A root canal (also known as endodontic therapy) is one of the most common dental procedures performed. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
In the center of every tooth lies a hollow chamber which contains a soft tissue known aspulp. This pulp tissue possesses a blood supply, many different types of cells, various connective tissues, and the nerves that give sensations to the tooth. When root canals are performed, this tissue is removed from the inside of the tooth. The removed tissue is replaced with a rubber-like filling material that is sealed in place with a calcium hydroxide paste.
Root canal treatment may be needed for one of several reasons:
- Pulpal necrosis. In this case the pulp tissue has died and degenerated. The necrotic debris that remains becomes a source of infection. This infection may be symptom-free, or it may be associated with the severest of dental pain, and even facial swelling. Sometimes abscessed teeth can be discovered with routine radiographs before any symptoms develop. Early intervention not only prevents pain and swelling, but also has more favorable success rates.
- Pulpal inflammation. In this case, the pulp tissue has not died, but has become
severely and irreversibly inflamed. This inflammation is called pulpitis, and will not cause swelling. Pulpitis results in a tooth that is overly sensitive. Mild pulpitis (reversible pulpitis) causes mild elevations in sensitivity and may not require a root canal. More advanced pulpitis results in pain that is severe, or spontaneous, or long-lasting, and cannot be reversed. In this case the pulp must be removed to eliminate the pain. - Insufficient remaining tooth structure to allow for a crown. When teeth are severely broken down, inadequate structure may remain to support any type of dental restoration. In such cases, a specially designed post can be placed within the remaining root of the tooth. This post serves to hold the crown firmly in place and allows the patient to retain his or her natural tooth rather than resort to a bridge or implant.
Root canals are almost always a painless procedure. They retain a somewhat bad reputation which was earned decades ago before advances in dentistry made pain control so complete. Though some moderate post-treatment discomfort sometimes occurs, root canal procedures in our office are not uncomfortable.
When posterior teeth (back teeth) receive root canal therapy, it is essential that they be crowned as soon as possible. If not crowned, most endodontically treated posterior teeth will eventually suffer a severe fracture which often requires extraction. If crowned, an endodontically treated tooth has a very favorable long-term prognosis.
