooth is particularly complicated.
When the root canal is treated, the dental pulp is removed and all the canals and pulp chamber of the tooth are filled and sealed with a biocompatible material to prevent bacteria from entering.
Many factors can damage the pulp or nerve of the tooth. when a patient feels pain or other symptoms that alert them to need root canal treatment, but many times there are no symptoms or warnings. These are the common reasons for needing root canal treatment.
A toothache is the most common symptom of needing a root canal treatment. If the tooth is still vital, the affected person will experience extreme sensitivity to hot or cold liquids or foods and that sensitivity will continue even after the hot or cold stimulus is removed. Sensitivity to heat, instead of cold, is a symptom that is very specific to a tooth requiring root canal treatment.
The tooth may start to paining spontaneously, in the middle of the night, or sometimes when the patient isn’t even using the affected tooth to eat or drink. The pain can progress to the severe generalized headache that may cause the person to even forget what initially caused the pain.
If the tooth is non-vital and has become abscessed, the patient will feel pain when they chew food or puts pressure on the tooth. An abscess may produce swelling or bleeding around the tooth, and sometimes it causes significant swelling of the cheek, jaw, or throat. If this swelling is noticed, emergency intervention is needed as soon as possible.
Therefore, it is very important, when feeling some pain around a tooth, to get a thorough examination with pulp vitality testing by a registered dentist for a proper diagnosis.
If a tooth has become abscessed or there is any sinus opening, it will require a root canal. An abscess is an infection that forms when the pulp of the tooth necrosed and a pus pocket forms around the root apex. The pus accumulates in an area of necrosed pulp tissue that is infected with bacteria.
Sometimes the abscess will form a bump that looks like a pimple on the gums. sometime patients may even notice pus draining from the pimple or notice a bad taste.
An untreated abscess will continue to grow and infect the bone around the tooth root. It may spread into the surrounding bone and other oral structures. In rare cases, people have died from infections that started from a tooth abscess.
Root canal treatment along with antibiotic coverage is the only way to remove the infection completely. Other abscesses can affect the teeth aside from endodontic abscesses. Periodontal abscesses can be painful, for example, and require different treatment than root canals therapy.
If tooth decay progresses deep into the tooth and reaches to the pulp, then pulp will become infected. It will either become inflamed and painful or it will be necrosed and become decayed tissue. Sometimes there will be no pain, but the only way the dentist can get all of the tooth decay out by performing a root canal and removing infected pulp tissues and nerves.
If a tooth got traumatized, the nerve can be severed at the end of the root and eventually die. This could happen after the traumatic incident, or it may happen over many years following the tooth trauma.
A tooth that has become fractured may need a root canal treatment if the fracture line extends deep into the tooth and approaches pulp. If a tooth has fractured in a way that doesn't leave very much tooth structure left above the gingival tissue for a crown or other restoration, a root canal may be required to be performed so a post can be placed down the canal of the tooth to help retain the restoration.
Resorption of the root is a condition where the tooth root decayed as a reaction to injury, trauma, tooth replantation, or aggressive tooth movement during orthodontics treatment. Not all of the causes of resorption are fully understood. If the resorption starts from the outside of the root and goes inward, it is called external root resorption.
If the tooth resorption from the middle or inner side of the tooth and progresses toward the outside, it is called internal resorption. In either situation, the resorption can invade the pulp tissue and the vital nerve & vessels contained therein.
If this happens, the tooth requires root canal treatment with specialized conditioning and repairing of the defect quickly before the resorption destroys more tooth structure. The defect is typically repaired with MTA. Usually, resorption does not cause any pain and is usually diagnosed by taking X-rays.
Root resorption is a condition whereby the tooth structure dissolves away as a reaction to injury, trauma, tooth replantation, or aggressive tooth movement during orthodontics.
Not all of the causes of resorption are fully understood. If the defect starts from the outside of the root and goes inward, it is called external root resorption. If the tooth dissolves from the middle or inside of the tooth and progresses toward the outside, it is classified as internal resorption.
In either situation, the resorption can invade the pulp canal and the vital nerve and blood vessels contained therein. If this occurs, the tooth needs root canal treatment in combination with specialized conditioning and repairing of the defect quickly before the resorption destroys more tooth structure.
The defect is typically repaired with a material called mineral trioxide aggregate (MTA). Resorption usually causes no pain and is usually only diagnosed using X-rays.
To confirm that a tooth requires root canal treatment, the dentist will take an IOPA X-ray of the root and may perform a vitality test. Most pulp vitality tests involve placing a cold stimulus on the tooth to check the normal response. Many teeth will be tested to compare the responses of vitality.
If the test confirms that the tooth requires root canal therapy, it will be completed in either one or multiple appointments.
The dentist will determine whether the root canal will be treated in one or multiple appointments depending on the size and duration of an abscess and other factors. A tooth is likely to be treated in two to three appointments if it is getting retreatment. Patients are often curious about how long a root canal treatment takes to finish.
Before starting the root canal treatment, the dentist will anesthetize the tooth with local anesthesia to ensure patient comfort. When the tooth has become numb, the dentist will perform the further procedure of root canal treatment.
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