When pain in any tooth trouble you incessantly, you rush to a dental office, right? While you are eagerly waiting in the reception room, for your turn or getting your tooth examined by the dentist, there is only one thought that repeatedly runs through your mind. It goes like this ‘I hope it is a simple cavity and not Root Canal Treatment that I have to undergo!’
However, if that’s exactly what your radiograph and oral check up confirms, all you can think of whilst the dentist explains the details related to the procedure is pain, thin needles piercing through your oral tissue, several recurrent visits and not to forget, the drilling sound of the rotary machine working through your tooth.
This is the scary image people are fixated over whenever it comes to root canal treatment. Even the American Association Of Endodontics agrees that innumerable myths related to this endodontic treatment exist. Let’s find out about the details linked to this safe mode of dental treatment so that your curiosity and anxiety level takes a dip.
Causes That Make One A Candidate For Root Canal Treatment
The normal structure of a tooth consists of four layers, namely enamel (the outermost protective, hard layer) dentin, pulp (occupying the pulp chamber and root canals), followed by cementum that covers the submerged root portion of the tooth. The soft, living tissue situated in the central portion of every single tooth is packed with delicate nerve supply, blood vessels and connective tissue. The attack caused by acid and oral microorganisms results in the initiation and formation of a dental cavity.
If left unchecked, the carious ditch, acts as a breeding place for noxious bacteria, which invade through, enamel, dentin and finally pulp. Inflammation and death of the invigorate tissue can also occur after a traumatic impact that leads to a cracked tooth. Large sized dental restorations, if not finished properly, can make way for the remnant decay to cause problems for the unaffected pulp tissue.
The Effects Of Pulpal Damage
When any of the above factors trigger oversensitivity, inflammation or infection of the pulpal tissue, certain modifications take place. With the vitality of the tooth, compromised, bacterial by products and toxins cause further damage, which travels from, the pulp to the root and beyond, ultimately resulting in an abscessed tooth. The pus filled dental abscess forms near the apex of the tooth root. This puts not just the tooth at risk, but also the surrounding bone structure.
If, even at this stage, the patient does not seek dental help, the loss of bone continues and the abscess breaks through the bone, draining into the cheek or gum region. These painful swellings can further invade areas like the neck and lead to a medical emergency such as sepsis.
Signs And Symptoms Of An Infected Tooth
The characteristic symptoms which indicate that the infected tooth needs dental intervention in the form of Root canal treatment include the following-
Pain Of Varying Degree
The most common symptom is pain of moderate to severe, unbearable intensity. The pain is usually of a constant nature, which aggravates on lying and diminishes on sitting upright. Chewing food, especially hard substances becomes painfully difficult. Sometimes, the painful sensation radiates to the temporal (in an upward direction) and mandibular region, preventing the affected individual from doing his/her routine work.
Another sign that hints towards a decayed tooth in need of a Root canal treatment is the increased level of sensitivity towards hot and cold fluids or solid food items. Tooth sensitivity is a common feature, but you can understand that it is linked to pulp invasion when the duration for which it lasts is more.
Gingival Swelling And Tenderness
Deep seated tooth decay almost always incites an inflammatory process that involves the surrounding soft tissue. The affected tooth is, thus surrounded by sore and tender gums.
As the pulp within the tooth disintegrates and the blood supply decreases or stops, changes occur in the tooth colour, as well. If there has been history of physical trauma to the face or teeth, the slow death of pulp will be seen in the form of tooth discolouration.
A Brief Explanation Of The Steps Involved In Root Canal Treatment
This endodontic procedure involves the removal of infected tissue, debris, bood vessels and a few other cellular entities that thrive the pulp chamber and root canals. The aim of such removal is to clean and disinfect the necrosed tissue and control the pain.
Although the mere mention of the term ‘RCT’ before patients sends shivers down their spine, the truth remains, that it is not as terrifying or eerie as it has made to believe. In fact, when the treatment starts, patients who visit the dental clinic with excruciating pain and tenderness find instant pain and pressure relief.
Administration Of Local Anaesthesia Prior To Beginning First RCT Sitting
Before the endodontist starts the multi step process, he/she makes it a point to administer a specific amount of local anesthesia in the affected side of the oral cavity. In many of the cases, this step is not needed as the infected tooth is devoid of any vitality. Moreover, it has a relaxing pyschological effect on the patient’s mind, specifically those who fear pain. Once the area of interest is numb, the next step is started
Dentist Gains Access To The Troubled Pulp
The dental professional, then prepares an access cavity on specific tooth surface. For upper anterior teeth, the palatal suface is chosen whereas for lower anterior teeth, it is the lingual (tongue facing) surface. In case of upper and lower back or posterior teeth, the occlusal surface is targeted. These deep cavities are prepared to access the pulp chamber and the thin, tapering canals within the roots.
During the entire treatment, the dentist usually takes many radiographs of the tooth in question so as to get a clear idea regarding the shape, length and curvature of the root to be cleaned. With the advent of modern techniques in dentistry, it is now easy to estimate the exact working length of the root canals via Apex locators.
Removal Of Infected Pulp Tissue With Dental Instruments
The removal of contaminated debris and dead tissue is carried out through the skilled use of fine, long instruments called endodontic files and reamers, of varying diameters.
These are used to thoroughly debride and enlarge the canals. One of the extensively used disinfectant solution during each sitting is Sodium hypochlorite (as a cleaning aid)
Root Canal Obturation
Once it has been ascertained that the pulp chamber and canals are wholly devoid of microbial debris, the single or multiple canals are packed with a biocompatible material of inert nature, called Gutta percha, which is essentially a rubber extract. The obturation blocks all the possible portals of entry for the notorious bacterial species.
The prognosis of the endodontically restored tooth is directly proportional to the precision with which gutta percha filling is done. After the root canals are sealed, the prepared access cavity is filled with a temporary filling. The final restoration is done when the tooth has healed completely and shows no sign of reinfection. This is the second-last step of Root canal treatment.
Crown The Restored Tooth
It is crucial to protect the devitalized, treated tooth and thus needs a dental crown cemented over it. Hopefully, after reading the details, Root Canal Treatment would seem less intimidating.
Photo Credit: http://www.aae.org/patients/endodontic_treatments/root_canals.aspx