When the nerve of a tooth is affected by decay or infection, there are two choices - Extract it or Save it & the only way to save it is by Root Canal Treatment. In this treatment, the pulp i.e. the living tissue inside the tooth, nerves, bacteria and any decay are removed and the vacant space is filled with biocompatible material - Gutta Percha to restore the tooth to its full function. Root Canal treatment when done properly is highly successful and usually lasts a lifetime, but occasionally a Root Canal treated tooth may have to be retreated due to new infections.
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Endodontics is the branch of dentistry that deals with diseases of the tooths pulp. The pulp is found in the center of the tooth and in canals (called Root Canals) inside the root of each tooth. Pulp includes connective tissue, nerves and blood vessels. Pulp nourishes the tooth when it first emerges through the gum. Once the tooth matures, the pulp can be removed without destroying the tooth. That is because each tooth also is nourished by a blood supply in the gums. Removing the pulp is called endodontic treatment, but it is often referred to as Root Canal treatment or Root Canal therapy. Many people refer to pulp removal as "having a Root Canal." Root Canal treatments are quite common. In the United States, they save about 24 million teeth each year.
Root Canal is thus a dental procedure which helps in removing the entire internal parts, mainly pulp chamber of the tooth. It also involves the filling of the prepared empty cavity with a suitable biocompatible material. This procedure is done and advised only when the tooth can not compensate restoring material in a small cavity on the surface. The procedure involves the removal of the nervous elements of the tooth which have been infected or decayed already due to microbial action or any physical pressures. This is the only procedure that can help when the entire pulp and its contents are decayed. This procedure of Root Canal treatment can be done by any general dentist.
Root Canal treatment is needed for two main reasons. The first is infection. An untreated cavity is a common cause of pulp infection. The decay erodes the enamel and dentin of the tooth until it reaches a Root Canal. This allows bacteria to infect the pulp. Antibiotics can not get to infections inside teeth. The inflammation caused by the infection reduces the blood supply to the tooth. The reduced blood supply also keeps the pulp from healing. The second reason for a Root Canal is damage to the pulp that can not be fixed. Trauma or a fractured tooth can damage the pulp. So can a lot of restoration, such as several fillings placed in the same tooth over a period of time. Sometimes, common dental procedures, such as preparing a tooth for a crown, can hurt the pulp. Then the tooth might need a Root Canal. When the pulp is inflamed but not infected, it may heal on its own. Your dentist may want see if this will happen before doing Root Canal treatment. If the pulp remains inflamed, it can be painful and may lead to infection. An infection in the pulp can affect the bone around the tooth. This can cause an abscess to form. The goal of Root Canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty Root Canals with a material called gutta percha. If Root Canal treatment is not done, an infected tooth may have to be extracted. It is better to keep your natural teeth if you can. If a tooth is missing, neighboring teeth can drift out of line. They also can be overstressed from chewing. Keeping your natural teeth also helps you to avoid other treatments, such as implants or bridges. Also, if you ignore an infected or injured tooth the infection can spread to other parts of your body. Having Root Canal treatment on a tooth does not mean that the tooth will need to be pulled out in a few years. Once a tooth is treated, it almost always will last the rest of your life.
If you have an infection of the pulp, you may not feel any pain at first. But if it is not treated, the infection will cause pain and swelling. In some cases, an abscess will form. Your tooth might need a Root Canal if:
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To determine whether your tooth needs Root Canal treatment, your dentist will often place hot or cold substances against the tooth. The purpose is to see if it is more or less sensitive than a normal tooth. He or she will examine the tissues around the tooth and gently tap on the tooth to test for symptoms. You also will be given X-rays of the bone around the tooth. The X-rays may show a widening of the ligament that holds the tooth in place or a dark spot at the tip of the root. If either of these is present, your dentist probably will recommend a Root Canal procedure. Your dentist may need more information about the tooth. He or she may use an electric pulp tester. This hand-held device sends a small electric current through the tooth. It helps your dentist decide whether the pulp is alive. This test does not cause pain or a shock. You may feel a tingling sensation. It will stop when the tester is removed from the tooth. An electric pulp tester should not be used if you have a cardiac pacemaker or any other electronic life-support device.
Root Canal treatment can be done in one or more visits. It depends on the situation. An uncomplicated Root Canal treatment often can be completed in one visit. Some teeth may be more difficult to treat because of where they are in the mouth. Some teeth have more roots than other teeth. Treating a tooth with many roots takes longer. Some teeth have curved Root Canals that are difficult to find. If you have an infection, you will visit the dentist several times so that he or she can make sure that the infection is gone. There are a few factors which decide the amount of chair time and the number of sittings in a Root Canal:
Firstly, your dentist will numb the area around the tooth. Your dentist also has other ways to reduce your anxiety. The dentist will make a hole in the top or back of your tooth to get to the pulp chamber. He or she will remove some of the diseased pulp. Then the Root Canals have to be measured. Your dentist needs to know how long the canals are to make sure the entire canal is cleaned. He or she also needs to know how much filling material to put in the cleaned canals. To measure the Root Canals, dentists use X-rays or an electric device called an apex locator. For an X-ray, your dentist will place a file into the canal and then take an X-ray. An apex locator measures a Root Canal based on its resistance to a small electric current. Many dentists use both methods.
After the canals have been measured, your dentist will use special tools to clean out all of the diseased pulp. Then the canal is cleaned with antiseptic. This helps treat and prevent infection. All the canals within a tooth must be cleaned. Teeth have different numbers of canals:
The location and shape of the canals can vary quite a bit. Some dentists look inside the tooth with a microscope to make sure all the canals have been cleaned out. Once the canals have been thoroughly cleaned, the roots are filled. A temporary filling is then placed over the tooth. The temporary filling you receive is not meant to last. The top of the tooth should then be covered with a permanent filling or crown. Once the Root Canal treatment is finished, you will need to see your general dentist to have a crown or filling placed on the tooth. You are likely to receive a crown if the tooth is discolored or if it is used for chewing. The purpose of the crown is to prevent the tooth from breaking in the future. In most cases, the tooth will need a crown. A crown will help to restore the tooths strength and protect it from cracking. If a crown is indicated it should be placed soon after having Root Canal treatment. The pulp that was removed during Root Canal treatment is the part that responds to temperature. Your tooth will no longer be sensitive to hot or cold after the Root Canal is treated. There still are tissues and nerves around the tooth, however, so it will respond to pressure and touch.
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Your tooth may be sore for two to three days after the procedure. The worse the infection and inflammation was, the more sensitive the tooth will be after treatment. Avoid chewing on the affected side. You can take pain killers. A pain killer also reduces inflammation & is likely to be most helpful. Examples include Combiflam & Ketanov.
As with most invasive medical or dental procedures, complications can occur. Here are some possibilities:
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In most cases, you will not have any pain during a Root Canal procedure. Your dentist will numb your tooth and the surrounding area. Let your dentist know if you are feeling any pain during the Root Canal. Some people fear the numbing shots more than the Root Canal treatment itself. Today, numbing gels and modern injection systems have made injections virtually painless. If it does hurt when you are getting an injection, let your dentist know immediately. He or she can change the way the injection is given to avoid causing pain.
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