The term “root canal” is used to identify the natural cavity inside the tooth where the soft area called pulp or pup chamber is found. The nerves of the tooth whose function is sensory can also be found inside the root canal. If the pulp gets injured (repeated dental procedures, fillings, cracked or broken tooth) or infected (due to tooth decay), the pulp tissues and nerves die which could lead to severe infection when bacteria starts to multiply and therefore has to be removed. If gone untreated, the surrounding tissues might also get infected which will result in the following: tooth abscess, bone loss around the tip of the root, swelling might spread to the face, neck, or head, and occurrence of hole at the side of the teeth which might cause drainage problem into the gums, cheek, or skin.
However, unlike in the old days when a tooth had to be removed when it became infected, there is a special procedure nowadays called root canal or endodontic treatment where a tooth can be saved from extraction. Root canal therapy involves repairing and saving the badly infected tooth by removing the pulp and nerves and then protecting it by cleaning and sealing the inside of the tooth. A crown is then placed over the treated tooth to make it stronger.
Saving a natural tooth includes many advantages such as not having to wear artificial tooth/teeth, efficient chewing, prevents jaw problems, and protects other teeth from too much wear and strain.
The branch of dentistry that deals specifically with diseases of the tooth’s pulp and the surrounding tissues is called Endodontics. Root canal treatment can be done by general dentists, but if the issue gets complicated or is being done a second time, patients are often referred to an endodontist. Endodontists are dentists that have gone through specialized studies and trainings that deal solely with root canal treatments.
Symptoms and signs that you might need a root canal treatment:
- A broken, decayed, cracked, or loosened tooth
- Acute, sharp, and spontaneous pain that is hard to locate and may be due to the infected pulp or formation of abscess at the tip of the root.
- Discoloration or darkening of the tooth
- Dull ache and pressure
- Pain extends to the ear, temples or jaw areas.
- Prolonged pain and sensitivity to hot or cold drinks and foods
- Recurring or persistent pimple on the gums that may discharge pus causing bad odor or taste
- Severe toothache pain when biting, chewing, or touching the tooth because of the infection or inflammation of the root tip and the application of pressure on its socket irritates the root area.
- Swelling and tenderness of the gums near the infected tooth
- Swelling of the face
However, there are instances where a tooth pulp can become damaged or infected without any of the above symptoms presented. When this happens, the dental issue is often detected by X-rays or special dental tests during checkups or other dental treatments.
Causes of tooth pulp damage or infection:
- Abscess where a pus pocket forms around the end of the root when the pulp of the tooth dies and which can spread to the surrounding tissues and bones
- Advanced gum infection
- Bruxism or teeth grinding
- Deep tooth decay beneath a tooth filling that gets untreated
- Deep tooth cavity
- Repeated dental procedures that can cause a lot of strain on the tooth such as drilling, filling, and crowns
- Traumatic damage to the tooth such as a chip, crack, or even root fracture where the nerve was severed at the end of the root causing it to die; this can happen immediately or years after the trauma
There are several steps your dentist will do to determine if you need root canal treatment and these will include: look for any symptoms that you might have needing the treatment, check the tooth and the gum’s condition and for any dental procedure done on it before, examine the nerves and tissues on the tooth and the surrounding area by applying hot and cold substances on it, tap on the tooth gently or have you bite on something to determine if the tooth is sensitive to touch or pressure, take X-rays of the tooth and the bone around the tooth to show how the treatment will be done, and use an electronic pulp tester that sends a small amount of electric current through the tooth to determine if the pulp is still alive.
Treatment procedures of root canal:
The first step in treating root canal is taking X-rays of the infected tooth to determine the shape of the root canals and to see if there are any signs of infection and then numbing the infected tooth and the surrounding tissues by applying anesthesia.
Next, the dentist will use a dental gum (a thin sheet of rubber or vinyl) to isolate the infected tooth from the rest of the mouth and also to keep the tooth dry.
A small hole is then drilled into the infected tooth to gain access to the pulp chamber and root canals to be treated. Using special instruments like root canal files, the dead pulp, nerves, and tissues along with bacteria and other debris, are removed by flushing with water or with sodium hypochlorite.
After the root canals are cleaned and disinfected with antibacterial solutions and antiseptic, followed by shaping of the canals for the root canal fillings and then washing and cleaning once more before sealing them.
At the next appointment for treatment, a rubber-like material known as gutta-percha together with an adhesive called sealer is used to fill the root canals and seal them. A crown is often placed over the tooth to avoid any infection or contamination in the future.
The final procedure might include restoration of the tooth to its full function with a crown to help prevent it from further breaking or damage. Your dentist will tell you if you need any additional dental procedure. After the treatment an antibiotic will be prescribed for you to take to prevent infection.
Alternative means to a root canal:
Taking the necessary steps to save your natural teeth is the very best alternative possible. Tooth extraction is another most unlikely option. Removal of tooth/teeth means replacing the lost one/s with removable or partial denture, with a bridge, or tooth/teeth implants. However, these alternatives require more time for treatment, extra procedures to be done on nearby tissues and adjacent teeth, and more expensive.
Cost of a root canal treatment:
The cost of a root canal treatment will depend on which tooth is affected and the severity of the problem. The cost will be based on the degree of difficulty, number of canals to be treated, and location of the infected tooth/teeth in the mouth (for example, front teeth are easier to treat than back teeth). Endodontic treatments are covered by a lot of dental insurances, but it still depends on your coverage. Endodontists might charge 50% more than regular dentists.
Root canal treatment makes it possible for an infected or diseased tooth to be saved rather than having it removed like in the past. This treatment involves removing the inflamed or infected pulp, cleaning and disinfecting the inside of the tooth, and then filling and sealing the tooth with a rubber-like material known as gutta-percha. The final step is restoring the tooth with a crown for protection against future dental issues. The root canal treatment is a highly successful procedure and can last a lifetime and the treated tooth can function like any other tooth after restoration.