- Root canal treatment overview
- Some of the common causes of pulp damage
- Symptoms of an infected pulp leading to root canal treatment
- Root canal treatment procedure- what does your dentist do in the root canal treatment?
- Is root canal treatment painful?
- Success of root canal treatment
- Failures of root canal treatment
- What if you don’t want to have an RCT? – alternatives of root canal treatment
- What care to be taken after root canal treatment?
- Root canal treatment cost in India
Root canal treatment overview
Root canal, a word that gives you shivers down your spine. A treatment of the core element of the tooth called as pulp that is the formative organ of the tooth.
But the pulp is a highly resistant tissue with good healing ability. This resistance depends on the nutritional supply, age cellular damage and other metabolic and physiologic parameters. This remembers me of a remark for the pulp “Some pulp will die if you look crossly at them while others can’t be killed with an axe”. (Source: Grossman’s Endodontic Practice, Twelfth Edition)
In simple words root canal treatment is the removal of the diseased pulp tissue, cleaning the canal and shaping it to receive an artificial filling material. The root canal treated tooth needs to be covered with a crown over it.
Any kind of injury to the calcified structure of the tooth can cause damage to the pulp beneath. These changes in the pulp can be reversible or irreversible, that depends on the duration, intensity, and pathogenic of the host.
Here we are going to discuss the needs and the procedure of the root canal treatment in detail.
Many root canals are treated today and before not only to save the decayed tooth but also to use the teeth as abutments or you can say support for the construction of fixed bridges and fixed or partial dentures.
Let us discuss the diseases commonly affecting the pulp that can may you visit your dentist or an endodontist.
Some of the common causes of pulp damage
- Traumatic accident to the tooth while sports or during any dental procedure like filling the tooth.
- Pathological wear of the tooth caused by attrition of the tooth that commonly occurs in a case of patients with bruxism or clenching of the tooth.
- A crack that can occur on the tooth due to higher occlusal forces can lead to pupal injury.
- A toothache can also bother you when to fly to lower temperatures like in flights.
- Heat can also cause pulpal injury that is produced during tooth cutting.
- The types of cement that are used to fill the decayed tooth does produce heat while setting thus leading to damage to the pulp below.
- In the case of deep decay to the tooth, high strength types of cement are filled into the cavity that bothers to the pulp.
- Certain types of cement contain a small amount of acidic content like phosphoric acid that damage the pulpal tissue.
- The bacterial attack on the tooth (dental caries) or direct invasion due to trauma that can also damage the pulp.
- Even some blood borne microorganisms produced can cause pupal infection being a cause to remove the pulp from the tooth.
Symptoms of an infected pulp leading to root canal treatment
- A short, sharp shooting pain that lasts for a moment and is specific to stimuli and is relieved on removing the stimulus. Example by hot and cold food or beverages.
- Pain caused by sudden temperature changes mainly cold, sweet or acidic foods and due to sudden pressure from any food entering the decayed tooth.
- Even after you remove the cause the continuous pain is experienced. It lasts for minutes to hours.
- The pain is mainly increased during lying down posture.
- It may be referred to the adjacent teeth in extreme cases and also to the head and ear.
- In a case of the higher grade of infection like pulp necrosis, you may not notice any symptoms but you may notice the dull or opaque appearance of the crown instead of translucency.
- The tooth may show grayish or brownish discoloration.
- In a case when the infection has reached below the pulp you may experience pain or tenderness in mastication or during percussion done on the tooth by the dentist.
- In the case of higher infection below the pulp, the tooth becomes elevated in its socket and more sensitive.
- Redness and swelling of the gingiva (gums) are also noticed.
Root canal treatment procedure- what does your dentist do in the root canal treatment?
Root canal treatment can take you several visits to your dentist. This procedure can take more than 3-4 visits than it depends on the damage and the frequency of the tooth infection.
Every individual is distinct in their canal anatomy that we discussed in our other article of root canal anatomy. Some individuals have curvy, and tortuous canals so for this the general dentist is the one who needs to decide whether he could comfortably perform a root canal or he needs to call an endodontist for this.
The first step of the root canal begins with the X-ray that is important to be done before going for a root canal therapy to check the course of the canal, the extent of infection into the pulp or any kind of infection beyond the pulp tissue, the damage to the tooth and adjacent tooth.
