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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 Canals: Everything You Ever Wanted to Know

Why are root canals done?

Root canal therapy is required when the nerve of the tooth becomes irreversibly damaged. This damage can occur from decay, trauma, or a crack in the tooth.

What is a common root canal symptom?

Pain, swelling, and sensitivity to hot or cold. Another indication of nerve damage is the tooth becoming darker in color. Sometimes, it can only be diagnosed with an x-ray or other tests by an endodontist.

What is done during a root canal procedure?

The purpose of root canal therapy is to clean out the infected tooth pulp tissue within the roots. After all the nerve has been removed, the canals are filled with a sealer.

How long will the procedure take?

Generally, root canals take 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; all of the roots must be treated. Difficult cases may require even more visits.

Will the tooth need any more work after the treatment is finished?

Yes, the tooth will require a permanent restoration. This could range from a simple filling to a large build-up with posts and pins. The tooth is more brittle after a root canal treatment and therefore is more susceptible to fracture. If the filling is large, the tooth may need a crown as well. A crown protects the tooth from breaking.

Isn't it simpler to take out the tooth?

It may seem simpler to have the damaged tooth removed; however, it is really much healthier and more economical to save it. If the extracted tooth is not replaced, the teeth next to it can drift into the empty space. Replacing an extracted tooth involves either expensive bridgework or a partial denture.

Will the root canal procedure hurt?

During the actual treatment, your tooth will be numb as it would be for simply filling a cavity. The treatment is usually started because the tooth is sensitive; it may take a day or two for the tooth to get back to normal. Generally a mild painkiller is enough to keep you comfortable during this time. If something stronger is needed, your endodontist will prescribe it. If the tooth is badly infected, an antibiotic may be needed as well.

How much will it cost?

The cost of root canal treatment and therapy varies with the number of canals which need to be treated. There will be a separate charge for the restoration, depending on the extent of the procedure. Your dentist will be glad to discuss the charges with you for all the expected 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.