Mention “Root Canal,” and many people would feel their teeth chattering in fear. Root canal treatment, also known as endodontic ( inside the tooth) treatment, is a dental treatment to remove an infection inside a tooth. It helps in protecting the tooth from future infections.
Many people would say it is an excruciating procedure, but in reality, it is a pain-relieving treatment that saves your tooth from further decay and eventual falling. Done correctly, you should not feel anything at all during the procedure. Compared to tooth removal or replacement with a crown or bridge, root canal treatment is more conservative and preserves your natural tooth structure. less costly.
The "ins" and "outs" of Root Canal Treatment (RCT)
What is a root canal treatment?
When a patient undergoes a root canal, the inflamed or infected portion of the pulp is removed. The tooth is then carefully cleaned and disinfected from the inside. After disinfection and cleaning, the tooth is sealed and filled.
The dentist makes a small access opening on the top of an infected tooth during a root canal to access the soft tissue inside. The dentist then removes the infected dental pulp, fills the space with tiny rubber rods called gutta-percha, and caps the repaired tooth with a crown. Root canal treatment is designed to remove bacteria from the infected root canal, prevent reinfection of the tooth and save the natural tooth.
What exactly is a root canal?
To understand endodontic or root canal treatment, let’s first understand the anatomy of the tooth. Under the white enamel inside the tooth, there is a hard layer called dentin and soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development.
A tooth consists of a crown and roots. The crown is mainly above the gum, while the roots are below it. The roots secure the tooth to the jawbone. Root Canal is a part of the tooth, and the root canal treatment is commonly referred to as root canal.
A root canal is the hollow section of the tooth that contains nerve tissues, blood vessels, and other cells, also known as the tooth’s pulp. The pulp also nourishes the tooth and provides moisture to the surrounding material. The nerves in the pulp sense hot and cold temperatures and signal them as pain. The exposed nerves from the pulp of the tooth are removed during root canal treatment.
The pulp is vital during a tooth’s growth and development. It extends from the tooth’s crown to the tip of the roots, where it binds with the tissues surrounding the root. During the growth stage of the tooth, the pulp plays an important role. However, once the tooth is fully mature, it can very well survive without the pulp, drawing nourishment from the tissues surrounding the tooth.
What happens when your root gets infected?
The infected or diseased pulp inside your tooth cannot repair itself, and the tissue gradually starts dying. If there is a deep cavity, a chipped or cracked tooth, even a loose filling, the bacteria can enter the pulp and eventually destroy it.
Furthermore, if these bacteria manage to get through the root openings, they could cause an infection in the bone, which could be very serious since it could weaken the bone and break it down. The ligaments around the tooth could have swelling and one could lose the tooth. Injury to the pulp is the leading cause of tooth sensitivity.
People also feel pain while chewing, and some even suffer from the continuous, throbbing pain.
How do you know you need a Root Canal Treatment?
Do I need a root canal?
Many patients start their consultation with this question.
If you have a cracked tooth from injury or genetics, a deep cavity, or your previous filling does not effectively protect your tooth from reinfection, you need a root canal treatment for a more long-term solution.
Generally, we recommend a root canal when the patient complains about sensitive teeth, especially hot and cold sensations. Several other treatments could make you consider root canal treatment-
- Severe pain when biting or chewing
- Painful boils/ inflammation/pimples on the gums
- A chipped or cracked tooth
- Lingering sensitivity to hot or cold, even after removing the sensation
- Swollen or tender gums
- Darkening of the gums
- Decay of tooth or gums
If you have one or more of these symptoms, you should consult your dentist immediately and discuss the options to salvage the natural tooth.
What happens during the Root Canal Treatment?
Root canal treatment is a quick and comfortable procedure that relieves your pain and saves your natural tooth.
Steps in Root Canal Treatment
Root Canal Treatment is a systematic step-by-step procedure performed by a specialist dentist. (https://www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/root-canal-explained/)
These are the steps that are followed:
1. Cleaning of the root canal
This procedure is done under local anesthesia, where the dentist removes everything inside the root canal. The dentist first makes a small access hole to get to the inside of the tooth and then removes the diseased and dead pulp tissue using tiny files.
2. Filling the root canal
The dentist cleans, shapes, and decontaminates the hollow area using files and irrigation solutions in the next stage. After the inside is thoroughly cleaned, the dentist fills the tooth with a rubber-like material and seals the canals completely using adhesive cement.
3. Adding a crown or filling
A tooth with no pulp needs nourishment from ligaments and tissues that attach it to the jawbone. As a result, the tooth is now more fragile than it was before. In time, the nourishment might not be adequate, and the tooth could become more brittle. Therefore, a crown or filling offers extra protection. After the crown or filling, the patient can use the tooth as before.
