Root Canal Therapy
Initial Endodontic procedure to remove infected or damaged tissue and/or abscess. During Endodontic treatment an opening is made through the crown (the top of the tooth). Tiny instruments are then used to remove the damaged tissue from the canals. The canals are then shaped to a form that will be easy to fill. When completely clean and free to infection, the root canals are filled and sealed with a material that prevents bacteria from reentering. The opening made in the top of the tooth is sealed with temporary filling. The temporary filling will be replaced by your regular dentist with permanent filling, or some other protective covering such as a crown.
Knowing about the anatomy of your teeth helps your understanding why you need endodontic treatment. Your tooth essentially has 3 layers: the outer layer, known as the enamel; the inner dentin, and the centermost layer, known as the pulp. The outermost layer, the enamel, serves to insulate the tooth, and is lacking a nerve connection. The 2nd layer, or dentin, does have a nerve supply and is a sensitive structure within the tooth. The innermost layer, the pulp, carries the blood vessels, nerves, and the connective tissue of the tooth and is central in tooth development by creating hard tissue surrounding the tooth. Furthermore, the pulp is contained within the canal system of the tooth that composes the pulp chamber in both in the crown and in the root canals, connecting through the apex, or tip of the roots.
If the pulp becomes infected or swollen, endodontic treatment is necessary. Swelling or infection of the pulp may be caused by various conditions such as repeated dental procedures performed on the tooth, deep decay, or a chip or crack or other trauma on the tooth. Left untreated, infection or swelling can cause tenderness or cause an abscess to develop.
Symptoms of damage to the pulp might include throbbing pain, ongoing sensitivity to cold or heat, discoloring of the tooth, or inflammation or tenderness in the adjacent gums. Additionally, there may, in fact, be no symptoms at all.
Required endodontic procedures may often be completed in only 1 or 2 visits, based on the severity or complexity of the canal system and associated infection. The following steps may be taken:
Step 1: Your endodontist will examine the tooth and include several tests in order to determine the status of the pulp, including performing an x-ray, and anesthetize the surrounding gum and tooth. Once the tooth is numbed, the endodontist will place a “dental dam” over the area to isolate the tooth and keep it clean and saliva-free during the procedure.
Step 2: Your endodontist will then create an opening in the crown to access the pulp chamber and the root canals. Molars have three to five canals, bicuspids usually two, and anterior teeth and lower bicuspids will have one canal. Files, which are very small instruments, are utilized to clean and shape the canals, preparing them for the canal filling.
Step 3: After cleaning and shaping the root canals, your endodontist will fill them with a rubber-like substance called “gutta-percha,” which is biocompatible. Gutta-percha is put into place with an adhesive cement to safeguard that the root canal is completed sealed. Usually, a temporary filling is placed to close off the opening. This temporary filling will be replaced once the tooth is restored.
Step 4: Once you are finished with the visit to your endodontist, your family dentist will restore your tooth with a crown or other device to protect and to make your tooth fully functional. If this final step is not completed, your tooth may fracture and ultimately be lost.