Endodontics (Root Canal Treatment)

Nobody would like a tooth to be removed when it can be saved. Saving a tooth which would otherwise need extraction is what root canal therapy or endodontics is all about. Once there is tooth decay and the decay involves the outer layer (enamel), the second layer (dentin) and reaches the pulp then there is extreme pain. Sometimes, the tooth becomes dead and can fracture. The treatment for this is called Root Canal Treatment.

Root canal therapy treats the disorder of the nerve (pulp) of the tooth and saves it.

Root canal therapy is needed in the following cases.

Injury A physical blow to a tooth which causes an injury to the tooth. The tooth may need a root canal to avoid any cyst formation or discolouration of the tooth. A fractured tooth exposing the pulp should also be root canaled in order to save the tooth for functional and aesthetic reasons.

Physical irritation This occurs either due to deep decay. Regardless of the initial cause, the tooth pulp becomes irritated and an abscess (infection) occurs. This can cause the bone around the tooth to be destroyed.

In cases of severe attrition (wearing of the teeth), the pulp eventually gets exposed. Exposure or even near exposure causes severe pain and sensitivity.

These teeth can also be saved with root canal treatment.

The procedure

Once it has been determined clinically and radiographically that root canal treatment is necessary, further appointments are scheduled. It is very important not to delay the treatment and healing.

Step I

The tooth is anesthetised and an opening is made through the crown into the pulp chamber. The pulp chamber is shaped for proper access.

Step II

The length of the root canal is determined.

Step III

Removal of infected pulp The root canal area inside the tooth is cleaned, enlarged and shaped and an open pack is given. This allows the infection to drain.

Step IV

In this second appointment the canals are checked for any pulpal remnants. If there are any, they are cleaned and root canal is shaped for final restoration. A temporary filling pack is given as a shield against bacterial growth and to reduce infection.

Step V

If the canal is clean and dry, then the canal is filled hermetically (airtight seal), to the apex of the root.

Step VI

Finally, the tooth is fully restored to chewing function.

Step VII

After about a week when the patient is comfortable chewing with the root canaled tooth, the softer filling on the top is removed and a permanent or harder filling is put in the crown portion.

Care following the treatment

Once the root canal treatment has been completed you should be aware of the following considerations:

Discolouration

You may notice that your endodontically treated or root canaled tooth undergoes discolouration. Though this is of no great medical concern, you should get the tooth crowned.

Brittleness

A nonvital root canal tooth becomes brittle compared to a vital one. It is more susceptible to fracture. Therefore, it is recommended to crown the root canal treated tooth. This saves the tooth over a long period of time.

As a general rule all teeth which have undergone root canal treatment should be crowned to protect them from any further fracture.