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Root Canal Treatment

Root canal treatment involves the removal of the nerve from the tooth by drilling a hole in the top surface of the tooth. The inside is cleaned out with disinfectants and needle-like instruments.

The root canal is then dried and a rubber filling placed down the inside of the tooth,therby sealing the pulp space & preventing bacteria from entering the space again.

With the removal of nerves and blood supply from the tooth, it is best that the tooth be fitted with a crown which increases the prognosis of the tooth by six times.

Single Visit Endodontics orSingle sitting root canal treatment refers to cleaning, shaping & disinfection of the root canals of the tooth followed by obturation, all carried out during the same visit.

Tooth anatomy and root canal treatment

Our teeth have their own circulation and nerves. The veins and nerves running inside the teeth can be damaged by various factors (such as deep decay or trauma). Inside each tooth is a pulp chamber that contains the nerves and blood supply for the tooth. When the pulp becomes infected due to decay or injury to the tooth, the pulp must be removed from the center of the tooth and the canals of each root. Once the infected pulp is removed, the remaining chamber is filled with a rubber-based material to seal it off.

All teeth that have had root canal therapy must be protected with a tooth-like artificial covering known as a crown (see crown section). This is because teeth that have had the pulp removed are more susceptible to fracture.

Does it hurt?

The mention of "root canal" evokes images of severe pain. In truth, however, root canal treatment is maligned unfairly. Advances in technology, and the experience of specialists(endodontist) have made root canal treatment far less painful than its reputation suggests. Ironically, root canal is designed to minimize the pain from an infected tooth; it does not produce the pain.Moreover the procedure is done under local anaesthesia.

When is root canal treatment necessary?

Root canal treatment becomes necessary when the pulp inside your tooth gets infected. The pulp is the soft tissue inside your tooth, home to connective tissues, blood vessels and nerves. The pulp goes from the crown of your tooth to the tip of the root in your jawbone. Normally, the tooth itself protects the pulp, but if the tooth is damaged by a very deep cavity, or a crack, or trauma from repeated repairs, bacteria can reach the pulp. Then the bacteria grow from the crown towards the root, pus accumulates at the root tips, and the mouth becomes painful and sensitive to hot and cold. Not all pulp infections bring pain; sometimes they spread so slowly that the patient feels nothing.

How is root canal treatment performed?

Root canal treatment occurs in three stages: First comes the diagnosis. Next comes the root canal itself, in which a dentist or an endodontist (a dentist who specializes in treating the inside of the tooth) removes the pulp (and thereby also the infection), and cleans the inside of the tooth preparatory to filling it, sometimes applying antibiotics to prevent further infection. A temporary filling is placed at the crown opening. Finally, during a subsequent appointment, a crown is installed to seal the tooth and protect it from further damage or infection.

What results can I expect?

With successful root canal treatment, the tooth will no longer cause pain. However, because it does not contain an internal nerve, it no longer has sensitivity to hot, cold, or sweetness. These are signs of dental decay, so the patient must receive regular dental check-ups with periodic x-rays to avoid further disease in the tooth. The restored tooth could last a lifetime; however, with routine wear, the filling or crown may eventually need to be replaced.Excellent oral hygiene after your root canal can help ensure success and prevent reinfection. Keeping your original teeth should always be your main objective. An untreated infection inside a tooth will only worsen over time; the pulp cannot heal itself. Without treatment, you may eventually lose the tooth, and require a bridge or other costly restoration. Protect your teeth by getting treatment as soon as you learn that you need it.

What complications can I expect?

Signs of a failed root canal treatment are:

  • Mild to severe tooth pain
  • Slight to more pronounced tenderness or swelling in the gums in the area near the tooth that can either be in a persistent or transient mode following root canal treatment.

Factors influencing the failure of the treatment

  • Shape of the tooth's root canals
  • If they have branches or forks they may be difficult to detect and therefore are overlooked during treatment.
  • Unexpected number of root canals
  • When a tooth has root canals that are tiny they may be overlooked during treatment
  • Undetected cracks in the root of the tooth
  • Defective or inadequate dental restoration allowing bacteria to seep into the inner core and recontaminate
  • Disintegration of the tooth seal with the passage of time causing bacteria to recontaminate the tooth
  • Tooth structure that has broken as a result of the treatment and require restorative work for stability
  • The treated teeth are not impervious to tooth decay and gum disease, in which case if extra hygiene is not maintained it can result in the loss of the teeth
  • Poor response of certain bacteria to the root canal treatment

What are the other complications associated with root canal treatment?

  • Breaking off of the dental instruments or files in the root canal while cleaning the pulp chamber. This can be removed later but only by a specialized endodontist.
  • Infection as a result of incomplete treatment or filling as a result of the root canals being complex or not being detected on the X-ray
  • Poor response of certain bacteria to the root canal treatment

Single sitting root canal treatment

Single Visit Endodontics or single sitting root canal treatment refers to cleaning, shaping & disinfection of the root canals of the tooth followed by obturation, all carried out during the same visit. Traditionally root canal treatment was done in multiple sittings.Recent advances in diagnostic techniques,emergence of new material/equipment and advanced technology have made it possible to do the root canal procedure in a single sitting.

Endodontics is no longer “blind treatment”, based only on the touch and the experience of the clinician. The emergence of new canal preparation instruments, of means to electronically determining canal length,the use of Apex locater, of the use of ultrasound in endodontics and, last but not least, of the endodontic surgical microscope have all led to an increase in treatment possibilities and indications and in success rates.

Is it different from the tradional root canal treatment

The steps of the procedure remain the same,except that the entire procedure is completed in a single visit

Advantages

  • Faster,less time consuming
  • Prevents recontamination of the root canals between successive appointments.
  • Less dose of anaesthesia?(only once)