Endodontics / Toothaches
Or, root canal therapy, can become necessary if the nerve or pulp of the tooth is dying, or has died and become infected. Modern treatment techniques now allow this to be carried out comfortably and painlessly, with good (90-95%) long-term results. The following diagrams show the processes involved.
What is Root Canal Treatment?
Root canal treatment it the replacement of a damaged or infected pulp (nerve) in a tooth with a special filling.
What is Pulp?
The pulp is a strand of tissue running from the tip of a root into the centre of a tooth. It is made up mainly of nerves and blood vessels.
What is a Root Canal?
A root canal is a miniature tube that has houses the pulp in the root portion of a tooth. In the centre of the tooth it opens up into an area called pulp chamber.
How Many Root Canals Does a Tooth Have?
Front teeth have usually one root canal whilst back teeth can have two or three. Therefore back teeth are far more difficult to treat.
How Can a Pulp Become Damaged?
A number of things can cause a pulp to become inflamed or infected. These include:
- Deep decay
- Decay under a loose filling
- A blow
- Severe wear of the teeth
- Severe grinding of the teeth
- Some types of gum disease
An example of root canal treatment
Deep decay under a loose filling has caused irreversible damage to the pulp.
The decay and the filling are removed.
The pulp is removed and the root canals are cleaned and shaped.
If the canals are not completely clean a medicament is placed and sealed in with a temporay filling.
At another visit the root canals are filled with a special root canal filling.
The final filling is placed.
What are the Signs of Pulp Damage?
With a very inflamed pulp the tooth can be sensitive to hot and cold foods and drink.
If the pulp had become abscessed the tooth can be very sensitive to hot foods and drink and to bite on. Swelling may also be present.
On occasions the pulp degenerates quietly without giving any symptoms and the only sign of a problem is seen on x-rays.
Why Save a Tooth?
Basically there is no substitute for one’s own teeth. The replacements for a lost tooth can be expensive or, in the case of a partial of full denture, an inefficient substitute. Implants are becoming more affordable for badly damaged teeth.
What is Involved with a Root Canal Treatment?
With present-day anaesthetic and other techniques, removal of an inflamed pulp is a, comfortable procedure. So is the treatment of an infected pulp. The pulp is removed with special instruments and the root canal cleaned out. The cleaning procedure involves a widening and shaping of each canal.
It is usually carried out with a rubber drape (rubber dam) around the tooth to keep out saliva and to make the preparation of the canal and canals easier.
It may take a number of visits before a canal is finally filled. A medicament may have to be temporally sealed in to eliminate all infection. The root canals are then filled. The filling is usually a combination of materials called gutta percha and a special sealer.
Note: It is important not to leave a root canal unfilled. Bacteria can grow in the empty space and the tooth can become reinfected.
Are X-Rays Required?
Yes. Apart from the initial diagnosis, x-rays are necessary for the dentist to determine how long each root is and how far the cleaning and root filling have to go. A follow-up x-ray or x-rays may be needed to determine how healing is progressing.
Is There Any Discomfort with the Procedures?
Sometimes there may be some temporary sensitivity after the root canals have been opened and cleaned.
Are There Any Special Problems with Root-Filled Teeth?
A root-filled tooth is no different from an ordinary tooth except that it has no pulp. With proper home care (brushing, flossing and the use of a fluoride toothpaste) it can last a life-time.
Final Restoration of the Tooth
A final restoration is placed after the root filling is completed. The type of filling required will depend on the amount of sound tooth structure remaining.
It may be necessary to reinforce the tooth by placing a post in one or more of the root canals.
One of the normal filling materials is then used to build up the tooth to make a core. A crown is placed over this.