Root Canal Treatment – Why, When & How?

Root Canal Treatment - ASAP

A Root Canal Treatment is a dental procedure performed to remove infected dental pulp from the innermost layer of the tooth. After the pulp is completely removed, the hollow cavities inside the tooth and the root canals are filled with an inert material to prevent future infection.

Root Canal Indication

The tooth consists of three layers. The outer enamel and the middle layer, dentine are hard. While, the innermost layer, the dental pulp, consists of soft tissue that contains a rich supply of blood vessels and nerve tissue. In dental caries and trauma, the outer enamel and middle dentine of the tooth are destroyed. This results in the direct exposure and inflammation of the underlying pulp.

This situation prompts restoration of the tooth. If timely corrective measures are not adopted, it progresses into an irreversible infection of the pulp. At this stage, the only way to salvage the tooth and to alleviate throbbing pain, swelling and abscess, is to perform a root canal treatment.

Symptoms

The dentist is the best authority to determine and guide appropriately, whether a root canal treatment is warranted or the tooth can be restored atraumatically. It is time to get a root canal treatment, if:

1. Continuous, throbbing pain in a tooth, which is referred to the ear, nose and throat, with disregard to pain-killers.

2. Sleepless night.

3. Inability to open mouth normally.

4. Inability to chew from the affected side.

5. Visible, extra and intra-oral swelling in the region of the infected tooth.

6. Redness around the area of the infected tooth.

7. In the advanced stage, purulent discharge from the soft tissues, surrounding the infected tooth i.e. localised abscess formation.

8. Running a fever with general malaise.

Root Canal Treatment Procedure

Root canal treatment is a tooth’s life-saving procedure. Depend on the severity of the tooth decay; it is carried out in a single or multiple sittings. The Endodontist is a specialist who is skilled and trained for performing RCT.

1) Patient Evaluation

Before starting the procedure, the dentist first examines the general and oral health of the patient. Some blood biochemical investigations would also be advised. Essentially, a few radiographs are obtained, to determine the extent of the infection and gravity of the tooth decay.

Decayed Tooth with Abscess

Decayed Tooth with Abscess

These radiographs provide valuable information of the shape and length of the root canal. This helps the Endodontist to strategise the treatment and determine the number of sittings required for the procedure.

2) Administration of  Local Anaesthesia

Root canal treatment is a painful procedure. Hence, it is performed under local anaesthesia. However, for extremely anxious patients, inhalation or general anaesthesia is also considered.

3) Preparing the Access Cavity

A cavity is prepared by the dentist in the infected tooth, to reach and gain access to the underlying dental pulp. This is done by drilling through the tooth crown until the pulp chamber is exposed.

Preparing the Access Cavity

Preparing the Access Cavity

4) Pulp Removal

The next step is to remove the infected pulp with the help of specialised endodontic instruments, the Dental Files & Reamers. This ensures that the root canals are thoroughly disinfected and cleaned. During pulp removal, the pulp cavity is continuously irrigated by an antibacterial agent or distilled water.

Pulp Removal with the help of Endodontic Files

Pulp Removal with the help of Endodontic Files

5) Cleaning and Drying

Cleaning and Drying During Root Canal Treatment

Cleaning and Drying During Root Canal Treatment

Once the root canals have been thoroughly cleaned, They are dried with the aid of paper points. Complete drying and disinfection of the root canals is necessary for preventing future infections.

6) Obturation

Obturation

Obturation

In this step, the root canals are filled with an inert material like gutta-percha (GP Points). This procedure is known as obturation and is performed to tightly close the root canals, thereby preventing chances of re-infection.

7) Tooth Restoration

After obturation, a temporary filling is placed over the tooth allowing complete healing. This temporary filling is later removed and is replaced by a permanent filling.

Severely Damaged Crown

Severely Damaged Crown

Post & Core on Root Canal Treated Tooth

Post & Core on Root Canal Treated Tooth

8) Placing a Dental Crown

As a root canal treated tooth is devoid of blood & nerve supply, it tends to become brittle. To avoid fracture of the treated tooth, while chewing,  and to regain lost strength & functionality of the treated tooth, it is reinforced by a Post and a Core. Finally, it is strengthened by placing a Dental Crown over it. This culminates the entire Root Canal Treatment Procedure. Now, the treated tooth functions like the vital natural tooth.

Dental Crown on Root Canal Treated Tooth

Dental Crown on Root Canal Treated Tooth

Restored & Functional Tooth

Root Canal Treated Tooth – Restored & Functional Tooth

The Life expectancy of the Root Canal Treated tooth is pretty long if proper care and regular follow-ups are maintained.

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