When is Root canal treatment done?
* Root canal treatment is preferred when the infection has reached the vital tissue i.e the pulp and has infected the pulp tissue, it is also recommended when the tooth has lost its vitality (died)
* It is done when the patient wants to preserve the natural tooth structure without it being extracted.
* When there is a fracture to the tooth where the pulp tissue is damaged due to the trauma caused to it.
* If the pulp infection reaches the bone, and root canal treatment is not done there will be an abscess formation which may lead to extraction of the tooth and treating the affected bone.
What is the alternative for Root canal treatment?
* Extraction is the only alternative to root canal treatment.
What happens when the root canal is infected?
* Sensitivity in the tooth.
* A swelling with pus in the area around the tooth.
* A swelling that may spread to other area of the face.
* Bone loss around the tip of the root.
* Abscess formation around the root tip.
* If neglected for long a Sinus or a drain hole is formed starting from the root draining its contents to the outside.
What are the Signs and symptoms of an infected tooth?
* If a root canal is infected then there will be no pain in the beginning but as the infection progresses there will be pain and if left untreated then it may lead to an abscess formation in which case it has to be extracted, so RCT should be done before the abscess formation takes place.
* A tooth that hurts significantly when pressure is put on it, by biting on something or sometimes even on touch.
* Sensitivity to different modalities like heat, cold, pressure etc..
* Discoloration of the tooth with or without pain.
* Discoloration of the tooth after trauma to the tooth, which indicates that the tooth is becoming non vital.
Procedure of Root Canal Treatment:
The procedure of root canal treatment begins with the diagnosis of the infected tooth. The diagnosis is done with the help of the above mentioned symptoms and the main and the final diagnosis is done after taking a radiograph of the suspected tooth. The infected region can be detected by slight discoloration in the region from the normal and the presence of infection in the apex of the root. After diagnosis is done the cavity is prepared on the tooth surface to accesses the root canals. The root canals can be seen from the occlussal surface after preparation of the cavity, so that the infected pulp tissues can be removed.
After this Endodontic files are used to remove the pulp tissue from the root canals. The endodontic files are available in different sizes. These files are used based in the width of the canal as it is different in different teeth and in different individuals. These files are then inserted into the root canals from the occlusal surface to clean the infected root canals by removing the pulp tissue. These files are flexible to ease the procedure as the root canals are not always straight they are seen with many curvatures at the tip.
Above given is the infected tooth which has to be operated on by the root canal treatment. Seen in it is the caries infiltration in the Enamel and Dentin which is extending into the pulp, and seen in the root apex is the formation of an abscess. After removal of the pulp tissue from the root canals, the empty root canals are then cleaned with disinfectant irrigating solutions to make sure that no infected tissue remains in the canal which is capable of causing the infection again.
Then after successfully rinsing the canals, gutta-percha points are placed into the empty root canals to replace the pulp tissue which was removed. These gutta-percha points are available in different sizes so as to completely fill in the root canal which was emptied, the gutta percha points are adapted with the use of pressure into the canals with the help of a plugger or a dental instrument with a tip to put pressure on the gutta-percha points. The gutta-percha points are placed into the canal by applying cement onto them so that they are well adapted to the walls of the root canal.
After the canal is filled with the gutta-percha points an X-ray is taken to see weather the points are in place and weather there is any gaps. The gutta-percha point must fit well enough so that you know, with the utmost predictability, what the final result will look like even before you complete the procedure. If the preceding instrumentation has been done well the point will be very easy to fit and the result will be predictably excellent. After confirming that the gutta-percha points are well placed then comes the turn of the restoration to be done to replace the tooth structure removed during the cavity preparation. Mainly a tooth coloured restoration is preffered by the patients for the aesthetics to be maintained. The success of the Root canal treatment is confirmed by taking a radiograph after the complete restoration is done.
