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What
is root canal treatment?
Root
canal treatment usually involves the removal of the tooth's pulp,
a small threadlike tissue that was important for tooth development.
Once removed, it is replaced with materials that seal off the root
canal from its supporting structures. Years ago, diseased or injured
teeth were often extracted. Today, even if the pulp of one of your
teeth becomes injured or infected, it often can be saved through
root canal (endodontic) treatment. Endodontics is the area of dentistry
concerned with the prevention, diagnosis, and treatment of diseases
or injuries to the dental pulp.
What
is the dental pulp?
The
pulp is the soft tissue that contains the blood vessels, nerves,
and connective tissue of a tooth. It lies in a canal that runs through
the center of the dentin--the hard tissue on the inside of
the tooth that supports the outer layer of tooth enamel. The
crown (the portion of the tooth visible above the gums) contains
the pulp chamber.
The pulp extends from this chamber down through the root canal to
the tip of the root in the bone of the jaws. Teeth have only one
pulp chamber but may have more that one root and several root canals.
What
happens if the pulp gets injured?
When
the pulp is diseased or injured and unable to repair itself, it
loses its vitality. The most common causes of pulp death are a cracked
tooth, a deep cavity, or traumatic injury to the tooth. Bacteria
and its products can leak into the pulp, eventually causing it to
lose vitality. If not treated with a root canal, an abscess can
form at the end of the root, resulting in pain and swelling.
Why
does the pulp need to be removed?
If
the injured or diseased pulp is not removed, the tissues
surrounding the root of the tooth can become infected, resulting
in pain and swelling. Even if there is no pain, certain substances
released by bacteria can damage the bone that anchors the tooth
in the jaw. Without treatment, the tooth may have to be removed.
Why
couldn't you just remove the tooth?
There
are many disadvantages to losing a natural tooth. When a tooth is
removed and not replaced, the adjacent teeth may begin to shift
from their normal position. This may cause the teeth to become crooked
or crowded, which decreases biting and chewing efficiency. Crowded
or crooked teeth may be more prone to gum disease because they are
harder to keep clean that properly aligned teeth. A replacement
tooth (an implant or bridge) is usually more expensive than endodontic
treatment and can involve more extendsivce dental procedures on
adaent teeth. A natureal tooth is normally better than an artificial
tooth.
What
does treatment involve?
Treatment
usually involves from one to three visits. During treatment, your
general dentist or endodontist (a dentist who specializes in problems
of the pulp) removes the diseased pulp,. The pulp chamber and root
canal(s) are then cleaned, shaped, filled and sealed off from the
bone surrounding the root. In case of considerable tooth structure
loss, a metal or plastic rod or post may be placed in the root canal
for structural support, and a crown is usually placed over the tooth.
What
material will be used for the crown?
Crowns
are made from a number of materials. Gold allots or nonprecious
alloys, porcelain or ceramic, acrylic or composite resin or combinations
of these materials may be used. The type of material used for the
crown will depend on a number of factors including where the tooth
is located your mouth, the color of the tooth and the amount of
natural tooth remaining. Talk with your dentist about which option
is suited to your situation.
How
long will the restored tooth last?
As
long as the root(s) of a treated tooth is nourished by the tissues
around it, your tooth can remain healthy. However, the tooth could
still become decayed, so good oral hygiene at home and regular dental
exams are necessary to help prevent both tooth decay and periodontal
(gum) disease.
Here's how
your tooth is saved through treatment:
| 1 |
First,
the tooth is isolated from the saliva with a dam ( a rubber-like
sheet placed around the tooth), An opening is then made through
the crown of the tooth in to the pulp chamber. Local anesthesia
is usually given prior to this step so that you will be more
comfortable during treatment. |
| 2 |
The
pulp is then removed carefully from both the pulp chamber and
root canal(s). The root canal(s) is cleaned, enlarged, and shaped
to a form the can be filled. |
| 3 |
Medication
may be put in the pulp chamber and root canal(s) to help eliminate
bacteria. |
| 4 |
A temporary filling will be placed in the crown opening to prevent
saliva from getting into the chamber and root canals. You might
also be given antibiotics if infection is present and has spread
beyond the end of the root(s). |
| 5 |
During
the next stage of treatment, the temporary filling is removed.
The root canal(s) are then filled and permanently sealed with
a a natural, biocompatible material, usually gutta-percha. |
| 6 |
In
the final step, a crown made of porcelain or metal alloy is
usually placed over the tooth to restore structure, function,
and appearance. If an endodontist performs the root canal treatment,
he or she will usually recommend that you return to your general
dentist for the crown's preparation. |
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