Root Canal Treatment
The inner part of the tooth, known as the pulp chamber, contains nerves, blood vessels, and lymph vessels that enter the tooth through the root canals. If teeth are left untreated, this can lead to the conditions favorable for bacteria to enter the root canals where they can cause inflammation. Root canals should be treated when inflammation takes place in the soft tissue (pulp) inside the teeth. This treatment is directed toward the eradication of bacteria present there and the prevention of teeth and surrounding tissues from infection. Root canal treatment involves 2 steps: chemomechanical preparation of root canals and their filling.
Chemomechanical Preparation of Root Canals
The chemomechanical preparation of root canals is done when inflammation is present in root canals. It is the first step of root canal treatment.
The inner part of the tooth, known as the pulp chamber, contains nerves, blood vessels, and lymph vessels that enter the tooth through the root canals. Different teeth have a distinct number of root canals ranging from 1 to 4. If teeth are not treated, this can lead to the conditions favorable for bacteria to enter the root canals and bone at the root tip where they can cause inflammation. Then, in turn, the procedure of chemomechanical preparation of root canals, is needed to be performed during which the root canals are cleaned and washed out. The procedure is necessary due to several reasons:
- Inflammation in root canals often causes extreme pain, and it subsides only when the nerve is dead or it is removed from the canal;
- Contaminated root canals are a source of infection from which bacteria can spread to the bone supporting the tooth and cause more severe inflammation resulting in pain and swelling;
- Root canals are often very narrow and curved; therefore, they are needed to be precisely enlarged and given a shape so that medications could be delivered where needed, and root canals could be successfully sealed in the future.
How Is the Procedure Performed?
The procedure is done under local anesthesia. It takes 30–60 minutes.
First, the tooth is isolated by using a rubber dam to protect it from saliva and washing liquid. Then, all the canals in the tooth are identified; their length is determined by inserting needle-like instruments, so-called files, and taking x-rays. The canals are enlarged with a series of files, each of which has a larger diameter, and are irrigated with a disinfectant solution. Thus, the remnants of inflamed tissues and majority of bacteria are removed, and the root canal is properly shaped to be sealed. Until the next visit, the canals are filled with a calcium hydroxide paste, which has an antimicrobial effect.
What Else Should Be Known About the Procedure?
- After the procedure, the tooth can be very sensitive. Usually it diminishes in a few days;
- During the entire period of treatment, the patient is advised not to chew hard foods on the tooth being treated, as it may cause the tooth to fracture;
- Once the root canals have chemomechanically been prepared, they have to be filled;
- Sometimes inflammatory processes in the root canal can be asymptomatic. However, eventually this leads to the formation of infection sources; therefore, the root canals have inevitably to be treated. This is detected by taking an x-ray.
Filling of Root Canals
It is the second step of root canal treatment done after cleaning the root canals, i.e., after their chemomechanical preparation. The properly cleaned and prepared root canals are sealed with special materials.
Root canals are filled to prevent the recontamination by bacteria and eventual spreading of the infection to the bone at the root tip.
Materials used for filling the root canals have an antimicrobial effect.
Once the root canals have been filled, the tooth should be restored and sealed by placing a restoration (filling, inlay, crown, or onlay).
How Is the Procedure Performed?
The procedure is done after the chemomechanical preparation of root canals, usually during the next visit. Time in procedure depends on the number of root canals; usually it takes 30–60 minutes to complete.
There are a few methods of root canal filling. During the procedure, the remaining calcium hydroxide is washed out, and the root canals are dried and then filled. Once the root canals have been filled, an x-ray is taken to ensure that the root canals are filled completely to the root tip.
What Should Be Known After the Procedure?
After the root canal treatment, the tooth can be sensitive for a short time period. Sensitivity usually remains for a half-day and less frequently, for a few days.