Reasons for Root Canal: Why and How

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Root canal treatment has changed considerably since the hollow tube theory was first postulated in 1930.1 Root canal treatment is to treat an infection inside the tooth, and like all surgical procedures, it is done in aseptic technique. Researchers have shown that all microorganisms must be removed from the entire root system for complete success in root canal treatment. Modern endodontic practice is concerned with shaping first, to open canal wide, cleaning can be effectively carried out prior to three-dimensional filling.1

Why do we need root canal treatment?

Root canal treatment is a dental treatment that removes the soft center of the tooth called pulp. The pulp is found in a canal that is in the center of the tooth in between hard tissue called dentin, and it extends from inside the crown to the root tip. The pulp is made up of connective tissue, nerves, and blood vessels. The treatment is performed when this pulp is either inflamed due to infection or damaged. Common causes of damage in this area are due to untreated cavity causing deep decay, multiple procedures done on the same tooth, or a chip/crack in the tooth. If pulp becomes damaged, bacteria can leak in and feed on decaying matter.2 Untreated pulp leads to abscess formation under the root, which causes considerable pain sensation. Without the treatment, the tooth may have to be extracted.

How is a root canal treatment performed?

On the initial visit, the dentist would numb the gum near the affected area with numbing medication, and after it has taken into an effect, a local anesthetic shot would be injected into the gum in order for a patient to not feel a pain when canal is being cleaned.2 After placing the rubber dam, an opening is made through the crown, and once injured pulp is exposed, pulp is removed with the special tool called files. Files manually take out any bacteria in the canal and addition of sterilizing chemical is added to ensure bacterial-free-state inside the canal and to remove the colonization down below. The dentist may coat topical antibiotic on the area to ensure the infection is gone and may prescribe an oral antibiotic if the infection has spread beyond the root to become the abscess.2 Dentist fill this canal with gutta percha then a temporary filling (build up) is placed in the crown opening to keep the saliva out.

On the next visit, the dentist takes X-rays to make sure infections are gone. The temporary filling is removed and replaced with a permanent filling. Crown is placed on the tooth for the end of the treatment.

Follow up:

Your tooth might sore after the initial treatment when the numbing medication wears off. Most dentists will have you treat this symptom with over-the-counter medication such as acetaminophen or ibuprofen. Call Dr. Ji if the pain becomes extreme. Avoid chewing with the temporarily filled tooth since it could break the tooth. Discuss with the dentist what is the best crown for you and the dentist will

keep track of the treated tooth on your routine visit through updated X-ray or through oral hygiene examination.

Citation

  1. Carrotte, P. “Endodontics: Part 1 The Modern Concept of Root Canal Treatment.” British Dental Journal, vol. 197, Aug. 2004, pp. 181-183
  2. ADA Division of Communications, “Getting to the Root of Endodontic (Root Canal) Treatments.” American Dental Association, Journal of the American Dental Association, vol. 132, Mar. 2001, pp. 407

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