Root of the problem

People go in for root canal treatment to save their teeth. This is because trying to save one's natural teeth is a better option than extraction, says DR. ARUN N. SINGH.

SAVING your natural teeth, if possible, is the best option. People all over the world go for root canal treatment to save their teeth. This helps patients chew efficiently, maintain the natural appearance of their smiles and enhances their enjoyment of life. Through root canal treatment, dentists enable patients to have their natural teeth for a lifetime.

When the pulp of a tooth, which contains the nerves and blood vessels that supply the tooth, is damaged by decay or trauma (such as a fall), bacteria enter the nerve chamber and infect it. If left untreated, severe infection can ensue, and tooth loss is inevitable.

Root canal treatment removes the damaged pulp tissue and cleans and shapes the pulp chamber and canals. Once there is no more infection, and the symptoms disappear, the canals are sealed. Then the tooth is filled or crowned. Root canal therapy usually takes two or three visits. Sometimes antibiotics are necessary to treat the infection.

Here are some situations where root canal therapy might be the proper solution: A tooth is causing pain or else has a history of being so; experiencing pain while biting or chewing; sensitivity to temperature.

There may be a tooth which requires root canal treatment, but the person may not be aware of the problem because there has been no indication.

Problem teeth identified by x-rays: The nerve tissue in a tooth can die quietly. The degeneration of a tooth's nerve is not always painful and the need for treatment can be undiscovered, even for some years. It is not uncommon for a dentist to identify a tooth for root canal treatment during a routine x-ray. In the most obvious case the x-ray will show a dark spot on the tip of the tooth's root.

A persistent or recurring lesion on the gums: Sometimes a tooth with a dead nerve will produce a pimple-like lesion (dentists call them fistulous tracts) on the gums. These may come and go. They are literally drains for pus from an infected tooth, so a person may have a bad taste in the mouth. A dentist may notice this lesion during examination even though the patient has not noticed it.

Teeth which have been traumatised in an accident: The health of the nerve tissue found in those teeth which have been traumatised (such as being hit/knocked in an accident) can deteriorate, thus making root canal treatment necessary.

What happens if the pulp is injured? When the pulp is injured or diseased and cannot repair itself, it dies. The outcome of the health of the nerve tissue (pulp) is difficult to predict. These teeth can do quite well, even for many years. But this may let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth. Without treatment, pus builds at the root tip, in the jawbone, forming an abscess which can damage the bone around the teeth. The changes in the nerve tissue make the tooth appear dark in comparison to the other teeth.

Why does the pulp have to be removed? When the infected pulp is not removed, pain and swelling can result. Certain by-products of the infection can injure the jaw bones. Without treatment, the tooth may have to be removed.

Treatment: First, an opening is made through the crown of the tooth and the pulp is removed. The root canal is cleaned and shaped to a form that can be filled. Medications are put in the pulp chamber and root canal to help get rid of gems and prevent infection. A temporary filling is placed in the crown opening to protect the tooth between dental visits. The dentist may leave the tooth open for a few days to drain and prescribe medicines to control the infection that may have spread beyond the tooth. The temporary filling is removed and the pulp chamber and root canal(s) are cleaned and filled. In the final step, a crown is usually placed over the tooth.

The material used to fill the root canal will probably last a lifetime, but eventually the filling or crown may need to be replaced.

Are there any alternatives to root canal treatment? If root canal therapy is indicated there is no alternative but an extraction. Root canal treatment deals with the inner aspects of a tooth unlike other dental procedures. If such treatment is not possible then the tooth should be extracted.

Should the tooth be extracted rather than go in for root canal treatment? The cost or simplicity of a tooth extraction might seem attractive in comparison to the root canal treatment but this solution might not be the easiest or least expensive treatment choice in the long run. When a tooth is missing neighbouring teeth tend to shift, sometimes significantly. This can have a major impact on dental health. Even the removal of a single tooth can lead to problems related to chewing, problems with the jaw joint, and predispose the teeth which have shifted to problems as well.

A patient should not decide to have a tooth extracted quickly. Explore all options with dentist.

Myths about root canal treatment: There are many misconceptions surrounding root canal treatment.

Myth 1 - Root canal treatment is painful.

Reality - Root canal treatment does not cause pain, it relieves pain. Most patients see their dentist when they have a severe toothache. The toothache can be caused by damaged tissues. Root canal treatment removes this damaged tissue, thereby relieving the pain you feel. With the latest technologies and anaesthetics, root canal treatment today is no more uncomfortable than having a filling placed. In fact, a recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as "painless" than patients who have not had root canal treatment.

Myth 2 - Root canal treatment causes illness.

Reality - Root canal treatment is a safe and effective procedure. Research has shown no relationship between the presence of root canal treated teeth and the presence of illness.

Myth 3 - A good alternative to root canal treatment is extraction (pulling the tooth).

Reality - Saving the natural teeth, if possible, is the best option. Nothing can completely replace a natural tooth. An artificial tooth can sometimes lead to a person avoiding certain foods. Keeping the natural teeth is important so that the patient can continue to enjoy the wide variety of food necessary to maintain proper nutrient balance in his diet.

Root canal treatment also has a very high success rate. Although this treatment is easy on the patient it takes technical excellence and advanced training by a dentist and the team to ensure its success.

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