Root Canal Treatment

Root canal treatment is designed to eliminate caries causing bacteria from the infected root canal, prevent reinfection or secondary infection of the tooth and save the natural tooth. When one undergoes a root canal, the inflamed or infected pulp is removed and the area inside of the tooth is carefully cleaned and disinfected, then filled with endodontic medicaments and sealed with root canal sealers to prevent leakage.

What is a root canal treatment? #

A root canal treatment is a dental procedure involving the removal of the inflamed and infected pulp and some portion of infected dentin also. The pulp is made up of nerves, connective tissue, and blood vessels that provides the tooth with nutrition that help the tooth to grow. In the majority of the cases the root canal treatment is done under local anesthesia.

When is a root canal treatment needed? #

• Deep decay due to an untreated dental cavity

• Multiple dental procedures on the same tooth

• A chipped or cracked tooth due to accidents etc.

• An injury to the tooth (one might injure tooth if you get hit in the mouth; the pulp can still be damaged even if the injury doesn’t break the tooth)

• Dental recession with involvement of pulp

• Dental attrition cases where pulp is exposed

• Discolored teeth due to injury or due to fluorosis

How is a root canal treatment performed? #

A root canal treatment is performed in a dental office mostly under local anesthesia. When you arrive for your appointment, a technician will escort you to a treatment room, help you get situated in a chair, and place a drape around your neck to protect your clothes from stains.

Step 1: Anesthesia administration

The dentist will place a small amount of numbing medication on your gum near the affected tooth by using local anesthetic sprays or topical anesthetic gels. Once it has taken effect, a local anesthesia is administered using syringe or catheter into gums. You’ll remain awake during the procedure, but due to the anesthesia you will not feel any pain.

Step 2: Removing the infected pulp

When your tooth is numb, the endodontist or general dentist will make a small conservative opening in the tooth. The procedure is carried out using airotor and dental bur. The dentist starts drilling the tooth until the infected pulp is exposed and once the infected or damaged pulp is exposed, the specialist will carefully remove it using special tools called rotary files. The dentist will completely clean the canal using various liquids like 3% hydrogen peroxide, 5.25% sodium hypochlorite, EDTA etc.

Step 3: Antibiotics

Once the infected and inflamed pulp has been completely removed, the dentist may coat the area with a topical antibiotic solution to ensure that the infection is completely removed and also to prevent reinfection or secondary infection. Once the canals are cleaned and disinfected. They also may prescribe you oral antibiotics to prevent bacterial growth.

Step 4: Temporary filling

The dentist will end the procedure by filling the small opening in the tooth with a soft, temporary filling material. This sealant helps prevent the canals from being infected by saliva. The examples of temporary root canal filling materials are zinc phosphate cements and glass ionomer cements etc.

Step 5: BMP of root canal

BMP is known as biomedical preparation. Biomechanical preparation is the achievement of free access to the apical foramen via the root canal by mechanical means mostly by using rotary files or endodontic hand files. It is directly related to subsequent disinfection and filling the root canal because it creates enough space for medication and irrigation.

Step 6: Obturation of root canals

In this step the dentist will fill and seal the tooth with a sealer paste and rubber-like material called gutta-percha. Gutta-percha is a biocompatible material which doesn’t cause any kind of allergy and will help in completely sealing the canals to prevent reinfection or secondary infection due to seepage.

Follow-up #

The tooth and gums might feel sore when the local anesthesia effect wears off. The gums may also swell in few cases. Most dentists will treat these symptoms with over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil). Immediately call your dentist if the pain becomes extreme or lasts for more than a few days. You should be able to resume your normal routine the day after the procedure. Avoid chewing or bitting with the damaged tooth until it’s permanently filled, or a crown is placed over the top to protect it from masticatory forces. You should visit your dentist within a few days of the root canal for follow-up checkups. The dentist might take X-rays to make sure that the infection is still persistent, or it is removed completely. They’ll also replace the temporary filling with a permanent filling. It may take you few days to several weeks to get used to how the tooth feels after the procedure. This is normal and needs no cause for concern.

Risks of a root canal treatment #

• A root canal is performed in an effort to save the tooth conservatively. Sometimes, however, the damage is too deep, or the enamel is too frail to withstand the procedure. These factors can lead to loss of the tooth and has to be replaced with other appropriate procedures.
• Another risk is developing an abscess at the root of the tooth if some infected material remains behind or if the antibiotics aren’t effective. This has to be taken care by dentist by taking x-rays and by follow-up visits.
• If you’re apprehensive about a root canal, you can talk to your dentist about an extraction instead but saving your natural teeth should be your first choice. This often involves placing a partial denture, bridge, or implant in place of the damaged tooth if you opt for extraction instead of root canal treatment.
• You should maintain your oral health to prevent food lodgment under the crown to prevent secondary infections.