By Dr. Randall LeDuke, DDS
This month we are going to examine the why’s and wherefore’s of root canal therapy, clinically known as Endodontics.
Root canal therapy is a fact of life at the dental office. Although the conditions that lead to root canal therapy are mostly preventable through regular dental examination and hygiene maintenance, every day, in every dental office in the land, patients present with painful tooth problems that can only be resolved by means of either root canal therapy or removal of the tooth.
At the center of each vital tooth, protected inside a very hard shell of enamel and dentin, is a delicate organ called the dental pulp. Dental pulp consists of blood vessels, nerve tissue, cells and connective tissue. This pulp organ can be compromised by deep, penetrating dental decay that introduces bacterial infection, by a crack or fracture that exposes the pulp or even by a traumatic blow to the facial area as in a sports injury or an auto accident.
Dental pulp has a limited capability to rebound from these insults if treated quickly and effectively, but very often the pulp succumbs to the insult and eventually breaks down leading to necrosis and infection which, in turn, leads to inflammation with swelling and pain.
Two Treatment Options
Since dental nerves have a direct neural pathway to the brain’s pain perception apparatus, dental injuries and infections tend to be exquisitely painful. Treatment for the condition of dental pulp necrosis and infection consists of two options; extraction, that is, removal of the tooth, or selective removal of the infected dental pulp remains, allowing the tooth to remain in function. This is the root canal therapy process.
Often your dentist will initially prescribe oral antibiotics to help reduce the inflammatory conditions that generate discomfort. After a few days of antibiotics, the tooth is in a much more manageable condition for treatment. Root canal therapy gets its bad reputation from its association with the extreme discomfort of the infected tooth. Once swelling and pain are reduced by means of antibiotics, root canal treatment can proceed in relative comfort.
The root canal procedure consists of removal of decayed tooth material (if, in fact, a deep cavity is the cause of the problem), establishment of access to the pulp chamber and discovery of the openings to the canals. Each root has one or more canals that must be located, opened to the length of the root, cleaned of gangrenous pulp material and shaped for receiving a specialized canal filling material. Once the canals are prepared, they are then filled and sealed. This is a very tedious and delicate microsurgery, usually done under surgical magnification and lighting. If the root canal system can be effectively cleaned, shaped and sealed, the body’s infection-fighting ability will complete the process and the tooth can then be restored to normal function, usually with a crown.
The process often can be finished within the space of one visit, but sometimes conditions require multiple visits for completion. Root canal systems usually are relatively simple and straightforward in anterior or front teeth but can be very complex in back teeth with multiple, curved canals and more difficult access. If the initial pulp injury is not infection-related but caused by a fracture or a traumatic injury, root canal therapy can usually be initiated immediately without the need for preliminary antibiotic therapy.
Prevention through Regular Maintenance
As in all things dental, prevention of problems through regular maintenance care is far better than treatment, disease recovery and restoration of damage. However, dentists successfully save thousands of teeth each year by means of effective root canal therapy.
To learn more or to schedule a consultation, please contact Dr. LeDuke at 731-885-0497. We are always happy to answer your questions.
214 West Church
Union City, TN 38261