Despite all the misleading myths and misconceptions that exist, root canal treatment (endodontic treatment) is still invaluable. It is a means by which damaged teeth can be saved and you can quickly get rid of toothache. In this article I will explain in detail how a root canal treatment works.
What is a root canal treatment/endodontic treatment?
A root canal is a process in which a dentist treats the internal aspects of a tooth, primarily the “pulp tissue” space. Most people think that the pulp tissue of a tooth consists only of the “nerve” , however, this is not entirely true. The pulp consists of connective tissue, nerve fibers and small blood vessels. This pulp can become inflamed due to tooth decay, a leaking filling or a fall. This can cause severe toothache.
Where exactly in a tooth is the nerve located?
Teeth are not solid objects. Each tooth has a hollow space where nerve tissue is located. Dentists use the following terms to name different areas of this nerve space:
- The pulp chamber. This is the hollow space that is located approximately in the middle of the interior of the tooth (the part of the tooth that is above the gums)
- The root canals. The root canals are connected to the bone via the root tip. This allows inflammation in the pulp to spread to this area.
Teeth always have only one pulp chamber, but the number of root canals can vary. Each tooth will have at least one root canal, and some may have 2, 3, or perhaps more. Each canal will then have to undergo root canal treatment. The above incisors and front teeth usually only require one root and therefore one root canal treatment. Molars often have 3, 4 and sometimes even 5 root canals.
What does having multiple root canals mean to you?
The number of canals in a tooth affects you, the patient, in the following ways:
- The cost of root canal treatment is usually based on the number of individual canals being treated. The larger the number, the higher the costs.
- Treatment is influenced by the number of channels being treated. It is more time-consuming for a dentist to treat a tooth with 4 canals instead of a tooth with one canal.
What is the purpose/function of the dental nerve?
Nervous tissue in a tooth has a sensory function. But this one is probably different than what you expect. Under normal circumstances, you would not notice much of the nerve tissue in your teeth, except when it is exposed to pressure or extreme temperatures, or after an accident/condition (such as tooth decay or the formation of a crack). In this case, your teeth may give a painful feeling.There are a number of functions that the nerve performs. In your youth, nerve tissue plays an important role in the formation and development of the tooth. Later, this tissue is intended to contribute to the health of the tooth and maintain the vitality of the tooth. The nerve tissue helps maintain your enamel and dentin and supply your tooth with nutrients and moisture. It also produces new tooth structure (repairing dentin) and is needed to protect the nerve from injury (such as tooth decay).
The root canal treatment step by step
When performing a root canal treatment, the dentist follows several steps :Placing the rubber dam After anesthetizing you, but before starting your treatment, your dentist will have to “isolate” your tooth. To do this, they make a small hole in a sheet of rubber. This rubber is placed over your tooth and secured with a small tooth clamp to hold it in place. One of the basic goals of root canal treatment is to remove bacteria and contaminants from a tooth. Saliva contains contaminants, a rubber dam can prevent this saliva from entering the tooth being treated.Drilling a Cavity As a starting point for performing your treatment, your dentist will first need to gain access to the nerve space in your tooth. They do this by using their dental drill to drill a hole. This hole is drilled up to the pulp chamber. On your molars, the hole will be made on the chewing surfaces of the tooth. On front teeth, the hole is usually made at the back of the tooth. The overall size of the cavity will vary depending on factors such as the location of the individual canals and how difficult it is for the dentist to find them. The dentist will also have to remove any crowns, fillings and loose or vulnerable parts of the tooth.Cleaning and shaping the root canals The next step of root canal treatment consists of cleaning and shaping the inside of your tooth (the pulp chamber and all root canals). The purpose of the cleaning is to remove bacteria, toxins, nerve tissue, and associated inflammation that resides in your tooth. The shaping process begins with determining the size of the root canals.What instruments are used? For the most part, a tooth is cleaned and shaped with root canal files.These files look like straight pins, but if you look closely you will see that the surface is rough and not smooth. These instruments are therefore really files and are used as such.How are the instruments used? Your dentist will move the file up and down in each root canal in a circular motion. This action will ensure that the channels are cleaned and formed. The dentist will repeat this method a number of times, each time using a different file with a slightly larger diameter, until the entire canal is clean.While performing this work, your dentist will also occasionally rinse your tooth with a disinfectant. This helps to remove built-up dirt and other contaminants.Measuring the Length of the Root Canals The dentist’s goal is to clean the entire spring of each root canal, but must be careful to remain in the root canal and not pass through it. There are a number of ways a dentist can determine the length of the root canal. The dentist can place a stick in your tooth and then take a photo. The photo will show whether the stick covers the entire length of the canal or not. Nowadays it is also possible to use an electronic device for length determination.Closing the tooth – Placing the filling material Once the tooth has been thoroughly cleaned internally and properly shaped, the tooth can be closed again and the hollow space drilled into the tooth can be filled. In some cases, the dentist will place the filling material immediately after cleaning the tooth. In most cases, this is waited for and the tooth is filled with a bacteria-resistant paste and closed with an emergency filling. After a few weeks you will have to return to complete the treatment. This treatment may consist of repeating the filing and rinsing of the tooth again. Your tooth will then be permanently closed and filled.What filling material is used? The most commonly used root canal filling material is a rubber post called gutta-percha . It comes in pre-formed posts whose dimensions correspond to the size (diameter) of the files used to file the tooth. An antibacterial paste is also used together with the gutta-percha. The material is applied to the surface of the post before it is placed in a canal. Multiple gutta-percha posts may be needed to completely fill the canal. A dentist can possibly heat the gutta-percha (before or after it is placed in the tooth) to soften it. In this way it can be ensured that the posts fit properly to the shape of the interior of the tooth. Alternatively, a dentist can use a “filling gun” instead of the gutta-percha. This is comparable to a glue gun.
How long does a root canal treatment take?
The total time required for root canal treatment will vary from case to case, depending on the tooth involved and the number of canals within it. For example, canal treatment of a molar could take 2 to 3 times as long as that of a tooth with only one canal. The duration of a root canal treatment varies between half an hour and two hours. You may also have to return to the dentist several times to complete the treatment because the complaints have not yet diminished. In this case the treatment will be repeated. Further treatments may also be required if the tooth is too weakened, such as placing a crown.
is a root canal treatment painful?
Root canal treatment can almost always be performed painlessly after anesthesia. However, some after-pain may occur after the treatment. This can be easily combated with painkillers. If the after-pain lasts for a very long time, contact your dentist.