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A root canal has to be performed if the dental nerve (Latin: Pulpa) has died and/or is infected. The objective of a root canal is to completely remove the destroyed tissue (which may also be infected with bacteria in some cases) from the interior of the tooth, so that the infection is prevented from spreading to the bone.
Root canal treatment is a common dental procedure that is not often well explained by dentists. There is a considerable school of opinion that many dentists carry out this treatment when it is not absolutely necessary.
What is a root canal?
A root canal is a funnel-shaped channel full of soft tissue that runs from the surface of a tooth down through the tooth itself and into the root. Both root stems have a root canal. The canal is where the main nerve tissue in the tooth is found.
Why does it require treatment?
The treatment of root canals is normally carried out when a tooth shows some level of decay or infection. The procedure is designed to prevent further decay or spread of infection that may lead to total loss of the tooth. The soft tissue is completely removed from the canals and replaced with artificial cement.
What happens in root canal treatment?
Because the soft tissue in the canal contains the nerve tissue, the procedure will require the administration of an anesthetic. This is normally a local anesthetic that will numb the tooth and surrounding areas. Once the anesthetic has taken hold, the dentist will drill down through the tooth, removing decaying or infected tissue. Where the canal narrows in the actual root stem, the dentist will use a manual device to extract all the soft tissue.
The space left by the extracted tissue is filled with rubbery cement. To ensure that no air pockets remain in the canal, the dentist will take an x-ray of the treated tooth. If an air pocket is found, the dentist will have to remove the cement and refill the canal. This part of the procedure may have to be repeated several times.
When the dentist is satisfied that there are no air pockets, the hole is sealed permanently and the remaining cavity in the upper part of the tooth is filled.
Is the treatment painful?
Root canal treatment has a bad reputation as being an unpleasant treatment for some reason. The procedure is only carried out under anesthetic and, in the vast majority of cases, is no different to having a filling done. In some circumstances, the patient may feel some sensation as the treatment involves removing the nerve endings and some patients will experience moderate pain for a day or two after the procedure.
Because of the nature of the treatment, having a root canal done can sometimes be quite a lengthy procedure, so the patient is in the chair for longer than normal, and this may add to the discomfort, particularly for the more nervous patients.
Is there an alternative to the treatment?
The vast majority of dentists would argue that there really is no alternative. In cases where infection is the problem, some dentists believe that attempting to treat the infection with antibiotics is preferred. The case against this approach is that if the antibiotic treatment does not work, it may be too late to save the tooth with root canal treatment. The primary reason for carrying out the procedure is that, prior to a new method of antibiotic administration that may lead to a different approach, there was no way to directly target the infected area.