Root canal treatment – Purpose and Process
Author: Dr. Siri P.B.
It is known as RCT in short, it’s one of the most commonly carried out treatment. Let’s know what are the dental problems that demands root canal treatment.
Tooth decay is the most commonly seen oral health problem. Initial state of tooth decay is limited to outer surface of the teeth. It starts as slight demineralization of tooth structure. If addressed early, it can be corrected by simple restorative procedure. When tooth decay at initial stage is neglected, it starts extending into underlying layers of the teeth. If left untreated, it enters to the pulp of the teeth and thereby calling for root canal treatment. Once the decay and microbes encroach the pulp i.e. the innermost layer of teeth, the patient experiences pain. This stage is too late for simple restorative procedure to save the teeth and demands RCT.
What is Root Canal Treatment ?
Root canal treatment deals with removing the infected tissues in the pulp, thorough cleaning of the root canals and filling the canal. This procedure involves series of steps. The pulp of the tooth carries sensation due to innervation of nerves. Pulp also has blood vessels in it. All this helps in maintaining the vitality of the pulp. Exchange of nutrients, gases occurs in this system. Hence, pain arises in this richly innervated layer of teeth when decay reaches. The root canal procedure is carried out under local anesthesia in most of the cases except when the tooth has completely lost its vitality. The procedure usually takes place in sittings or according to the clinical situation it can be done in single sitting as well.
Process of Root Canal Treatment
Initially, the pulp of the tooth is reached using various dental instruments. Later, the root canals of the teeth are found. Thorough removal of infected pulpal tissue is carried out using various instruments meant for root canal treatment. Irrigation protocols are followed. Medicated irrigants are used to eliminate microbes and other debris. If the situation demands, intracanal medicaments are placed for better prognosis of the RCT. Later, once the root canals are cleaned, it’s filled with a filling material.
After the entire root canal procedure is carried out, the lost tooth structure is replaced with crown/cap. Crown/cap serves for better efficiency in chewing, for strength of the root canal treated teeth and also improves esthetics maintaining natural appearance of the teeth.
Root canal procedure is a savior, since it avoids extraction of the teeth completely.
Factors affecting success treatment
Many factors involve in success of a root canal treatment. The immune system of the patient, the extent of damage to the tooth, patient compliance to the treatment, experience and expertise of the dentist and many more. This procedure is technique sensitive, requires precision, skill and thorough theoretical knowledge about the anatomy of the tooth and procedure protocol. Appropriate selection of irrigation protocols during the procedure, knowledge on medications, the root filling materials is important. Suggesting appropriate crown/cap to the root canal treated teeth depending on the tooth i.e. whether front/ back tooth is important for the success of root canal treated teeth. Also the load falling on tooth, it’s function in oral cavity, esthetics are to be considered for deciding crown/cap.
The health of the gums also plays an important role. If the tooth is mobile, if there is recession of gums, if the most of the part of root of the teeth is exposed to oral cavity, it cannot undergo RCT.
Through testing of the teeth clinically and radiographically is important before and during every step of root canal treatment. Some clinical situations demand intentional root canal treatment though the tooth is not caries affected/decayed.
Take home message
Root canal treatment is a very popular treatment modality in dentistry with very high success rate. It’s always better to go with this procedure when your dentist suggests rather than extracting the natural teeth.