Endodontic (Root Canal) Treatment
Natural teeth are meant to last a lifetime. Even if one of your teeth should become seriously injured or diseased, oftentimes it can be saved through a specialized dental procedure known as endodontic treatment. Although this technique, popularly called root canal therapy, has been around for several decades, recent advances in the field of endodontics have made root canal therapy almost a routine procedure.
How Your Tooth is Saved Through Endodontic Treatment
The type of material used for the crown will depend on where the tooth is located in your mouth, the color of the tooth, and the amount of natural tooth remaining. A front tooth that affects appearance, for instance, most likely will be restored with a porcelain crown. When a back tooth has been badly fractured or decayed, a gold or porcelain-fused-metal crown may be used. Your dentist will discuss these options with you.
- First, the tooth is isolated from the saliva with a rubber dam (a sheet of rubber placed around the tooth). An opening is then made through the crown of the tooth into the pulp chamber. You may be given a local anesthetic prior to this step so that you will be more comfortable during treatment.
- The pulp is then carefully removed from both the pulp chamber and root canal(s). The root canal(s) is/are cleaned, enlarged, and shaped to a form that can be properly filled.
- Medication may be put in the pulp chamber and root canal(s) to help eliminate bacteria and prevent infection.
- A temporary filling will be placed in the opening in the crown to protect the pulp chamber and root canal(s) between appointments (if necessary). If the pulp is severely infected, however, your dentist may leave the tooth open for a few days to drain. You might also be given antibiotics to help control infection that may have spread beyond the tooth.
- During the next stage of treatment, the temporary filling is removed. The sterilized pulp chamber and root canal(s) are then filled and permanently sealed with a material that prevents bacteria from re-entering the canal. This may be done in the initial appointment if your tooth is not severely infected.
- In the final step, a crown is placed over the tooth to restore the tooth structure, function, and appearance. If an endodontist performs the treatment, he or she may recommend that you return to your family dentist for this step.
Frequently Asked Questions
To help you understand when and why such a procedure might be needed and how a damaged tooth can be saved, we have answered some of the most frequently asked questions about endodontic treatment.
What is endodontics?
Endodontics is the area of dentistry concerned with the prevention, diagnosis, and treatment of disorders of the dental pulp (the tooth's soft core.) Years ago, teeth with diseased or injured pulp were extracted. Today, endodontics is a means of saving teeth that once would have been lost.
What is the dental pulp?
The pulp is a soft tissue that contains nerves, arteries, veins, and lymph vessels. It lies within the dentin, the bone-like tissue that supports the enamel, and that makes up most of the tooth structure. Within the dentin, the pulp extends from the pulp chamber in the crown (the portion of the tooth visible above the gums) down to the tip of the root via the root canal. Teeth with more than one root, such as molars, have more than one root canal; but all teeth have only one pulp chamber.
What happens to the damaged pulp?
When the pulp is diseased or injured and unable to repair itself, the pulp dies. The most common cause of pulp death is a fractured tooth or a deep cavity, which can expose the pulp to the bacteria causing an infection inside the tooth. This infection, left untreated, causes pus to build up at the root tip, forming an abscess. Eventually, the pulp surrounding the tooth will be destroyed.
Why does the pulp need to be removed?
If the damaged or diseased pulp is not removed, the tooth and surrounding tissues become infected. Pain and swelling may accompany the infection. Even in the absence of pain, certain by-products of a diseased pulp can injure the bone that anchors your tooth in the jaw. Without treatment, your tooth will eventually have to be removed.
What does endodontic treatment involve?
Treatment usually requires one, rarely two, appointments. During these treatments, your dentist or endodontist (a dentist who specializes in the disorders of the pulp) removes the diseased pulp. The pulp chamber and root canal(s) of the tooth are then cleaned, sterilized, and sealed to prevent recontamination of the root canal system.
Why couldn't you just remove the tooth?
The choice is yours, but there are many disadvantages to losing a tooth. When teeth next to the empty space begin to shift from their normal positions, the teeth may become crooked or crowded, thus decreasing your chewing and biting efficiency. Crowded or crooked teeth are also more prone to dental disease because they are harder to keep clean than are properly aligned teeth. As a result, you may lose even more teeth if the missing tooth is not replaced.
Whenever a tooth is lost, it is important to have a replacement tooth (bridge) put in place of the removed natural tooth. A bridge is usually more expensive than endodontic treatment and involves dental work on adjacent teeth.
On the other hand, endodontic treatment can safely and comfortably save a tooth that otherwise would have to be removed. In fact, root canal therapy is successful 90% of the time. Remember, a healthy restored tooth is always better than an artificial one.
How long will the restored tooth last?
Your restored tooth could last a lifetime if you continue to care for your teeth and gums. A long as the root(s) of an endodontically treated tooth are properly nourished by the surrounding tissues, your tooth will remain healthy.
In order to maintain healthy tissues and prevent future infection, you should brush and floss your teeth daily, eat balanced meals and reduce the number of times you eat sugar-rich foods, use fluoride daily, and visit your dentist regularly. These measures will help you keep your natural teeth and enjoy good dental health for a lifetime.