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Root Canal Treatment

Root Canal Treatment

by admin on September 29, 2008

A Root Canal Treatment (RCT) is carried out to repair and restore a tooth which has been badly decayed or infected and comes under a branch of dentistry called as Endodontics. The RCT actually focuses towards elimination of any infection to the Pulp Chamber of the tooth.

Root Canal Treatment is the last option to save the tooth failing which the tooth has to be extracted. After the RCT the tooth is basically dead as the entire pulp inside the tooth is removed and filled with an inert material.

When is RCT Required?

When tooth decay occurs and is detected, a normal filling procedure is carried out .However, if this tooth decay is not detected, it progresses to deeper layers and finally reaching the pulp chamber. When the tooth decay reaches the Pulp chamber, there is no alternative but to perform a Root Canal Treatment. This is because, the infection in the pulp chamber must be removed else it will progress further.

What is the Pulp Chamber?

The pulp chamber is the inner most layer of the tooth. It is present at the center of the tooth and consists of nerves, connective tissue and blood vessels. It is through these blood vessels the tooth receives nutrition. The cells in the pulp chamber are predominantly odontoblast cells (cells which form dentin) apart from other cells.

The pulp chamber is broad at the center and narrows to a very thin root canal which runs towards the root.

What if I don’t undergo an RCT?

It is essential for you to undergo the Root Canal Treatment to save your tooth failing which you might loose your tooth. The bacterial infection in your pulp can cause tooth abscess, bone loss around root tip and swelling which can spread to your face and neck.

Why has been my Pulp Infected?

You might be thinking why did the infection to the pulp occur in the first place. There can be quite a few causes for this such as:

  • Tooth Decay which wasn’t detected and it spread to your pulp chamber.
  • Large fillings
  • Secondary Caries after tooth filling which lead to further decay progressing to your pulp.
  • Physical trauma to the tooth by accidental blows.
  • Spread of infection from periodontal pockets to the pulp

RCT Procedure

The Root Canal Treatment procedure should ideally be carried out by an endodontist. An Endodontist is a dentist who specializes in treating diseases and injuries of the pulp and tissues surrounding the root of the tooth. The RCT procedure can be completed in one or more visits.

Root Canal Treatment

Root Canal Treatment

An X-ray will be taken to examine your tooth and detect the presence of infection in the surrounding bone.

  1. The area surrounding the tooth is numbed using a local anesthetic which desensitizes the patient to any pain.
  2. The tooth to be worked upon is isolated by placing a rubber dam around it.
  3. The drill is employed to make an access hole to the pulp chamber and the pulp along with decayed tissue and debris is removed. The entire pulp chamber including the root canals is cleaned and disinfected.
  4. If the Root Canal Treatment is to be spread over multiple visits and some dentists prefer this, the empty pulp chamber is filled with disinfecting agent. This is covered by a temporary filling which is removed in subsequent visits and replaced by a permanent filling.
  5. The next step is filling of the pulp chamber with an inert material as the tooth is effectively dead. Gutta percha (along with Zinc Oxide eugenol) is generally used to fill the empty pulp chamber and root canals.
  6. A permanent filling (similar to the filling for treating cavities) is carried out on the tooth and a crown is placed over the tooth. A crown is required in most cases as the tooth becomes brittle due to absence of pulp.
  7. If your RCT procedure is spread over more than one appointment, minimize the chewing on the affected tooth till the procedure is entirely completed. This will prevent recontamination of the pulp chamber and will also reduce the risk of fracturing or damaging your tooth

Failed Root Canals

The RCT is a very effective procedure and enjoys a 90% success rate. However, complications can and do arise leading to the failure of root canal. A failed root simply means you have get Root Canal Treatment procedure done again or get the tooth extracted by the dentist.

Causes for Failure of Root Canals

Extra Canal: Some teeth may have an extra root canal which might not be apparent to the dentist. Hence, the failure to remove the pulp from this root canal causes the failure of the treatment

Some patients have irregularly shaped root canals and its not possible to remove the pulp from such root canals.

Now, you can probably guess the main reason for the failure of root canal treatment. Any infected pulp left behind leads to the failure of the root canal treatment.

Hypersensitivity to material: Some patients are allergic to the material used in the root canal treatment and hence leading to failure of the procedure.

Defective or inadequate restoration: If a restoration is inadequate or defective, bacteria are able to creep past the restoration causing reinfection.

Instrument left in the root canal: The files used to remove the pulp are quite brittle and often chip inside the root canal and cannot be retrieved. This may cause the failure of the treatment.



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