Root Canal Treatment is an area of dentistry involved with saving a tooth that may otherwise need to be extracted. The treatment is needed when the area inside the centre of the tooth (the root canal), which houses the nerve and blood supply, becomes damaged or infected which can cause on-going pain and severe discomfort.
A damage or infected tooth could be caused by decay, a fracture, leakage, trauma or bacteria. In extreme cases if left without treatment the tooth can lose its blood supply and become non-vital. Once the tooth is infected there is a high risk of an abscess forming. The purpose of having root canal treatment is to restore the problem tooth or teeth to a good health and take away the pain or infection.
Endodontic (root canal) treatment is based on a very simple concept: the dental pulp in a mature tooth can be removed when it becomes inflamed or infected and the tooth remains healthy without it. The pulp itself consists of very small blood vessels and nerve tissue located in the centre of each tooth in the root canal. The primary function of the pulp is to lay down hard tooth structure (dentine) during the developmental stage of each tooth. It has a limited blood supply, however, and is highly susceptible to inflammation and infection.
Decay, trauma, or extensive restoration of a decayed or cracked tooth may result in pulpal inflammation or infection. Pulpal inflammation is can occasionally occur following a deep restoration (filling) or preparation for a full crown. Unfortunately, fillings do not last forever. Over time they can break down and begin to leak which can promote decay or small cracks in the underlying tooth structure. For this reason, fillings eventually need to be replaced or, in some cases, filled teeth may require the support of a full crown restoration. The very act of replacing a restoration or preparing a tooth for a crown may occasionally result in inflammation and a damaged pulp. Evidence of this inflammation may be extreme sensitivity to cold, heat or pressure from biting. Endodontic treatment eliminates this sensitivity and allows the tooth to be healthy and functional.
Although the rationale for endodontic treatment is uncomplicated, the treatment itself can, at times, be tedious. As we age, the canals in our teeth tend to narrow or "calcify." This can make the process of locating and cleaning them somewhat time-consuming. With the use of our operating microscopes, treatments can often be completed in a single long appointment. It should be stressed that, although the treatment may require a long appointment, it should in no way be painful. To begin, a local anesthetic is administered and, once the area is completely numb, treatment is initiated. An opening is made in the biting surface on a back tooth or the tongue side of a front tooth. Through this access-opening, small instruments (files) are inserted to remove the pulp tissue and widen the root canals. This accomplishes two things: first, it eliminates the pulp, which is the source of inflammation or infection and second, it creates a shape inside the tooth that will accept a root canal filling. The filling material is called gutta-percha, which is a rubber-like material that is biocompatible and has been used successfully for this purpose for many years.
Success rates are in the 95% range when performed by a Specialist with a microscope. Factors that limit the success are the presence of lateral canals or irregularities in the root canal system that are difficult to thoroughly clean, or cracks in the tooth that permit contamination from the outside of the tooth. These limiting factors are infrequent and are much more easily rectified by a Specialist in Endodontics performing their procedures under a microscope. The majority of endodontically treated teeth remain comfortable and functional for a long time.
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