Root Canal Treatment for Decayed Teeth
Authored by Dr.Koya Kishore
When an injury or large cavity damages the root of the tooth and the root becomes infected or inflamed, the root canal treatment (RCT) is done to eliminate the infection and protect the neighboring healthy teeth from getting infected. A tooth is made up of a short crown and a long root. A pulp cavity is seen internally passing from the middle of the tooth up to the root tips. This root portion is called a Root canal. It houses the dental pulp, a tissue containing cells, and nerve supply maintaining vitality of the tooth. • Who should go for a RCT? When the dental pulp is inflamed, infected or traumatized to the extent that it develops irreversible changes, one must get a Root Canal procedure done.
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How does tooth get infected? What damages a tooth’s nerve and pulp in the first place? Grossly decayed teeth as a result of bacterial infection is the most common cause of a RCT. Damage to the pulp can also occur from other causes such as tooth wear causing severe sensitivity; trauma to the tooth; mechanical insults during cavity preparation, etc.
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What symptoms or signs indicate that a RCT is required? Pain is the first symptom that brings a patient to the doctor. Pain can vary from acute to chronic, mild to severe; dull nagging pain or sharp pain. Pain while intake of cold stuff is typical for early stage of pulp disease due to bacterial infection. Besides this, pain while chewing or a swelling of the gum that may or may not burst, requires dental examination.
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What are the causes that lead to RCT? Grossly decayed teeth as a result of bacterial infection is the most common cause of a RCT. Damage to the pulp can also occur from other causes such as tooth wear causing severe sensitivity; trauma to the tooth; mechanical insults during cavity preparation; etc.
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What are the steps involved in the root canal treatment? Under local anesthesia, an opening is made on the root of the tooth in order to access the root canal. The canal is drained of the infection, cleaned and shaped and finally an inert filler is placed in the space which was previously occupied by the dental pulp; following which the tooth is restored with a permanent filling and a crown.
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What are the post-procedure precautions? Some amount of post-operative discomfort or pain is expected especially when preoperative pain is present. The duration of pain varies from person to person; however medication is prescribed to relieve pain. It is better to avoid chewing on the affected side for up to two days not only to relieve discomfort, but also to protect the non-restored tooth from fracture. It is important to consciously avoid chewing food until the anesthetic affect is gone to prevent biting/chewing one’s own tongue or cheek.
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What is the prognosis of the root canal treatment? Every root canal treated teeth has to be covered with a crown. If oral hygiene is maintained properly, the tooth functions as a normal healthy tooth and lasts long.
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How long will the restored teeth last? Under favorable conditions, the teeth can last a lifetime.
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How painful is a root canal? The Root Canal Treatment is essentially a painless procedure. However, severe inflammation interferes with the action of the anesthetic when administered locally, and alternate anesthetic techniques are required. Fear of root canal procedure is greater than the pain, if any.
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What should one expect after the Root Canal? Numbness in the region of the affected tooth that lasts up to an hour after the procedure. Discomfort or pain that lasts from a few hours to a few days is a common occurrence and is relieved with pain medication. Mild to moderate tenderness on chewing with the affected tooth may last for few days.
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How successful is a Root Canal Treatment? Generally RCT is successful in preventing the tooth loss. Under favorable conditions, the teeth can last a lifetime.
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What are the complications that may be expected? Complications that may occur include: o Pain that persists may signify untreated/missed canals, (severely bifurcating canals) residual infection, perforation of root etc and need evaluation. o Fracture of RC Instruments: Occurs occasionally due to extremely curved canals. o Discoloration of Teeth: Yellowish tinge due to the reduced water content of the teeth following pulp removal o Deterioration of the seal of the treated tooth due to inadequate restoration etc. o Pain due to cheek/tongue/lip biting under the effect of anesthesia. o Allergy to one or more components of anesthetic or pain medication/antibiotics.
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What are the alternatives to a root canal? Extraction and Implant prosthesis.
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How can Root Canal Treatment be prevented? Dental and oral hygiene are important to maintain healthy dentures. It is important to go for regular dental check-ups from childhood once the teeth have erupted in the mouth. Simple habits like tooth brushing after eating sticky or sweet food and before going to bed goes a long way in preventing tooth decay. Also, avoiding excessive acidic food like colas, food with high lime or acidic content can help in maintaining healthy teeth, besides good nutritious food that includes fiber, proteins and vitamins.
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What are the latest techniques to this treatment and where are they available in India? Some of the latest treatment techniques include: Self-Adjusting files (SAF): are recent additions to the RCT armamentarium that manage the chance for file breaking in the tooth and clean teeth better. Microscopic Endodontic: Doing the treatment with the help of magnification increases the chance of locating root canals that can occasionally be missed. Regeneration of lost tooth structure with the use of stem cells is still in the nascent stage of research, but is promising. Stem cell banking of the fallen milk teeth can be done and those stem cells can be used for treatments related to not just dental but also for general medical conditions.
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