ROOT CANAL THERAPY
Toothache is one of the worst pains that one can experience and the best one can do is to avoid it in the first place by preventing tooth decay with good oral hygiene. But if you have an abscess or the nerve of the tooth is dead the first thing the Dentist will say is- Root Canal Treatment! Are there alternatives to root canal? Yes, extraction of the tooth! So if you want to keep your tooth and you have severe toothache, then root canal is the only way to go.
WHAT IS ROOT CANAL THERAPY?
Root canal therapy is a treatment used to repair and save a tooth that is badly decayed or infected.
There is a canal inside the roots of every tooth. These canals contain nerves and blood vessels.
Sometimes, for a number of reasons these nerves and blood vessels may become infected or may just die/necrotise. In both of these cases pain is the result.
Root canal treatment is the removal of the nerves from the canal inside the tooth and then sealing the space that remains, with a sealant which must prevent germs getting from the mouth down into the bone.
Root canal procedures have the reputation of being painful. Actually, most people report that the procedure itself is no more painful than having a filling placed. The discomfort experienced in the period leading up to seeking dental care is truly painful, not the root canal procedure itself.
THE PROCEDURE – HOW IS IT DONE?
Normally root canal treatments are done in more than one appointment. Usually 2 or 3 appointments.
First appointment
This appointment usually takes ± 30 minutes and is often referred to as an emergency root canal, as the aim is only to relieve pain the patient is often experiencing. During this first visit, the pulp of the tooth is removed. The pulp consists of a bundle of nerves and blood vessels and is located in small canals inside the root of your tooth.
Small hand files and rotary instruments are used to remove the nerve bundles and an irrigation solution is used to clean and rinse the debris from the canals.
A medicinal material is then placed inside the tooth, and a durable temporary restoration is placed.
Some pain or discomfort can be expected after this visit, but should be manageable.
There is usually a minimum of 3 to 4 weeks in between the first and second appointment.
Second appointment
On the second appointment, the canals are cleaned out further, and also shaped and widened. This can take some time, and this visit is usually at least 60-90 minutes long. The root canals are then filled with a special filling material, and sealed off.
After a root canal treatment, the tooth tends to become brittle and a crown or overlay is advised on the root canal treated tooth to protect the weakened root structure and restore the tooth.
Look at the diagram above. The first picture shows the tooth with the painful nerve. The second picture shows how the dentist has drilled into the nerve area and removed the nerve leaving an empty canal. The third picture shows the sealant filling the empty canal.
This final step is critical if the treatment is to be successful. Poorly filled or under-filled canals allow germs to move back down the canal and infect the area around the root tip. Your dentist will show the x-ray that he will take to confirm that the canals (there are usually more than one per tooth) are properly sealed.
PAIN
Root canal is often painful because of the condition of the tooth, not because of the procedure. To avoid pain your dentist will perform the emergency treatment first which is quick and the unpleasantness is dulled with an injection. Once the pain has disappeared completely the root canal can be done properly with the minimum of discomfort. An injection is all anyone needs for this procedure.
If you have started with a root canal but haven’t already had the sealing done make sure you get back to the dentist ASAP.
Very Important!
Please take note that according to the HPCSA (Health Professions Council of South Africa) the procedure of Root canal treatment is very specialized and falls only within the scope of practice of a qualified dentist or Endodontist (Root canal specialist). It should not be performed by an oral Hygienist or a Dental Therapist, since it DOES NOT form part of their scope of practice!
Please report any person performing unauthorized Root Canal treatment directly to the HPCSA on their website.