Understanding Modern Root Canal Treatment
“Sonic and ultrasonic equipment have made it easier and faster and is a more efficient way of cleaning inside the tiny root canal tubules”
Previously, root canal treatments were very painful and synonymous with pain. But with local anaesthetics and modern dentistry, most people experience slight pain, if at all pain is caused with a root canal treatment. And in tact, an infected tooth or a fractured tooth may be more painful than getting a root canal treatment done.
This treatment is carried out to save a severely damaged or an infected tooth instead of extracting it. Root canal treatment not only saves the tooth but also prevents the need of replacing the tooth with either a removable denture, a bridge or a more recent option – an implant.
In the past, many or most infected, broken or fractured teeth had to be removed, but now with modern dentistry, most of these teeth can be saved, salvaged and restored to its original shape size and form, rendering it totally normal to speak, function and also look good.
Structure Of A Tooth
The pulp of the tooth or the nerve is the soft structure in the centre of the tooth, which extends till the tip of the tooth. This structure provides the blood supply, sensations and lymphatics of the tooth. If this structure is exposed, damaged or infected, the tooth becomes very sensitive and painful. The aim of the root canal treatment is to remove the pulpal structures, clean and sterilize the cavity or void now created and fill or seal the void to prevent subsequent infections.
Diagnosing The Problem
A root canal filling is done by first diagnosing and identifying the causative tooth whether it is vital or alive, degenerating, or in the process of dying or totally non-vital, or totally dead. Once the clinician has identified and diagnosed the problem, he then proceeds to anaesthetize the patient.
The Root Canal Procedure
After the tooth is rendered totally painless or numb, the dentist then drills to remove the offending pulp or nerve. After the pulp chamber is de-roofed, the entire root canal system is removed, cleaned filed and shaped for the easy and smooth placement of the root canal filling material. Usually ‘gutta percha’ is used along with a cement sealer to completely obliterate the root canal space and hence it is called a root canal filling.
The root canal filling is usually done by an endodontist (a root canal specialist) or a general dentist. It may take more than one sitting depending on the severity of the infection. After the pulp is excavated, the pulp chamber and root canal space is thoroughly filed, widened and cleaned and flushed with different chemicals to render it sterile.
If the tooth is infected, a dressing of different medicaments is put into the tooth and a temporary filling is put on top of the tooth to prevent food contamination or infection coming into the space.
Providing The Finishing Touches
Finally, the tooth has to be restored to its original form for normal function. The tooth is filled with a tilling material and a crown is placed on top of the restoration to give the tooth the protection against breakage or fracture post the root canal filling.
A metal or porcelain (tooth coloured) crown can be fabricated to make the tooth as it were before. Once the root canal filled tooth has been crowned or capped, it can last the normal lifetime of a tooth. But one has to take care by having regular check-ups, cleanings and x-rays so that the remaining tooth under the cap doesn’t get infected or a cavity doesn’t form.
Modern Techniques New and advanced endodontic materials, equipment and techniques have made root canal treatment more predictable, less painful, faster and more efficient. Digital X-rays, which are now used, are visualized immediately and can be magnified as much as you want to get a sharper, clearer and bigger image of the tooth.
Rotary instrumentations have done away with the older conventional hand held reamers and tiles used to widen and shape the root canal system. Sonic and ultrasonic equipment have made it easier and faster and is a more efficient way of cleaning inside the tiny root canal tubules. And with continuous flushing, the tooth can be rendered much cleaner than before in a short period of time.
Binocular loops and magnification help a dentist to actually visualize the tiny canals up to three and a half times. For more magnifications surgical microscopes are used to magnify the field up to 35 times. Tiny surgical mirrors allow the dentist to actually see within the canals of the tooth and microsurgical irrigation has allowed the clinician to direct the air and water flow in a very precise and accurate way.
The modern techniques that endodontists use not only makes the dreaded root canal treatment painless, but it is even faster and more efficient and makes the tooth last a lifetime.