July 17, 2014
Root canal treatment is required when the dental pulp inside the tooth gets infected. The tooth pulp contains blood vessels, nerves and connective tissue which are essential for the tooth. During the RCT procedure the diseased pulp is taken out and the rest of the endodontic space is thoroughly cleaned and disinfected. It is then sealed to prevent recontamination.
Why do I need a root canal treatment?
Damage to the pulp can eventually lead to infection which can be extremely painful. Further, this infection can spread and cause swelling of the face and neck leading to more dangerous complications. The infection leads to bone loss and sometimes the infected tooth can not be saved. The infected pulp may cause pus accumulation. If it is not treated, it causes an abscess, damaging the bone around the affected tooth. In addition to this, the accumulated pus may start draining extraorally or intraorally creating a sinus tract and an extraoral or intraoral sinus.
Pulp damage causes
There are several factors that can lead to pulp damage:
- A crack in the tooth
- A deep cavity or a recurrent (secondary) caries
- Any kind of tooth injury that may have been caused by an accident. Sometimes the damage may become noticeable much later
When is root canal treatment needed?
Symptoms may not always be obvious, but treatment may be needed under the following circumstances:
- Intense toothache
- Pain or thermal sensitivity that lingers even after thermal stimulation has been taken away
- Swelling that has spread to gums around the affected tooth
- A pimple on the gums that does not clear out or recurs
RCT procedure in short
The procedure requires a few visits. The dentist begins with a diagnostic x-ray to assess the extent of damage as well as the shape of the root canal system. In the case of a pus filled abscess it may be necessary to drain it with a small incision. This may be followed by a course of antibiotics for a week. The actual procedure may be carried out after this treatment.
A local anesthesia is given to minimize discomfort for the patient. An endodontic cavity is drilled in the tooth to access the dental pulp and orifices (the part where the root canal meets the pulp chamber). This is followed by removal of the dead and diseased pulp. Root canal files are used to clean the remaining space to ensure that no bacteria remain and infection does not recur. These files are with an increasing diameter in order to shape and enlarge the root canal before sealing it. Irrigating solutions are used to flush out debris. Most common irrigants in the endodontic therapy are EDTA, NaOCl and citric acid. Generally gutta-percha is placed in the canals along with the sealer. The tooth can be restored with a filling, inlay or a crown.
In situations where the procedure is carried out in more than one sitting, a temporary filling is placed on the affected tooth to prevent contamination.Though it is normal for some sensitivity to occur after root canal treatment, this should clear out in a few days. This treatment is an effective method to save a diseased tooth that may otherwise have to be removed.
This video ilustrates the RCT procedure in a few seconds: