Endodontic Therapy

Endodontic therapy is a sequence of treatment for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future microbial invasion. This set of procedures is commonly referred to as a "root canal." Root canals and their associated pulp chamber are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities. Endodontic therapy involves the removal of these structures, the subsequent cleaning, shaping, and decontamination of the hollows with tiny files and irrigating solutions, and the obturation (filling) of the decontaminated canals with an inert filling such as gutta percha and typically a eugenol-based cement.

After endodontic surgery the tooth will be "dead," and if an infection is spread at apex, root end surgery is required.

Although the procedure is relatively painless when done properly[1], the root canal remains a stereotypically fearsome dental operation, and, in the United States, a common response to an unpleasant proposal is, "I'd rather have a root canal."

It used to be that if a tooth was infected or the nerve in the tooth was dying, the tooth would have to be pulled. Today because of a procedure known as root canal treatment the infection can be treated, the injured nerve taken out and the pain associated with such symptoms alleviated.

A common reason for root canal treatment is an infected or abscessed tooth, which may result from a deep cavity, periodontal disease, or even a fractured tooth. Sometimes, trauma - like a sharp blow to the mouth can result in damage to the pulp of the tooth. Should you have symptoms such as swelling, sensitivity to hot and cold or discomfort on touching your tooth, a dentist should be consulted immediately.

Root Canal treatment removes the pulp tissue, which is composed of a nerve and blood supply within the tooth. After all the material has been removed from within the root, the canal or canals if it is a multi-rooted tooth, are sterilized and sealed with a material that prevents bacteria from reentering.

Because a root canal removes everything, which feeds the tooth and keeps it alive the tooth will become very brittle after a period of time. This time period varies from person to person. It is for that reason that the tooth should be restored as quickly as possible and your dentist might recommend that a post and a crown be placed as a final restoration. Back teeth are usually crowned or capped shortly after a root canal has been performed to prevent the tooth from shattering due to the pressure put on it by chewing.

Root canal work is not uncomfortable, and in some instances can be performed in one visit. The discomfort associated with root canal is due to the infection associated with the need for the root canal. If there is recurring pain after the root canal has been started, or after it is completed be sure to notify your dentist as soon as possible.

IS ROOT CANAL THERAPY FOR EVERYONE?


Yes! Everyone who wants to save her or his teeth (having been diagnosed as having a problem needing root canal therapy) can benefit and expect to maintain the tooth in its healthiest state, once the root canal is completed. There is no limitation for age or state of health. Endodontic (root canal) therapy is an elective procedure for those people who want to invest their time and money in keeping their teeth.

An abscess that has formed around the apex of a lower central incisor can be favorably treated by retreating the tooth and/or an endodontic surgical procedure - a decision that should be made by your dentist.

The single limitation for root canal therapy for any given tooth is the restorability of the tooth. Simply, restorability means confirming there is enough tooth structure to save and ultimately restore the tooth to function. Once treated through root canal therapy and appropriately restored, a tooth (with a previous

abscess or infected dental pulp) can function normally for a very long time. Your general dentist can best determine the final permanent restoration for the root canal treated tooth. If a root canal ever does fail, consider that there are still treatment options with very good success rates that can save your tooth, root canal retreatment and endodontic surgery.

A tooth that has had a root canal can develop an abscess and/or infection. It can be due to the breakdown of the root canal material at the apex of the tooth. By retreating a tooth that has had a root canal a better seal can potentially be placed. Once the seal is reestablished, the abscess or infection may degenerate. Alternatively, if the abscess does not diminish, a surgical procedure, called an apicoectomy might be indicated as well.

Clearly root canals are not for everyone and everyone who has been told they need a root canal has the option of having the tooth extracted. If you have not in the past, or do not intend in the future, to make a concerted effort to be a dental wise patient, serious about routine dental care, are not committed to having the tooth properly restored after the root canal, and you do not mind the thought of losing a (or another tooth), then endodontic therapy may not be the treatment of choice for you.