GREETINGS to all frequent health care column readers, I am sure many of you may have heard of or even had a root canal treatment done at some stage.In today’s article I will briefly describe the structure of a tooth which is essential in order for one to fully understand and appreciate why and how a root canal treatment is done,I will also describe the indications (why a root canal is done), contraindications (when not to do a root canal treatment), how it is done and what to expect after it has been done.
Inside the tooth, under the white enamel and the hard underlying layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and helps to grow the root of your tooth during development. In a fully developed tooth, the tooth can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it.
Definition of Root Canal Treatment
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form as seen in the image above left.
Indications for root canal (when it should be done)
— Irreversibly damaged pulp tissue. A long standing dental infection in the bone that erodes through the side of the bone and causes sudden, serious and painful swelling.
— Injury (trauma): Complicated fracture of the tooth crown, root apex is already developed, darkening of the tooth after an accident.
— Prosthetic reasons: In case of severely worn out teeth, where crown is being advised by the dentist. Before placing a crown (dental prosthesis) in such a case, that tooth may need to be Root Canal Treatment.
— A patient complaining of severe toothache while chewing food or severe pain while taking hot or cold liquid where examination shows presence of severe tooth decay. This can lead to accumulation of blackish material (bacteria) on the tooth.
Contraindications for root canal (when it should not be done)
Lack of time (patient and doctor)
Restless patient (Down syndrome, Parkinsonism)
Lack of interest from the patient
Patient prefers other solution (denture, fixed bridge, dental prosthesis)
Extreme root canal anatomy
Vertical fracture of tooth root
Deep root decay
Huge resorption of the root (happens in children primary teeth)
Tooth with no importance (majority of those teeth are the wisdom teeth)