Learn About - Periodontal Disease

Root Canal Therapy- The Procedure To Relieve Your Pain

Many people flinch when their dentists tell them they need root canal therapy. While dentists are sympathetic to fears of pain, they also want patients to know that root canal procedure has three purposes:

• Stop the root canal symptoms of a toothache;
• Prevent bacteria and pain from spreading into the jaw; and
• Maintain the original tooth instead of replacing it with a denture or bridge.

Root canals are actually channels that run from the root of the tooth, which connects to the bone, up to the top surface of the tooth. The canal contains blood vessels, nerves and the complex cells that make up the living tissue inside the tooth. This lifeline inside the tooth is called the pulp.

When a tooth is decayed or cracked, bacteria can get to the pulp. The acid from the bacteria irritates the pulp and it becomes inflamed; it's the same process you watch when other parts of your body become infected. When the pulp tissue becomes inflamed, it's harder for blood to flow to the tissue, and the resulting pressure creates the pain symptoms inside your tooth.

There are two ways to get relief from root canal pain: perform the root canal procedure, or pull the tooth, clean the gum below, and replace the tooth with a denture or bridge. Dentists advise pulling teeth as a last resort because they know that your natural teeth are the ones best suited for your mouth.

It's important to have the root canal procedure done quickly. The bacteria will travel down the canal to the root and into the jawbone. If this happens, the pain of your toothache will spread to your jaw. Even more important, the infection can cause your jawbone to deteriorate and weaken the structure that holds your teeth.

The best way to avoid root canal therapy is to take good daily care of your teeth to prevent the growth and spread of bacteria. Brushing and flossing are important.

Just as important are regular trips to the dentist, to check for the first sign of decay or cracks that could eventually lead to an abscessed tooth. In this case, an ounce of prevention really is worth a pound of cure!

By Brian J. Gray, DDS, MAGD, FICO

An Endodontist Explains "What Is A Root Canal"?

We use our teeth so much during the day that we often forget how complex they are, that is, until we feel pain. Underneath each tooth is a soft tissue area, called the pulp, that carries nerves, veins, arteries, and lymph vessels. These are all channels of connection between our teeth and the rest of our bodies. These connections run from the top of the tooth down to its root by way of a root canal. Each tooth has at least one root canal, but may have as many as four or five, depending on the number of roots below that tooth.

How Do Root Canal Problems Occur?

When a tooth is cracked or has a deep cavity, saliva and the bacteria in it can get to the tooth pulp. An infection is likely to result and, without root canal treatment by endodontist, the pulp will die. The infection may cause pus to gather at the tip of the root, creating an abscess that can attack the bone. The abscess must be cleaned up to prevent deterioration, and the damaged tooth pulp must be removed by a root canal dentist.

Problems That Cause Root Canal Pain

When the pulp is damaged or dead, pressure is created inside the tooth. That pressure creates pain when you bite down on the tooth, chew on it, or when it feels the heat or cold of food and drinks.

Saving the Tooth with a Root Canal

Repairing the root canal is the way to save the entire tooth. The other alternative is to pull the tooth entirely. However, leaving that space empty may create other problems, like making chewing and biting more difficult. Teeth may also shift their position if missing teeth are not there to hold the space. If you decide to have the dentist pull the tooth and replace it with a denture or bridge, the cost will be significantly more than the cost of a root canal procedure.

What Is Root Canal Therapy and How Is It Performed?

To prevent further damage, ease any discomfort, and save the tooth, your dentist or endodontist (a dentist specializing in treating the tooth pulp) will perform a root canal procedure. Without endodontics therapy, tooth loss will occur. This therapy requires one or more dental visits to complete, depending on the extent of the infection.

Endodontists will first administer medication to make sure you will be comfortable. An opening is made in the top of your tooth and the diseased pulp removed. The root canal will be thoroughly cleaned and enlarged so it can be filled with a material that prevents bacteria from re-entering. Your tooth will not be permanently sealed until the infection has cleared. When the root canal is filled and the infection is gone, your tooth may need to be covered with a crown that will look and function just like your original tooth.

Root canal therapy is a tooth-saver. It has a very high rate of success (more than 90%)! To follow up, your dentist or endodontist will make sure that the root canal is intact and that the infection has cleared.

Endodontists recognize that root canal therapy has an image problem. Part of this is due to the type of treatment available more than a half-century ago when local anesthetics weren't as effective. It was also before the advent of antibiotics used to control the infection and pain associated with it. Research and technology now offer your endodontist valuable ways to reduce patient pain and anxiety during the root canal procedure. Probably, the greatest factor contributing to this negative perception is that people wait until they are in pain before seeking treatment. Obviously, regular visits are an important preventive measure.

With modern therapy, root canal treatment can be approached with confidence -- getting to the root of the problem, but without the pain.

By Brian J. Gray, DDS, MAGD, FICO