A root canal need not be such a pain, and it is affordable as well

A root canal is a procedure for repairing and saving a tooth that is severely decayed or infected.

The treatment is done when the nerve of the tooth becomes infected or the pulp becomes damaged. During the procedure, the pulp and the nerve are extracted, then the inside of the tooth is cleaned and sealed.

Many people have been made to believe that the procedure is painful.

However, most people who have undergone a root canal say that the procedure is no more painful than having a filling placed.

The anxiety experienced at the time of seeking dental treatment is the one that is painful, not the root canal.

DENTAL PULP

The pulp or pulp chamber is the soft area at the centre of the tooth.

The tooth nerve is located within root canals, which are at the base or roots of the tooth.

The root canals run from the tip of the root of the tooth through the pulp chamber, which contains blood vessels and connective tissue that nurture the tooth.

Basically, the nerves of the tooth are not important to the health of a tooth once the tooth has emerged from the gums.

Their only use is sensory, such as detecting hot or cold substances. The absence of nerves does not affect the normal functioning of the tooth.

WHY THE PULP MUST BE EXTRACTED

When the pulp or nerve tissue is damaged, it breaks down and bacteria start to multiply within the pulp chamber.

The bacteria, together with decayed debris, may lead to an infection or abscessed tooth.

An abscess is a pus-filled pocket formed at the base of the roots of a tooth. It occurs when the infection grows past the ends of the tooth roots.
Besides an abscess, infection of the root canals can lead to swelling in the neck, face or head, loss of bone around the tip of the root and drainage problems extending from the root.

A hole can emerge on the side of the tooth, with drainage into the gums via the cheek.

What damages the pulp and tooth’s nerve?

The pulp and a tooth’s nerve may be irritated, inflamed or infected as a result of severe decay, a crack or chip in the tooth, repeated dental procedures, a large filling or trauma to the face.

When is a root canal necessary?

There are various indications that a root canal is required.

They include severe toothache when chewing or when pressure is applied to the tooth, persistent pain on contact with hot or cold temperatures even long after the cold or hot agent has been removed, swelling and tenderness in the surrounding gums, discolouration of the tooth (darkening), recurring or persistent pimple on the gums.

Sometimes, there are no signs although the tooth may be damaged or infected.

THE PROCEDURE

Having a root canal involves one or more visits to a dentist.

The procedure can be done by either a dentist or an endodontist (a dentist who specialises in the causes, diagnosis, prevention and treatment of injuries and diseases of the dental nerve or pulp of the tooth).

The choice of who to perform the procedure depends on how difficult the procedure is likely to be and how confident the dentist feels about tackling the problem.

Normally, the procedure begins with an X-ray of the tooth to establish the shape of the root canals and to determine whether there are infections in the neighbouring bones.

The dentist will then apply anaesthesia to numb the area around the tooth. Even though the nerve may be already dead, a dentist will still apply anaesthesia to ensure that the patient is comfortable during the procedure.

This is followed by placing a rubber dam around the tooth to keep the area dry and free of saliva during the treatment.

An access route is then drilled into the tooth where the pulp and decayed nerve tissue, together with any bacteria and related food particles are extracted from the tooth.

This cleaning is done using root canal files. Water or sodium hypochlorite is used to flush out the debris during the process.

When the tooth is completely clean, it is ready for sealing. This may be done a week later, especially if there was an infection.

Meanwhile, medication is placed inside the tooth to clear this infection. Once the infection has cleared, the tooth can be sealed. However, in cases where the root canal is not completed the same day, a temporary filling is put on the outside hole to prevent contamination between appointments.

Once the tooth is infection-free, the interior of the tooth is filled with a sealer paste and a rubber material called gutta percha is put into the tooth’s root canal. A filling is also placed to seal the access hole created during the procedure.

Finally, a crown is placed on the tooth to enhance its appearance and shape. Sometimes, a crown and post may be added, depending on how damaged the tooth is.

DURING ROOT CANAL

During the procedure, it is good to minimise chewing with the tooth under treatment to avoid recontamination and also avoid it breaking before it is completely restored.

Having a root canal completely stops the pain that one was feeling before the procedure.

However, the tooth may be sensitive for a few days as a result of natural tissue inflammation, particularly if it was infected or painful during or before the treatment.

This can be successfully managed with over-the-counter painkillers.

Patients must maintain oral care, including brushing, flossing and visiting a dentist regularly. Root canals are highly successful, with many teeth fixed using the procedure lasting a lifetime.

COMPLICATIONS

Despite your dentist doing their best to clean and seal your tooth, there is the threat of new infections.

This may be due to one having more than the usual number of root canals. which might leave one of them uncleaned, an undetected crack in the root of the tooth, or a faulty or ineffective dental restoration that allowed bacteria to enter and re-contaminate the tooth.

In such cases, a repeat of the procedure can successfully rectify the problem. But in some instances, surgery might be necessary to save the tooth.

COST

A root canal is not as expensive as most people believe it is. It is quite affordable and largely depends on where it is done.

Some insurance firms cover part of the cost of dental treatment so it is advisable to confirm whether your health insurance does before undergoing the procedure.

How can root canal be prevented?

Since inflammation and infection of the pulp or tooth nerves are caused by severe decay, taking care of one’s teeth, including brushing at least twice a day, flossing and visiting a dentist regularly can minimise the need for a root canal.

And trauma to the tooth that might be caused through sports can be prevented by wearing a mouth guard.

Is there an option to root canal?

You can avoid the need for a root canal by taking care of your natural teeth.

The other alternative is having the tooth removed and replaced with an implant, a bridge, or removable denture to allow one to chew and also prevent adjacent teeth from getting misaligned.

These procedures are more expensive and the treatments required are cumbersome.

KNOW YOUR BODY

Tooth structure

Enamel: This is the hard external layer of the crown. It is the hardest substance in the human body.

Dentine: Lies beneath the enamel and it is not as hard as enamel. It forms the largest part of the tooth. If the protection given by the enamel is lost, it becomes sensitive.

Pulp: This is the soft tissue containing nerves and supplies blood to the tooth. It extends from the crown to the base of the root.

Centum: This is the layer of bone-like tissue that covers the root.

Structures surrounding the tooth

Gums: This is the soft tissue immediately surrounding the teeth and bones. It protects the bone and teeth roots while providing an easily lubricated surface.

Bone: Provides a socket to surround and support the roots.

Nerves and blood supply: Blood vessels nourish the root while nerves enable the teeth to respond to different stimuli.

Send your health questions to [email protected]