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De-mystifying Root Canal Treatment

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One of the least understood and most dreaded of dental procedures is undoubtedly Root Canal Treatment (RCT). It is the pun of many pain-and-torture-related jokes as well as the subject of some controversy regarding its efficacy. Well unfortunately its poor

reputation as a form of treatment has led many to opt for extraction rather than undergo this procedure to save a completely saveable tooth. The reasons are understandable- there are those whose experience of the procedure has not been a pleasant one; And then there are those who after having a root canal done, have had to eventually lose the tooth because of pain or because the tooth subsequently broke. Both scenarios are considered to be failures of Root Canal Treatment.

As I make a case for RCT, It might help to mention that I myself have undergone this procedure. It was not a bad experience at all, and I am rather glad that I didn’t have to lose my precious front tooth.

So let us de-bunk a few things about root canals..

  1. What is a root canal?
    It is that part at the center of a tooth where there are nerves and blood capillaries.
  2. What is root canal treatment?
    Basically it is the arduous task of accessing, thoroughly disinfecting and filling the root canal space.
  3. Why and when would you need to have a root canal?
    When the tissue ie nerves and blood capillaries (called pulp) within the root canal space have been irreversibly damaged, then we have to go in and basically treat that space by doing (number 2 above). Common scenarios that can lead to tissue damage within the root canal space include:
    1. A deep cavity that enables bacteria gains entry into the root canal space, and the immune response basically breaks down the pulp tissue.
    2. Trauma to the tooth: A tooth can break and expose the pulp and enable bacteria to enter the root canal, or even if the tooth does not break, the blood capillaries can be damaged and break down as a result of the impact of trauma.
    3. Gum disease can cause bacteria from the gum pocket to track down to the root tip and damage the pulp tissue.
      So in the above scenarios, root canal treatment is recommended to save the tooth.
  4. Do I have to be in pain to know that I need a root canal?
    You may or may not be in pain when the pulp of the tooth is damaged so pain is not   necessarily an indicator that you need to have root canal.
  5. Does root canal procedure have to be painful:
    The answer is no- it does not have to be painful especially if anaesthesia is well administered. However there are scenarios where the inflammation within the pulp makes it difficult especially in the lower molars- to achieve complete numbing. Your dentist should make every effort to achieve adequate anaesthesia, taking feedback from the patient seriously. There may be pain after completion of root canal or in-between multiple-visit RCT. Your dentist should prescribe painkillers and ask you not to chew on the tooth for a few days. However if the pain is excruciating following a root canal procedure, that may indicate a more serious complication and an extraction may then be considered.
  6. Why do some teeth break after root canal treatment?
    Well many times the teeth requiring root canal treatment have deep and extensive decay which implies that the crown of the tooth has already been weakened by the decay. It is therefore important to have a prosthetic crown placed on the tooth to prevent it from fracture in the future.
  7. Why do some root canals fail?
    Failure of a root canal is when pain on the tooth persists for a prolonged period following treatment, or if visible signs of infection appear or persist-(presenting as swelling or pus in the area around the treated tooth or on an xray as an area of darkening around the root)
    Several factors may lead to failure as follows:
    1. Inadequate disinfection and filling of the root canal space either due to complex root anatomy, missed canals or heavily infected canals.
    2. Fracture of the root during the root canal procedure
    3. In medically compromised patients the healing may be poor
      It is important for the dentist to be selective in what cases he or she can treat with their level of competence. Some cases should be referred to root canal specialists due to their complexity, while others should not be attempted at all due to their poor prognosis.
  8. Is the cost worth all the trouble of getting a root canal?
    I would say YES definitely! It may be cheaper in the short term to extract an aching tooth, however the long term costs can be quite high. The effects of tooth loss include: Adjacent teeth migrating thus creating gaps that trap food and plaque which can cause or exacerbate tooth decay and gum disease; Reduced chewing efficiency, continued passive growth of the opposing tooth among others. It costs more to replace missing teeth and deal with the aforementioned effects than to get a root canal.
    As a summary Root Canal Treatment should not be a horrible experience at all. With the right tools and competency, your dentist can give you a relatively pain-free and relaxed procedure that will allow you to keep your tooth for many years to come.

    Start by booking an appointment today.

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