If dental caries infect the pulp of a tooth or if it is damaged, root canal treatment is often the only way to save the tooth. The pulp, or nerve chamber, is hidden within the hard cover of the tooth. To reach the pulp, the tooth has to be numbed and drilled. Then, the inflamed pulp is removed. Root canals are cleaned out, enlarged and then polished. There are different filling methods. The standard filling material is gutta-percha, a natural elastic material.
Like the spinal cord within the spine, there is the pulp within every healthy tooth. It is formed of connective tissue, blood vessels and nerves. If bacteria caused by deep caries reach the pulp, this may lead to an inflammation of the pulp tissue which can be very painful.
If the bacteria reach further, it can result in a purulent inflammation of the root tip which can even break down the jawbone. Some of the symptoms connected with irreversible damages to the pulp are distinctive heat and cold sensitivity, painful response to biting and touching and sometimes tooth colour change. Steps of root canal treatment: At the first visit, the tooth will be locally anaesthetized so that the treatment is completely painless.
First of all, your dentist will open the tooth in order to get access to the pulp chamber. With special instruments and chemical ultrasonic cleaning, he will then remove the infected pulp. An electrometric measuring tool is used in order to define the exact length if every single root canal. This makes taking X-rays redundant.
With a special nickel-titan file, your dentist will then clean out every root canal to the root up to the root tip. The whole process is constantly controlled with the length measuring tool. When all the root canals are clean, they can be filled with a material which prevents bacterial inflammation and relieves pain. This filling material stays inside the tooth for about a week. At the end of the first visit, the tooth is closed with a temporary plastic filling to protect it from new bacteria.
At the next visit, the temporary filling is removed and each single root canal is once again cleaned out with chemical ultrasonic cleaning and special nickel-titan files. If the tooth is symptom-free, the canals can be filled with a sealer (cement) and latex cones (gutta-percha). Since this cement needs 24 hours to harden, your dentist will cover your tooth with a temporary filling once again.
Finally, the temporary filling is replaced with special material which provides a basis for subsequent preparations (grinding). Since root canal teeth are no longer supplied with blood, they tend to get brittle. It is very likely that they will break down some day. That is why root canal teeth should be covered with a crown to prevent fracture and tooth loss.