root canal therapy, also known as endodontic therapy, is a dental treatment for removing infection from inside a tooth. it can also protect the tooth from future infections.
root canals, and their associated pulp chamber, are the physical hollows within a healthy tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. together, these items constitute the dental pulp. decay or injury can destroy the living pulp. dead pulps lack a decent blood supply and are therefore more prone to infection leading to dental abcess and toothache.
endodontic therapy involves the removal of these structures, the subsequent shaping, cleaning, and decontamination of the hollows with small files and irrigating solutions, and the obturation (filling) of the decontaminated canals.
filling of the cleaned and decontaminated canals is done with an inert filling such as gutta-percha and typically a eugenol-based cement. endodontics includes both primary and secondary endodontic treatments as well as periradicular surgery which is generally used for teeth that still have potential for salvage.
when is root canal necessary?
if the pulp becomes injured or diseased, it cannot repair itself, and the tissue dies.
if a person has a deep cavity, a cracked tooth, or a loose filling, bacteria can enter the pulp. The bacteria will eventually destroy the pulp and if the bacteria penetrate through the root openings, this can cause an infection in the bone.
an infection will weaken the bone and break it down. the ligaments around the tooth will swell, and the tooth will become loose. a pulp injury will make the tooth very sensitive to high and low temperatures. there may be pain when chewing, and some people have a continuous, throbbing pain.
root canal therapy, extraction or implant?
without treatment, the infection will spread. eventually, the tooth will become loose and need extracting.
some patients may prefer to have the tooth pulled out, especially if it hurts a lot or if the tooth cannot be restored. this can happen if there is large decay, trauma, or loss of bone due to periodontal, or gum, disease.
be warned, removing a tooth may mean that the surrounding teeth start to move and become crooked. this not only looks unsightly, but can make it hard to bite properly.
root canal therapy will usually save the tooth and eliminate the pain.
if the tooth cannot be saved, the next best option is an implant, but it is better to save the natural tooth if possible, because nothing functions as well as a natural tooth.
root canal therapy complications
as with any surgery, sometimes complications can occur.
one problem is when the dentist only finds three root canals in a tooth that has four of them. if one canal remains untreated, the infection might continue and spread into the bone.
the dentist must also make sure the filling material goes far enough into the canal, to fill it up. if the root canal is not properly sealed, the infection could return.
during the procedure, the root of the tooth may crack, or instruments can break in the canal or perforate the canal. this makes it hard to fill the tooth effectively.
should complications occur, a specialist can try to correct the problem and complete the root canal. to avoid this, patients should always follow the dentist’s instructions. if an antibiotic is needed, it is important to finish the entire course.
it is essential to have a permanent restoration, such as a crown, placed once the root canal therapy is complete.