Then a little painful step comes is the injection of a local anesthetic that makes your tooth numb and you that you may not have any pain during the entire procedure. It’s just like a small pinch on your skin for a few seconds.
During the entire procedure, the oral cavity needs to be kept dry the dentist or endodontist does it by placing a saliva ejector or placing a rubber dam. A rubber sheet (rubber dam) is placed into your mouth that covers the whole of your mouth except the tooth to be treated when your dentist or endodontist use a rubber dam.
The cavity is drilled and all decayed portion is removed from within the tooth and it is cleared of all debris, this cutting is done along the course of the canal.
After the canal is opened, the dentist may carry out the cleaning and shaping but in some cases, the patient may be recalled after 2-3 days based on the extent of infection. During cleaning and shaping of root canals, various cleaning and shaping methods are done using files of increasing diameters and thus making the canal shaped to receive a proper filling material. During this entire procedure water, normal saline or sodium hypochlorite and EDTA (Ethylenediaminetetraacetic acid) are used frequently to clear away all the debris from within the canal. And then after the shaping and cleaning are done thoroughly the canal walls are dried and a plasticized rubber base material called as gutta-percha is inserted into the canal with the sealer to seal it against the canal walls.
After completion of cleaning and shaping of the root canals, a restorative material is placed in the access cavity. And above this, a crown is placed on the tooth to protect it.
Is root canal treatment painful?
Root canal treatment is almost a painless procedure to an extent, the pain you can experience is only during the first visit during the injection of local anesthetic, except this, the patient experiences no pain. Antibiotics are prescribed after the first visit for subsiding the infection and subsequently, as the infection is decreased the pain subsides eventually.
Success of root canal treatment
The success rates of the root canal are nearly high (95%). These rates depend on how the RCT is performed and after RCT the tooth is sealed with either a crown over it or a tooth filling is to be done. The tooth needs to be covered with a crown or tooth filling materials in order to prevent the fragile tooth from breaking and the crown also protects the interior of the tooth.
Failures of root canal treatment
Root canal treatment is one of the best alternatives to a grossly carious or pulpally decayed tooth. In spite of these as we know each coin has two faces root canal also at times is a failure because of several reasons:
- Improper canal filling, the dentist might have missed any canal for filling.
- Improper cleaning of the canal is also a reason.
- Any crack in the tooth that might not be noticed before the root canal treatment.
- The restoration was done on the tooth after the root canal treatment if improper can cause contamination of the canal by bacteria leading to failure of the treatment.
- If the seal done in the canal during the filing is broken can cause bacteria to enter the canal and get it infected.
After the failure of root canal treatment, we have an option to save the tooth by surgical means such as apicoectomy and root end resection. In this, we cut the apical end of the tooth and fill it with a bone regenerative media and help the infected bone to regenerate.
What if you don’t want to have an RCT? – alternatives of root canal treatment
A natural tooth comes with natural strength so, it is better to take due care of your teeth but in case you need to have a root canal treatment some other alternatives to a root canal treatment is to have an implant or a bridge and even a removable partial denture is an option but at the cost of natural tooth. Yes, you heard right. If you don’t want to go for root canal treatment then there is no hope for saving the tooth. That tooth must be removed or extracted.
That depends on your choice and the tooth that is affected.
Implants and bridge are a good option but a bit time consuming and needs more money. Whereas removable dentures are not a good option as they are outdated and have a small life with less comfort and less chewing efficiency. What is best for you, a dentist can suggest you and accordingly, you can decide.
What care to be taken after root canal treatment?
Root canal treated tooth has a crown over it that functions the same way as your natural tooth but it also needs to be cleaned as your natural tooth. Improper cleaning habits in a root canal treated tooth can lead to further problems.
So, better cleaning with an interproximal brush and dental floss can be helpful for cleaning. Your teeth love’s to be cleaned twice a day so brush twice daily and use a floss and gargle after each meal would be good.
Root canal treatment cost in India
In general, the cost of the root canal treatment varies according to the dentist or endodontist’s knowledge, skills, and experience. But on an average, the approximate cost of root canal treatment in India varies between Rs. 1200 to Rs. 3500.
So, here is it. A root canal treatment is a crucial step to salvage your decayed tooth. Now we hope this was fair enough to give you a clear idea of what is a root canal treatment and why it needs to be done. After all, a healthy mouth is a reflection of a healthy you. Stay Healthy, Stay Happy.