What is root canal therapy?

Root canal therapy (RCT) is designed to correct disorders of the dental pulp - the soft tissue inside the tooth that contains nerves, blood vessels, and connective tissue. Teeth with abscessed or infected nerves were once removed with corrective therapy. But now, in 95 percent of these cases of pulpal infection, the natural tooth can be saved through modern endodontic procedures. (Also called pulp specialists, endodontists have undergone specialized training in performing root canal therapy.)

What causes pulpal nerve damage?

The most common causes of pulpal nerve damage are:

Physical Irritation - generally brought on by aggressive tooth decay (cavity) reaching down to the nerve or through deep fillings, which allows harmful bacteria to reach the nerve resulting in infection and decay.

Trauma - a blow to a tooth or the jaw can cause damage to sensitive nerve tissue within the tooth.

What are the symptoms of pulpal nerve damage?

The following are the most common symptoms of pulpal nerve damage. However, each individual may experience symptoms differently. Symptoms may include:

• pain in the tooth when biting down
• tooth pain while chewing
• oversensitivity of the teeth with hot or cold drinks
• facial swelling

The symptoms of pulpal nerve damage may resemble other oral health conditions. Consult a dentist for proper diagnosis.

Why is root canal therapy necessary?

Without treatment, the the body's natural defence mechanisms for dealing with infection are not able to get inside the tooth to clear away bacteria, getting only to the surrounding bone where they cause local destruction and bone loss. In doing so, the infection of the dental pulp causes the bone around the tooth to be destroyed, making it not able to hold the tooth in place.

What does the root canal procedure involve?

Treatment begins with the initial removal of some of the tooth crown, or top, to allow access to the pulpal tissue. Once the affected pulpal tissue is exposed, the affected area is removed. The area surrounding and containing the pulpal tissue is carefully cleaned, enlarged, and shaped to provide a clean, bondable surface for filling with a permanent filler to prohibit any further infection and discomfort. After filling, a crown is fabricated to complete the rescue and restoration of the natural tooth. The procedure is generally spread over several visits to assure the infected pulp and associated bacteria have been adequately drained.

Post-operative care following a root canal:

Once the root canal therapy is completed, there will be changes to adapt to, including:

Brittleness - a pulpless tooth is more brittle than a non-treated tooth and great care should be used to avoid fracture and chipping.

Discoloration - a non-vital tooth may become discolored over time, which can be treated with bleaching. In most cases, the discoloration poses no threat to the health of the tooth.

In addition, soft tissue inflammation may be a source of irritation in the weeks following surgery. Consult your dentist, or other oral health specialist, for a treatment approach to help control any post-operative swelling and discomfort.