Ah, the pesky root canal. I did not know much about root canals, and I figured most people do not unless they have had one. So I asked Dr. Mehmood Asghar to help fill me in on the subject.
The following is what Dr. Asghar had to say.
A root canal is the last effort of your dentist to save your dying tooth from extraction. To better understand what the root canal procedure is and why it is necessary it would be useful to know the structure of your teeth.
The Internal Anatomy of the Tooth
The visible part of your tooth is called the crown. The part hidden in your gums is known as the root. The crown is covered by enamel, which is a translucent mineral material that happens to be the hardest tissue in the body; it is like the hard armor protecting your teeth. Inside the enamel layer is the dentin which is hard, but not as hard.
While the enamel covers only the visible part (and a little below the gum), the dentin covers the tooth down to the tips of the roots (Molars may have more than one root). Within the dentin layer, down the length from the crown to the root tip is a hollow structure called a root canal. This canal is filled with soft dental pulp, and is also called the pulp chamber. This pulp contains blood vessels and nerve tissue.
Infection of the Root Canal
The hard enamel layer on the tooth’s visible surface can sometimes decay due to poor oral hygiene maintenance. If the cavity is not treated in time, the enamel layer gradually gets punctured exposing the soft dentin layer which is more likely to become damaged or infected.
If you do not get immediate treatment, and the cavity extends down to the pulp chamber, the result can be very dangerous. The underlying pulp gets infected and creates a lot of pressure that builds up within the chamber. This produces incredible amounts of pain, in addition to typical signs of infection such as fever and swelling. The pain is so severe that even pain killers will only help temporarily. If the infection becomes this painful, then a root canal is necessary.
The Root Canal Treatment
The root canal treatment (RCT) consists of the following main steps.
• Assessment – The first step is to do an assessment of the tooth using X-rays. This helps the dentist visualize the location and extent of the infection and the number of tooth roots that have become infected.
• Dental Anesthesia – With suitable anesthesia, the amount of pain you feel will be lessened and makes the job possible for the dentist.
• Gaining Access inside the Tooth – To gain access into the tooth, the dentist drills into the tooth until the pulp chamber is exposed. At this stage, the access cavity is broadened to allow access of the dental instruments and visibility.
• Root Canal Preparation – The dentist, then shapes the canal by using different sizes of endodontic files. These files are used for removing infected pulp and debris from the root canal. To ensure proper cleaning, the dentist frequently uses a sterile or antibacterial agent to kill all microbes inside the root canal.
• Temporary Filling – After canals have been shaped and cleaned, they are completely dried, and an intracanal medicament (temporary filling) is inserted, and the patient is asked to return after a few days.
• Obturation and Permanent Restoration – In the next appointment, the dentist removes the temporary filling. If sufficient healing has taken place, the dentist will permanently seal the canals by putting a rubber-like inert material. Finally, the tooth is restored with a suitable filling material.
• Placing a Dental Crown over the Treated Tooth – Since the tooth structure gets weakened and brittle, an RCT treated tooth should usually be covered with a crown to prevent it from fracturing.
What Happens if You Do Not Get RCT?
If your dentist decides that you need an RCT, you should listen to them. It will give you immediate relief from pain, and your tooth could be saved. If you continue to delay your RCT, it means you will continue to suffer from pain, and ultimately, the tooth may have to be extracted. At least two deaths are on record, even in the USA, due to ignoring a root canal treatment. Other serious consequences of not getting a root canal are:
1. Loss of the Tooth
If you ignore having a root canal treatment despite your dentist’s recommendations, infection in that tooth will gradually destroy the tooth structure. Ultimately, the tooth will have to be extracted and replaced with expensive tooth replacement options such as implants, bridges or removable dentures.
2. Transfer of Infection
If an endodontic infection is not treated promptly, with a root canal procedure, the infection can travel into the surrounding structures such as the salivary glands and the jaw bone causing even more severe infection which could be life-threatening.
3. Ludwig’s Angina
Sometimes, the infection from an infected tooth travels down to the airway, resulting in swelling and complete or partial airway blockade. This situation, although rare, can lead to a medical emergency, and death, if not treated timely.
To summarize, when your dentist tells you that you need a root canal treatment, you should not delay it. However, a root canal treatment can easily be avoided in the first place by maintaining an optimal oral hygiene through daily brushing and flossing, and regular checkup visits to your dentist. I want to thank Dr. Asghar for his time and thank you for reading!