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Causes And Treatment Of Root Canal Disease

Why Does My Tooth Need Root Canal Treatment?

A tooth generally needs a root canal procedure because the pulpal tissue inside the tooth has become irreversibly injured because of root canal disease. The tooth pulp is composed of elements similar to any other tissue in the body and is susceptible to injury from bacterial decay, repeated or extensive dental procedures, traumatic accidents, or advanced periodontal disease. Pulpal disease occurs in an anatomically complex space termed the root canal system. When appropriate, root canal treatment is directed towards removing inflamed or abscessed tissue, disinfecting, and preparing this space to receive a biocompatible filling material. Once the root canal system has been sealed and a protective crown placed by an endodontist, the tooth can be retained as a healthy and functional member of the dental arch.

What Are the Usual Events That Trigger Root Canal Disease?

Events that may trigger root canal disease include:

• Decay: Dental decay contains bacteria that can infect the tooth pulp. Decay can progress through the outer enamel surface of the tooth into the underlying dentin, which is a hard, yet porous, structure. Ultimately, decay can invade the dental pulp and cause pulpal injury, which leads to an inflammatory condition that can potentially become an abscess. As dental decay and its associated bacteria invade the pulpal tissue, a patient may experience no discomfort or, in other instances, the pain may be acute.
• Traumatic events: The tooth pulp is vulnerable to trauma. A blow to the mouth may lead to a variety of dental injuries. A traumatized tooth may appear whole but exhibit root canal disease at a later date. A tooth may be only slightly chipped or it may be fractured to the extent that its clinical crown is broken off and the pulpal tissue is exposed. In severe situations, the root can be fractured within the bone or the tooth completely knocked out of the mouth, which is called an "avulsion." Frequently, these traumatic events will irreversibly damage the tooth pulp by causing bacterial contamination or by interfering with the tooth's blood supply and its ability to repair. Some teeth are traumatized to the extent that they are not treatable and must be removed.
• Repetitive or extensive dental procedures: The tooth pulp is also vulnerable to injury from repetitive or extensive dental procedures. Subjecting a previously injured pulp to the additional trauma of even the best planned and performed dental surgery may be enough to cause the pulpal tissue to become irreversibly inflamed and the tooth to require root canal treatment. The dentist may or may not be able to predict this outcome in advance. At times, based on the examination and treatment plan, the dentist may recommend the removal of the dental pulp before performing other planned dental procedures. In these situations, the tooth pulp is removed so that it will not become problematic at a later date under a new, and possibly complex, restoration. At times, initiating a root canal procedure through an existing restoration may compromise its integrity.
• Periodontal disease: Infection in the gum and bone around the tooth is referred to as periodontal or gum disease. Advanced periodontal disease may compromise the blood supply to the dental pulp and ultimately, bacteria may enter and infect the pulpal tissue in the root canal space.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Root Canal Frequently Asked Questions

Q. Why would I need a root canal?

A. When the nerve of a tooth becomes irreversibly damaged -- due to decay, trauma, or a crack in the tooth -- you'll need root canal treatment.

Q. How can the dentist tell if I need a root canal?

A. Often nerve damage causes tooth pain, swelling and sensitivity to hot or cold. You may also notice that the tooth is becoming darker in color. Sometimes, it can only be diagnosed with an X-ray or other tests.

Q. What happens during a root canal?

A. During root canal treatment, the dentist cleans out the infected pulp tissue within the roots. After all the nerve has been removed, the canals are filled with a sealer.

Q. How long will it take?

A. Usually, root canal therapy takes one or two appointments for a front tooth (anterior), and two or three appointments for a back tooth (posterior). A tooth can have from one to four roots and all the roots must be treated.

Q. After the root canal is finished, will the tooth need more work?

A. The tooth is more brittle after a root canal and requires a permanent restoration. This could range from a simple tooth filling to a large build-up with posts and pins. If the tooth filling is large, the tooth may also need a dental crown to protect the tooth from breaking.

Q. Why not just take out the tooth?

A. It's usually healthier and less expensive to save the tooth with root canal treatment. Replacing an extracted tooth involves either expensive bridgework or a partial denture. If the tooth is extracted and not replaced, adjoining teeth can move into the empty space, creating even more problems.

Q. Will root canal treatment be painful?

A. Your tooth will be numb during the treatment. If your tooth was aching or sensitive prior to treatment, it may take a few days for the tooth to get back to feeling normal. You can take a mild painkiller during that time. If it's necessary, something stronger will be prescribed. If the tooth had been badly infected, you may need to take an antibiotic.

Q. How much will it a Root Canal cost?

A. The cost of root canal treatment usually depends on the number of canals which are infected and need treatment. There will be a separate charge for the restoration, which will vary from the cost of a simple filling to a crown. All expected treatment charges will be discussed with you before treatment.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.