There are various myths and misconceptions associated with root canal therapy. This is why most people find it very difficult to voluntarily go for root canal treatment until their condition worsens and root canal therapy is the only option left.
However, this article is meant to dispel such fears by providing a comprehensive step-by-step walk-through of the actual root canal treatment procedure in order to prove that the dental procedure does not actually cause pain but relieves it.
Before getting to know more about root canal therapy, it is essential to basically understand what a root canal is. A root canal is any anatomic space within the root of a tooth. The canal consists of intricate anatomical branches connecting root canals either to the surface of the root or to each other and the pulp chamber.
Root canal therapy, which is also referred to as ‘endodontic therapy’ is a dental procedure meant to treat an infected tooth pulp resulting in the protection of the contaminated tooth and the elimination of potential future microbial infection.
Although all dentists receive adequate endodontic treatment training and can easily perform root canal procedures, most general dentists prefer to send their patients to recommended root canal specialists known as Endodontists.
Common reasons for root canal therapy
- Critical tooth decay that ends up invading the tooth, thus penetrating through both the enamel and dentin deeper into the pulp.
- The occurrence of trauma, such as broken or chipped teeth, which results in the exposure of dental nerves.
- Abscessed Tooth.
- One’s teeth are slowly dying as a result of past trauma or aging that was not treated in time.
- Critical pain brought about by toothache.
- Repeated dental procedures on a specific tooth.
- Gum diseases.
Regardless of the reason for root canal therapy, Endodontists have to carry out a thorough examination and medical history as well as study a radiographic picture1 of the affected area or tooth in order to make an accurate diagnosis as well as a proper assessment of the situation at hand.
Root canal therapy procedure steps
Step 1: Administration of local anesthesia
In order to minimize or eliminate pain during the dental procedure, a local anesthesia is administered by the dentist or endodontist to the patient via injections so as to numb the affected tooth as well as the surrounding tissues. Teeth with acutely inflamed pulps require more time to make them numb as they are even more painful.
Step 2: Dental dam placement
A dental dam made of either vinyl or rubber is then placed over both the affected and adjacent teeth. This then makes the tooth undergoing treatment to protrude through the hole punched in the dam while isolating it from the rest of the mouth. This step is very important as it allows the endodontic treatment to be carried out in a sterile environment that is free from bacterial contamination especially that found in saliva.
Step 3: Creating the access cavity
In order to carry out root canal treatment, the dentist or endodontist needs to gain reliable access to the tooth’s nerve space via a process called ‘creating an access cavity.’ The dentist then uses his or her drill to make a significant hole extending through the tooth surface down to its pulp chamber. It is important to keep in mind that the access cavity is made on the backside in front teeth and is made right through the chewing surface in back teeth. The endodontist or dentist also removes all manner of tooth decay as well as fragile portions of the filling or root during this process.
Step 4: Tooth length measurement
The root canal treatment procedure is mainly about treating only the entire length of the affected tooth’s nerve space. Any further extension is likely to result in serious health issues. This calls for the measurement of the actual tooth length so as to ensure the dentist works only in the required confines. The measurement process can either be carried out with the help of electronic equipment or accurate calculations evaluating the information provided by the tooth X-ray.
Step 5: Removing of the dead pulp and diseased tissue
The dead pulp and diseased tissue can only be removed using specially designed medical instruments whose main role is to clean out both the pulp chamber and the root canal. This process is never painful as the affected area is numb and the tissues being removed are either dying or dead. Once the nerves along with the pulp contained in the affected tooth are removed, the tooth cannot feel pain again. The canals are then disinfected with antibacterial solutions and antiseptic.
Step 6: Shaping and cleaning of the canals
Other tiny flexible instruments are then used to shape the root canals in a manner that allows them to receive the sealers and root canal fillings. The drilled canals are then cleaned and washed once more so as to remove any leftover root canal debris, toxins, bacteria and nerve tissues before sealing them.
Step 7: Filling the canal space
Various root canal fillings that can fit into the clean canals are then selected. The rubber-like material usually used as root canal fillings is known as ‘gutta-percha.’ It is thermoplastic in nature and is literally heated and then skillfully compressed against and into the root canal walls to seal them. A sealer which is an adhesive cement is also used in the sealing process to prevent bacterial infection.
Step 8: Sealing the access hole
Depending on the procedure, a permanent or temporary filling can be placed to seal the drilled access hole. The dental dam is then also removed after ensuring the treated tooth is free from contamination. Teeth lacking sufficient structures to hold the fillings in place are substituted by posts of either very strong plastic or metal to foster strength and balance.
Step 9: Use of antibiotic to prevent or treat infection
After the dental procedure has been successfully completed strong antibiotics are then prescribed to prevent or treat infections. This makes the post-treatment effects as minimal as possible, making them last for about a week. Minor discomforts including slight manageable soreness can be experienced. The discomforts can be easily managed using either prescription drugs or over-the-counter medications.
Step 10: Permanent restoration
After a short period of time, you are required to go for the final permanent restoration process to completely seal the operated tooth as well as replace any lost tooth structure. The Endodontist is likely to send you back to your general dentist so that he or she can determine the appropriate restoration that is appropriate for you. This last step is very important as any contamination of the operated tooth whatsoever is likely to result in recurrence of infection in and around the tooth.