Getting to the root of root canal treatment

  • Published
  • By Karen Maffei
  • 66th Dental Operations Flight
HANSCOM AIR FORCE BASE, Mass. --  In the past, teeth with a diseased or infected nerve frequently had to be removed. Today, they can often be saved with endodontic treatment, also known as root canal treatment. This procedure may be performed by a general dentist or a specialist called an endodontist.

Every tooth contains nerves and blood vessels which are necessary for its development. Together these nerves and blood vessels make up the pulp of the tooth. The pulp is located within a space in the crown of the tooth called the pulp chamber. The pulp chamber narrows as it extends from the crown to the tip of the root and is called the root canal space. If a tooth has more than one root, each root will have its own root canal space.

Teeth will generally require root canal treatment for one of two reasons: a cavity that extends directly into the pulp contains bacteria and will cause an infection or a large filling that is close to the pulp and causes repeated insult to the nerve over time resulting in degeneration. Trauma or a fractured tooth can also result in exposure of the nerve and the need for root canal treatment. Symptoms of these conditions will often be some combination of pain, swelling or possibly a draining abscess.

Sometimes a patient will experience discomfort and not be able to pinpoint the exact tooth. A dentist will conduct a series of tests to determine which tooth is causing the problem and whether it needs root canal treatment. These tests will include X-rays, tapping on the tooth, checking the gum tissue, checking to see if the tooth is loose, placing a hot or cold substance on the tooth and placing an instrument on the tooth to test the vitality of the nerve. The dentist will then make a recommendation for treatment.

If root canal treatment is required, the dentist will administer a local anesthetic similar to what one receives for a routine filling. The tooth is then isolated with a rubber-like sheet called a rubber dam. This is to prevent saliva and other contaminants from getting inside the pulp chamber during the procedure. An opening is made through the crown of the tooth and the pulp is removed with special instruments.

In some cases, medication may be added to the pulp chamber and root canal spaces to help eliminate bacteria. The root canal space is cleaned, shaped, disinfected and then filled with a rubber-like material to seal the tooth.

Most root canal treatment can be completed in a single appointment, but occasionally may require multiple appointments. Once the root canal treatment is completed, a temporary filling is placed in the crown where the opening was made to access the pulp and root canal spaces. Depending on the condition of the crown, the tooth may be restored with a simple filling or require a fabricated crown.

Root canal treatment has received a lot of negative publicity over the years, but advances in dentistry have made the procedure routine and comfortable. However, the best way to avoid a root canal is to practice good oral hygiene with regular brushing and flossing and see a dentist regularly.

Anyone with questions about root canals may contact the dental clinic at 781-225-6324.