Root canal treatment
The inner part of the tooth (called the pulp chamber) contains blood vessels, lymph vessels and nerves, which enter the tooth through the root canals. If teeth are left untreated, inflammation can be caused, due to the conditions enabling bacteria to enter the root canals. Treatment of the root canals should begin, when inflammation still takes place in the pulp (soft tissue) of the teeth. The main goal is to eliminate the bacteria present there and prevent the teeth and surrounding tissues from infection. Root canal treatment is a two-step process, first being chemo-mechanical preparation of root canals and then their filling.
Chemo-mechanical preparation of root canals
The root canal treatment begins with the chemo-mechanical preparation. It is done when inflammation is present in root canals. Different teeth have a particular number of root canals ranging from one to four. Conditions favourable for bacteria to enter the root canals and bone at the root tip, where they can cause inflammation, can arise, if teeth with are not treated in time. During the procedure of chemo-mechanical preparation, the root canals are cleaned and washed out. This procedure is necessary due to several reasons:
- Inflammation in root canals usually causes severe pain, and it eases off only when the nerve is removed from the canal;
- Contaminated root canals can cause an infection. From there, the bacteria can spread to the bone, which supports the tooth and create a more intense inflammation resulting in swelling and heavier pain;
- Root canals are often very narrow and curved; so, for the root canals to be successfully sealed in the future, they are needed to be precisely enlarged and given a shape so that medications could be targeted where needed.
How Is the Procedure Performed?
The patient receives local anaesthesia. The procedure might take up 30–60 minutes. First, the dentist isolates the tooth using a rubber dam to protect it from saliva and washing liquid. Later, the dentist inserts needle-like instruments (so-called files) and takes x-rays to identify all the canals and determine their length. Then, the canals are enlarged with a series of files, each having a larger diameter, and are sprayed with a disinfectant solution. Thus, the parts of tissues, which are inflamed and majority of bacteria are removed, and the root canal is shaped to be sealed. Until the next visit, the dentist fills the canals with a calcium hydroxide paste, which has an antimicrobial effect.
What else should be known about the procedure?
- The tooth can be very sensitive after the procedure, however it usually passes in a few days;
- During the whole period of treatment, it is recommended to avoid chewing hard foods on the tooth being treated, as it may cause fracturing;
- Once the root canals have been prepared chemo-mechanically, they have to be filled;
- Sometimes the patient may not feel any symptoms of inflammation process in the root canal. However, eventually this leads to the formation of infection sources; so, the root canals have to be treated inevitably. This can be detected by taking an x-ray.
Filling of Root Canals
The second step of root canal treatment, after properly cleaning and preparing the root canals, is sealing them with special materials. Root canals need to be filled in order to prevent recontamination of bacteria and stop eventual spreading of the infection to the bone at the root tip. The dentist uses the filling materials, which have an antimicrobial effect. After the root canals are filled, the tooth should be restored and sealed by placing a restoration (filling, inlay or onlay, crown).
How is the procedure performed?
The procedure needs to be done after the root canals are chemo-mechanically prepared, usually during tour next appointment. Time of procedure depends on the number of root canals, usually it is completed within 30–60 minutes. Root canals can be filled using a few different methods. During the procedure, the dentist washes out remaining calcium hydroxide, then dries and fills the root canals. After filling the root canals, he or she takes an x-ray to ensure that the root canals are filled completely to the root tip.
What should be known after the procedure?
After the treatment, the tooth can be sensitive for a short period of time. Sensitivity usually fades in the first half-day and less frequently, in a few days.