Root Canal Treatment

When do you need an Root Canal Treatments (RCT)?

A root canal treatment is generally indicated when

• There has been trauma to tooth as in an injury, fall or accident where tooth is fractured or discolored.
• There is a large decay in the tooth extending to the roots causing recurring pain or swelling or both.
• There is an opening in the gums, which drains pus through a sinus tract that leads to an abscess surrounding the roots. Cavities extend very close to the nerve extreme pain.

What exactly is done in Root Canal Treatments?

The root canal treatment procedure begins with an intra-oral X-ray, which shows the extent of tooth decay or the rounded black spot at the end of the roots indicating a decrease in the density of bone due to infection. After local anesthesia to the concerned tooth, access is gained to the nerve area by a dental drill and a hole is made which leads to pulp chamber. Cleaning the tooth out to remove bacteria, degenerated nerve and debris is then done using RC files. These files are a series of increasing diameter used with a twisting motion as well as up and down in tooth to scrape and scrub sides of canals.

The tooth is periodically flushed with saline or water. Once the tooth has been thoroughly cleaned, the interior is sealed by placing a root canal filling material either the same day or subsequently. The most common RC filling material, a rubber compound called ‘gutta percha’ comes in performed cones that are sized to match the files used to clean the canals. The cones are placed into the root canal (coated with a sealer) exactly to the tip of tooth, length is confirmed with an x-ray. The crown of tooth is then filled with amalgam (silver) filling which seals tooth from above.

Frequently Asked Questions:

1. What is Root Canal Treatment?

Root Canal Treatment (RCT) is a treatment wherein the diseased pulp (nerve) of the tooth is removed & the space (the root canal) is filled with an inert material.

2. Why is it required?

There are three common ways by which the nerve get affected

• By Injury to the tooth.
• By decay reaching the pulp through enamel & dentin
• Wearing out of enamel & dentin. Sometimes the damage to the nerve is irreversible & the tooth may cause serve pain particularly in the night or due to infection traveling through the root canal darken over a period and may also get infected. If such a tooth is to save, the nerve from within the tooth must be sacrificed.

3 . What does RCT Involve?

Before commencement of the treatment, an X-ray is taken to find out how the roots of the tooth are & whether the treatment is possible. The treatment is usually carried out in two visits. At the first visit the nerve is reached by drilling though the tooth & cleaned – this has to be done under the effect of local anesthesia unless of course the nerve is already dead. The root canal is cleaned thoroughly & a medicine is placed. In the subsequent visits after making sure that the nerve is completely removed & that the tooth is comfortable, the root canal is filled.

4 . Is the treatment is painful?

When pain is likely during the procedure a local an anesthetic is injected & takes care of the pain. Between two visits mild to moderate pain is possible but medicines prescribed by the dentist will make you comfortable. Many patients do not need more than a tablet or two.

5 . How long does it take?

As mentioned earlier usually 2-3 visits of about 30 minutes duration at interval of 3-4 days. Sometimes, infection may take time to subside & the treatment may take longer time & sometimes it may be possible to do it in a single sitting.

6 . Isn’t there any alternative to R.C.T?

Sometimes if the dentist feels that the nerve may recover from the damage (& just relief from pain does not mean that the nerve has recovered) he may try & protect the nerve. But, after a few episodes of pain, the chances of such treatment becoming successful are less. More often the alternative is removal of the tooth.

7 . Do you deaden the tooth by RCT? Does it affect other nerves on that side?

A ‘dead tooth’ is one which has the supporting tissues also ‘dead’. The tooth after RCT has only lost the pulp (nerve & blood vessels) from within the tooth & is called pulpess or nerveless tooth. You will not have sensation in this tooth. Otherwise it is like any other tooth.

8 . Does the tooth require any treatment after RCT?

Usually the tooth is so badly destroyed by decay & the cavity in it is so large that the cavity requires a filling & the tooth weakened by loss of structure needs to be prevented from breaking by covering it with a crown (a’ cap’).

9 . Is RCT Permanent?

In favorable cases the success rate is very high over 90 percent. In a very small percentage of cases the treatment can even fail & then the only thing to do may be the removal of tooth. In some of these cases a minor surgical procedure carried out after RCT also helps. But in the large majority of cases when the treatment is successful, the tooth with proper after care can last many years & the RCT is not required to be redone.

10 . Can this tooth decay/pain after RCT?

Whatever decay exists at the time of RCT is removed. Fresh decay can start later like in any other tooth. This can be detected at the time of your yearly check-ups. Pain in a successfully root filled tooth can be caused due to gum disease which in most cases is treatable. So this tooth also requires the usual care like other teeth.

Testimonial:

root canal treatment

One fine morning I had gone to a dentist for filling up one of my molar tooth not knowing that after a filling I will experience a severe pain in that tooth. The constant pain pushed me to look for another dentist’s advice that is popular and authentic in their practices in the city of Bangalore. In this era of computers, the fastest way was to browse the internet when I came across “Dr Trivikram's All smiles” Dental care by Dr. K.N Trivikram along with others. Immediately, I fixed my appointment the same evening and met the Doctor. As per the doctor the nerve was already exposed and hence a root canalling was the only option..

I was a bit apprehensive for this procedure since this root canalling was to be done for the first time in my life but the way the doctor explained and assured me of saving the tooth, convinced me to go ahead.

Throughout the four sittings, the root canalling procedures were done carefully and painlessly with proper instructions issued out to me. I did follow these instructions and found to my amazement that I was very comfortable and now after a month of fixing of the crown, I find myself quite normal and as natural as it could be.

All my complements goes to Dr.Trivikram, Dr. Shruthi, Dr. Kirthi and hisefficient team where each one of them attending to me including all the other staff proved to be excellent with their excellent smiles that goes aptly well with the name “Dr TRIVIKRAM’ S ALL SMILES” Dental care.

I therefore, recommend others too to visit Dr. Trivikram, Director “Dr Trivikram's All smiles Dental care Clinic” for a genuine dental advice. The clinic is situated at Shankarpuram, Basavanagudi, Bangalore.

Lt Col Rammohan Rao (Retd), Indian Army, 15 Aug 2012

Authored By Dr.K.N Trivikram Rao - Dentist, Bangalore