Endodontics: Root Canal Treatment

What is Endodontics?

Endodontics is the dental branch that treats the inside of the tooth. The tooth pulp, which contains the blood vessels and nerves, as well as the root canal, can become diseased, infected or inflamed for various reasons and cause severe toothache. The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the roots. The pulp is important during a tooth's growth and development. Once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it. Endodontic treatment, or more commonly called root canal treatment, involves the removal of the diseased tissue, cleaning and shaping of root canals before filling and sealing them from future bacterial invasion.

Do I really need a Root Canal Treatment?

A diseased tooth pulp may cause inflammation or severe infection and pain. The symptoms of a damaged or diseased tooth pulp may include:

  • Color change (darker tooth color, especially affected front tooth)
  • Unprovoked or spontaneous pain
  • Sensitivity to hot and cold drinks and foods
  • Pain when biting or chewing
  • Loosening of the tooth
  • Swelling of the gum near the affected tooth
  • Oozing of pus surrounding the affected tooth
  • Facial swelling.

Sometimes, tooth pulp may become damaged or diseased without presenting any symptoms. In these cases, the problem is usually diagnosed by special tests or x-rays during a dental check-up or treatment for other dental concerns.

Diagnosis of tooth pulp problems

Our dentist will list your symptoms, examine the affected teeth and perform other special investigations including taking x-rays of the mouth. These x-rays help the dentist to plan for the root canal treatment by revealing the number, size and curvature and depth of the roots, and showing how complicated the procedure may be.  Accurate diagnosis is important because, once treatment begins, you are totally committed.

Causes of tooth pulp damage or disease

There are many events that can lead to disease or damage to dental pulp. Some of these include:

  • Deep-seated and untreated dental decay
  • Decay beneath a deep filling
  • Accident that damages a tooth
  • Habitual tooth grinding (bruxism)
  • Advanced gum disease

Complications of tooth pulp infection:

If tooth pulp infection is left untreated, complications could include spreading of the infection into the pulp chamber, causing the bacteria will multiply unchecked. This can cause a severe infection or an endodontic abscess when it spreads into the surrounding bone (a pocket or ‘blister’ of pus).

Patients may also suffer localized bone loss in the jaw around the root canal as the infected tooth loses its ability to fight the infection. In end scenario, the tooth itself may be lost which interferes with the person’s ability to bite and chew. Tooth replacements such as dentures, bridges and dental implants may not be possible or may not be tolerated. They may be more costly and involve other issues that will also need to be considered.

Root Canal procedure

You may need one or more visits to complete the endodontic treatment, depending on the root canals in your tooth. The exact procedure chosen by the dentist may differ from the procedure outlined here to suit your particular need.

Generally, the typical root canal treatment includes:

  • The procedure is usually performed using local anesthetic. If the pulp is infected, anesthesia may not always be necessary because the tooth no longer has any feeling.
  • The affected tooth is wrapped in thin rubber called a ‘rubber dam’ to prevent contamination of the root canals.
  • The decayed portions of the tooth and any affected filling are removed.
  • The pulp or pulp remnants are extracted.
  • The dentist uses a special drill and instruments to thoroughly clean and shape the root canals and to remove bacteria, pus and debris. The root canals may need to be shaped or hollowed out to ensure a smooth and clean interior surface.
  • The interior of the tooth is flushed with disinfectants and then dried.
  • If the root canal is not infection free, it may be medicated and the tooth sealed with a temporary filling material. You may have to wait a few weeks, or even months, before the pulp canal is filled. If our dentist feels bacteria are still present at your next appointment, the cleaning procedure may be repeated and the tooth once again filled with medication. This stage will continue until our dentist feels the tooth is bacteria free. We aim to permanently rid you of pain, retaining your smile in the process.
  • The infection-free root canal is then sealed with long-lasting barrier materials (the root filling), usually a rubber-based material called ‘gutta-percha’.
  • The tooth then undergoes reconstruction and an artificial biting surface for the tooth is sculpted out of regular filling material.
  • In cases where there is considerable loss of the tooth structure, we can recommend an artificial crown made from porcelain or gold or other materials like EMax or Zirconia.

 

Are all root canal treatments the same?

Root canal treatment involves cleaning out the dying and diseased nerve tissues in the root canal system, which is composed of main branch and small accessory branches, and filling the canals. At our clinic, we can provide the most up to date root canal treatment in Delhi with all the attention, care and comfort you seek. It is strongly advised to have the initial root canal treatment done as expertly as it can be as the retreatment decreases the success rate and is also costly and time consuming.

You will receive adequate anesthesia so there will be no pain during the procedure. Root Canal Treatment is completed in one or two appointments. You will also be provided with medication to control post-operative pain.