Root canal treatment is required when damage to a tooth allows bacteria from the mouth to enter into deeper areas. Decay and fracture are two examples of how this entry can occur. There are other reasons for needing a root canal but the bottom line is that the tooth pulp tissue, that contains the internal nerves of the tooth, is damaged and requires removal. In this illustration to the left, decay can be seen to have penetrated through the enamel and the deeper dentin to reach the dark red shaded pulp of the tooth. This illustration also shows bone damage/inflammation/ infection at the end of the root tip.
An entry access is made in the top of the tooth to allow the dentist to get to the pulp tissue for removal. Very close measurements are made to calculate the length of the roots. Everything dark red, inside of the tooth in this drawing to the left, must be cleaned out of the tooth with special instruments and chemicals.
Very small files are used to clean out the damaged pulp tissue and open up the inside areas of the tooth. This portion of the treatment is referred to as "instrumentation" and it allows for thorough cleaning of the root canal spaces. During this step, special irrigants/liquids are used to help clean and prepare the internal areas of the tooth for a filling.
Finally, a special filling material, know as gutta percha, is placed in the opened root spaces once occupied by the injured dental pulp. This material is intended to prevent bacteria from reaching through the roots again and into the bone that supports the tooth. Note the "healing" in this illustration of the bone tissue at the end of the root. It does not occur quite that fast, but this healing is absolutely necessary to confirm a successful root canal.
Having successful root canal therapy can save teeth. However, teeth that require root canals become more easily fractured and usually have significant missing tooth structure after decay removal. For teeth in the back of the mouth, a crown (or a cap) is necessary to protect the tooth following a root canal. In essence, it is essential for a tooth to receive a definitive restoration after a root canal is completed. Failure to restore the finished root canal tooth eventually leads to fracture, additional treatment, and even loss of the tooth.
Once a root canal is completed, the tooth treated can no longer respond to cold. In most cases, the pre-operative discomfort is relieved immediately. However in some cases the socket of the tooth remains sore for a few days and simply takes a while to heal. This is most noticable when chewing or loading the tooth. Expect this to resolve and ask Dr. Hinson about medications to assist with this issue during healing.