How long does it take for the root canal treatment?
The root canal treatment usually needs only one or two appointments. In the first visit, the dentist assesses the tooth’s condition and checks for pain and inflammation/infection in the affected area. The dentist might prescribe a course of antibiotics before commencing the root canal treatment.
You can think of scheduling an appointment immediately after the antibiotics course is complete. This medication is just a temporary arrangement to give you some relief from the pain. Once you visit the dentist for your root canal treatment, it would usually take only one appointment.
Still, if there are specific challenges like curved canals, multi-canals, or significant, widespread infections, it could take one or two additional appointments.
Is the tooth dead after a root canal treatment?
In a word, Yes!
The tooth is dead after root canal treatment. It is barely a shell with all nerves and tissues that were infected are removed. There should not be any pain after the root canal treatment. However, the tooth that has undergone root canal treatment is weaker than a healthy tooth without a root canal.
That being said, the treated tooth could last a lifetime if proper care is taken. The support structures like the bone and ligaments are still intact and healthy. You must maintain good oral hygiene and visit your dentist regularly.
Today, scientists report developing a peptide hydrogel designed to stimulate new blood vessels and the dental pulp within a tooth after the procedure.
Source – Biomaterial could keep teeth alive after a root canal.
Why should you opt for Root Canal Treatment?
Root Canal Treatment is a highly effective treatment to save your natural teeth. It prevents further degradation of the tooth and retains your normal chewing and biting capabilities. It is also aesthetically pleasing because a natural tooth doesn’t lose its external structure. Root canal treatment is the most optimal solution for infected roots and dental pain combined with filling or crowns. There are several other advantages of getting root canal treatment.
- Improved chewing within just a few hours of the treatment
- Normal biting force and minimal loss of sensation while eating.
- Prevention from tooth sensitivity
- The unaffected natural appearance of tooth and jawline
- Safeguarding teeth from excessive wear or strain.
Is root canal treatment painful?
If you are afraid that root canal treatment is painful, you should give your dentist a chance! If a trained dental surgeon carries out the treatment, root canal treatment is relatively painless. You should know that the pain that you feel comes mainly from the pulp infection and not from the treatment. The treatment doesn’t aggravate the pain. It helps alleviate it.
As part of the procedure, the tooth and the surrounding area are numbed using anesthesia. Since it is a comprehensive procedure, you can expect tenderness and pain after the treatment, which is normal. Your dentist would prescribe appropriate OTC pain medication to relieve it. You may also be prescribed an antibiotic to prevent infection.
What is the alternative to Root Canal Treatment?
Many patients opt for extraction instead of going through the perceived discomfort and pain of Root Canal Treatment. However, patients must note that it will hurt even more if the tooth can not be restored. For example, there is significant decay, trauma, or bone loss due to periodontal/gum disease.
Removing a tooth may seem like a permanent solution as you remove the “root” cause of the problem. But it also affects the surrounding teeth as they start shifting and could get misaligned. (Malocclusion / misaligned teeth). It also makes it challenging to have a good bite.
A good dentist would always recommend opting for Root Canal Treatment if the salvaged tooth retains its maximum natural functionality. Root canal treatment could save the tooth and eliminate the pain without the loss of a tooth.
What does a root canal treatment cost?
A root canal or endodontic treatment costs less than extraction and subsequent implant or bridge to replace the extracted tooth. Overall, the root canal treatment costs are dependent on the amount of work needed, and crowns or filling could be added to your treatment based on the requirement. In addition, most dental insurance policies provide coverage for endodontic treatment.
With advanced dentistry techniques, modern-day root canal treatment is very similar to a routine filling. It can usually be completed in one or two appointments depending on the condition of your tooth and your convenience. It is relatively painless and highly effective, and you will be back to biting, chewing, and smiling with ease within no time.
Dr. Smita Warrier graduated dental school in 2004 from Tufts University in Boston. She relocated to Charlotte shortly after and started her practice in Ballantyne in 2007. She is very passionate about dentistry and providing top-notch care to her patients. She is a member of the American Dental Association as well as local and state dental organizations. She feels very strongly about staying abreast of the latest technologies and treatment care modalities and dedicates many hours in continuing education. She has been an Invisalign certified provider since 2006.
In her spare time, she likes to run, bike, hike and read. She has done countless half-marathons and several half Ironmans. You can usually find her on the weekends running at the greenway or hiking up in the mountains of beautiful North Carolina with her husband and two boys.