Root Canal Therapy
Root canal is the commonly used term for the main canals within the dentin of the tooth. These are part of the natural cavity within a tooth that consists of the dental pulp chamber, the main canals, and sometimes more intricate anatomical branches that may connect the root canals to each other or to the root surface of the tooth.
Root canal treatment involves the removal of the pulp tissues from the tooth in the event that it gets infected or inflamed. All root canal treatment procedures are done by isolating the tooth with a rubber dam to provide a clean and saliva-free environment. It may be done by single or multiple visits depending on the complexity of the tooth condition. In between treatment appointments, medications may be placed within the canals and the tooth is covered with a temporary filling.
Typical Root Canal Procedures:
- Radiographs – Throughout a root canal treatment the dentist will need several x-ray pictures of the tooth to determine the position of the instruments and filling material inside the canals. It is also advisable to have a good pre-operative picture to determine the approximate length of the roots and their particular shapes and curvatures.
- Access opening – First the dentist will remove any decayed and weak tooth structure. A suitable opening into the pulp chamber is prepared to allow access to the openings of the root canals in the pulp chamber floor.
- Instrumentation – The root canals are identified and then cleaned out with special root canal instruments, used either by hand, or rotated in a handpiece. They all have the function of removing debris from the canal and smoothing and shaping the walls of the canals to create a smooth, clean surface along the entire length of the canal. The canals are constantly rinsed to aid in debris removal and canal sterilization. In some, but not all cases, the canals may be dressed with various medications and sealed with a temporary filling material to allow time for the infection to clear.
- Sealing – Once the canals are suitably cleaned and shaped and infection free they can be sealed off. A root filling material (usually a rubbery material called gutta percha) is placed into each canal with a special sealer.
- Final restoration – Placing a suitable final restoration is almost as important as the root treatment itself. If the restoration leaks bacteria can migrate down the side of the root sealer and re-infect the tooth. A suitable permanent filling is placed into the access opening. Teeth with large amounts of damage may need a post (a metal or fiber reinforced resin rod) down one or more canals to anchor the filling securely onto the root of the tooth. However the access opening is closed, root treated teeth will always be weaker than natural teeth and prone to cracking or splitting. A serious fracture could mean removing the tooth that was so carefully saved with the root treatment. A good way to insure against such a disaster is to crown the tooth.