When you crack a tooth, cosmetic dental treatment, such as a crown, is often needed and could also require endodontic treatment, or a root canal. Endodontics is the aspect of dentistry focused on the study and treatment of tooth pulp. The word is derived from two Greek words: “endo,” meaning "inside," and “odont,” which means "tooth." Endodontists are specialist dentists who have received additional training on how to treat issues affecting the root and inside of the tooth.
The primary purpose of endodontics is to protect the teeth. Rather than removing the impaired or diseased tooth, the endodontist will attempt to get rid of the infection and decay to stop further damage to the inside of the tooth. A root canal procedure is the critical treatment that endodontists perform.
An endodontist is also qualified to perform corrective surgery on a tooth that fails to heal properly after a root canal or apicoectomy, a surgical procedure to take out the tip of the tooth’s root. Although dentists refer patients to endodontists in cases of severe decay and infection, they can also help save damaged teeth and ultimately restore the patient’s natural smile.
The root canal is a procedure performed by the endodontist to repair a severely damaged or infected tooth. The term “root canal” means cleaning out the canals in the root of the tooth. Alternatives include removing the affected tooth and substituting it with dental bridges, dental implants or partial or full dentures.
When is endodontic treatment necessary?
The core of the tooth is soft and called dental pulp. The pulp starts from the crown — the outer layer of the tooth — and extends down to the base of the tooth root inside the jawbone. The pulp comprises of connective tissue, blood vessels and nerves.
When the teeth suffer from damage or a severe cavity, bacteria can invade the pulp. If the invasion is not treated fast, the bacteria and decayed material in the tooth may lead to acute infection or tooth abscess. Once this happens, the pulp will die and eventually lead to bone and tooth loss.
If you experience tooth pain or have a history of tooth injury, you may be prone to infections in teeth roots and pulp. An appointment with the endodontist may also be needed if your tooth gets knocked out, cracked or moved out of place. The signs of pulp infection include facial swelling, gum swelling and sensitivity to temperature.
The root canal is performed by an endodontist or expert dentist. The treatment typically requires about one to three dental appointments.
First stage
If the dentist thinks you may require a root canal procedure, a series of dental X-rays may be performed to ascertain the level of damage and location of the decay. They may proceed to administer local anesthesia on the infected tooth to minimize the pain. As opposed to popular belief, root canal treatment is not more painful than a cavity filling.
The endodontist will proceed to place a rubber-like sheet called a dental dam in the mouth. This will keep the mouth clean, shielded and saliva-free. The decay will be cleaned out, and a laceration will be made through the crown to reach the pulp section. With dental tools, the infected or diseased pulp will be extracted.
Cleaning out the root canal infection
After extracting the infected pulp, the pulp section and the root canal will be adequately scrubbed and cleaned. The dental expert may re-mold and widen the root canal in case filling is required later. Before the root canal is filled up permanently, it should be cleaned thoroughly and free of moisture. Medications may be applied to the canal to remove traces of infection.
Sometimes, the tooth may remain open for a few days to allow proper draining. If the infection has extended outside the tooth, the dentist may prescribe antibiotics to treat the infection. If multiple dental appointments are necessary for the treatment, a temporary filling may be inserted into the crown to shield the tooth and prevent saliva or debris entry. It is important not to bite or chew on the tooth until the treatment or restoration procedure is complete.
Filling the root canals
After the cleaning and drying process, the inside — the empty pulp area and root canal — of the tooth needs to be filled. This stage may necessitate extra anesthesia. If the endodontist had inserted a temporary filling, it would be extracted to enable access into the tooth’s interior. The tooth is then filled up with sealing paste and rubber compound, accompanied by adhesive filling to protect the root canals adequately from saliva.
The last stage of a root canal procedure
Teeth restoration is the last stage of the root canal treatment. Since the tooth structure has suffered severe deterioration and weakness due to decay, it has to be fortified against potential damages in the future and restored to normal function. This is achievable using a dental crown, a lifelike version of the tooth.
Dental crowns can be manufactured from porcelain, porcelain-fused metal or gold materials, among others. Certain materials can be colored to match the existing teeth. In some cases, metal posts may need to be placed in the tooth to strengthen and support the crown. Discuss your restoration options with the dentist or endodontist.
Dentists usually recommend bridges if one or more teeth are missing. The space left by the lost tooth may cause the remaining teeth to turn or shift into the gap, causing a poor bite. The disruption caused by the missing teeth may eventually result in temporomandibular joint (TMJ) disorders and gum diseases.
Bridges replace the missing tooth or teeth. They cover the gap left by the lost teeth. Bridges are fused to the healthy teeth or implants near the space. The teeth-shaped materials are called abutments and function as anchors for the bridge. The substitute tooth, called a pontic, is bonded to the crowns covering the abutments.
Your tooth may feel sensitive a couple of days after the root canal. Over-the-counter pain medications can alleviate that. If the pain extends beyond a few days, you should reach out to the endodontist.
Following a successful root canal treatment, the repaired tooth and new crown will function normally like a healthy tooth and appear cosmetically appealing. With proper oral hygiene, you should be able to preserve your beautiful smile and keep your teeth healthy.
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