What’s a root canal?

August 21, 2008

Root canal treatment – it’s no big drama or mystery and gets very bad press.  Basically the centre of your tooth is hollow and filled with blood vessels and nerves just like the rest of your body.  If bacteria get in here you get swelling like any other cut or infection, except the swelling strangles the blood supply leaving an infected chamber in the tooth.  Without a blood supply, your body can’t heal this area, and the toxins spread out from the root into the surrounding bone eventually causing swelling, pain or damage to the root.

Root canal treatment involves cleaning away the bacteria and toxins – imagine flushing out termites from an ‘infected’ tree.  Then a filling material is placed into the hollow root chamber to prevent further bacteria getting back in.  Just as a dead tree doesn’t fall out of the ground, a ‘dead tooth’ doesn’t fall out either.

Here is a picture of an infected front tooth – the dark area around the root is the extent of the infection.  The white areas are all filling – basically this tooth has been filled to death from larger and larger fillings.

The next 2 pictures show the root treatment the day it was completed and then 12 months later when the bone has healed.

Most teeth need a crown to protect the seal and rebuild the tooth due to the damage from the original decay, large filling, or trauma.

Myth: pain – more people fall asleep during root treatment for me than any other procedure.  If the tooth is properly numb then it is a time consuming but uneventful procedure.  Some people may feel pain if the tooth is acutely inflammed and infected – and this may mean a temporary sedative dressing for a few weeks and treating when the infection has settled.  With patience and a gentle technique it is not a difficult procedure.

Myth – I had root treatment and the tooth was pulled out anyway. – some treatments do fail.  A large number fail from not sealing over with a crown – the filling compromise leaked or cracked.  Some teeth should be done by a specialist – an endodontist, if the roots appear really twisted or hard to clean thoroughly.

The most important thing to know is that root treatments become the only option a dentist has to save your tooth if you wait until you are getting pain before you come to the dentist.  Your choices in dentistry are:

1 – small cavity found during check-up means a small filling needed

2- leave the hole a while a large filling and risks that the tooth will need a crown or root canal treatment 5 or 10 years down the track

3- leave the hole till it starts getting sensitive means a large filling that may or may not work and probable root treatment between 1 week and a few years in the future

4 -leave until a throbbing toothache means root treatment now to save the tooth, and it may not go numb and could hurt more and need a dressing

5 – leave till the tooth rots further and pain goes – only alternative is extraction and risks of serious infection.  Although rare people still do get hospitalised and even die from dental infection.

It is an old but true saying – “A stich in time saves nine”