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Root Canal Therapy

WHAT IS ENDODONTIC (ROOT CANAL) TREATMENT?

Endodontics means inside (endo) the tooth (dontia). The dental pulp is the tissue (composed of nerves, blood vessels, etc.) that is contained inside the tooth. Its primary function in life is first, the development of the tooth, then secondly, the sensation or feeling in the tooth. The specialty of endodontics is devoted to the biology, physiology, pathology and treatment of the human dental pulp.

• The reason you need a root canal can be placed into two broad categories of pathology;

  • Vital Pulp Pathology

  • Non-vital Pulp Pathology
    

• The most common reasons a tooth develops pathology are:

  • Dental decay (large deep cavities)

  • Accumulative effects of placing several fillings over time

  • Restorative insults to teeth (drilling, heat and desiccation)

  • Traumatic injury (accident)

   

  For vital pathology, the dental pulp has become diseased and inflamed yet the tissue is still alive and vital. The damage (most often indicated by unusual severe sensitivity to temperature changes or a severe toothache) is so advanced that the condition of the pulp tissue is not expected to get better. This irreversible problem requires removal the dental pulp, hence a root canal.

  For the non-vital pathology, the dental pulp has already become dead tissue. This tooth will no longer respond to stimuli such as temperature changes and sweets. The necrotic contents of the inside of the tooth (consisting of dead pulp tissue, debris, and bacteria) affect the bone and cause pathology outside the tooth at the tip of the root(s). Symptoms most commonly associated with non-vital pathology are a tooth that hurts to bite on, becomes sore to touch or push on, and in acute stages facial swelling occurs. An x-ray will help in the diagnosis of this problem, but only when the pathology is so advanced as to cause an abscess of the bone around the root tip of the tooth (periapical area).

  The treatment of either of those two categories of pathology is largely the same in routine cases. The treatment options are root canal therapy or extraction of the offending tooth. Root canal therapy is the treatment of the inside of the tooth so that the source of the infection or the source of inflammation causing the dental pain can be removed and then the tooth is protected from the problem recurring in the future.

  The goal of root canal therapy is to create an environment inside the tooth so that the pathology can heal, resolve and remain symptom free. This environment should be as clean and sterile as possible (all tissue debris and bacteria removed to the tip of the root), and the space must be filled with an inert material to maintain this clean space.

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