This is also known as endodontic treatment. It is a way to save a tooth that is badly damaged due to decay, injury or disease and it has an abscess at the root tip. Short of an extraction of the badly decayed tooth, the alternative is to save it through RCT which then affords the owner better functionality than an artificial tooth.
Another reason to save the tooth is to prevent the teeth on either side of it from tilting into the space left by the missing tooth. This can make chewing and biting difficult.
In this practice, patients who take this option, are advised to follow up with crowning the tooth. If they choose not to have the crown, it is best they have the extraction as not following up the treatment with a crown could result in the tooth splitting and hence money spent would be wasted.
Root canal therapy is only done if the dentist feels it has a high success rate.
Procedure
An X ray is taken to show if there is an abscess at the tip of the root. If the latter is present, it is usually dark at the tip.
An injection is given to block the pain. A sheet of rubber latex called rubber dam is used to isolate the tooth and keep it clean and dry during treatment. It also helps in preventing any of the instruments from falling into the throat.
To reach the pulp, an opening is made in the tooth with the drill. Then using special instruments called files, the dentist removes the infected material and dead pulp.
Each canal is cleaned with bleach, EDTA and rinsed with saline. The canal is enlarged and shaped and antibacterial and anti-inflammatory medicines are added to the canal to help stop the infection and inflammation. If there is an abscess, oral antibiotics may be needed to further treat the infection.
2 to 3 visits are required for RCT depending on the number of canals. A temporary filling material will protect the inside of the tooth between visits. When the inside of the tooth is satisfactorily cleaned, the canals are filled and the pulp chamber sealed. To confirm a job well done, the dentist then takes an X Ray. This will show how well sealed the canals are. Then, a post may be inserted for strength and a general core build up prepared in anticipation for a crown. However, it is advisable to wait and watch for a few weeks before a crown is placed.
The crown protects and further strengthens the tooth, restores it to normal function and occlusion and restores an aesthetic appearance.
Pain or discomfort may cease immediately after treatment is started. However, sometimes, the pain lingers for a few more days. Patients are advised to take pain killers such as Ibuprofen or paracetamol.
When is it done?
It is done when there is infection or inflammation of the pulp. This could be due to:
- breakdown of a filling or a crown.
- A very deep cavity
- Trauma
- Gum disease
- Crack or chip in the tooth
- Extreme wear or severe grinding
- Extensive dental work to the tooth
Symptoms
- pain, sensitivity to heat and cold
- tooth discoloration
- swelling and soreness at the root tip
- throbbing sensation
- tooth becomes loose to touch
- pain on biting