Root Canal Therapy (RCT)
Root Canal Therapy is a procedure where the pulp of the tooth is treated so that the natural tooth can be maintained. The pulp tissue, which contains blood vessels, nerves and connective tissue, is vital to the development of the tooth. Once the tooth is formed, the function of the pulp is sensory. The tissue of the dental pulp can be subject to irritation or injury caused by deep cavities, trauma to the teeth, tooth cracks, chemical or thermal damage. The pulp can become inflamed. If it cannot repair itself, the pulp needs to be removed, the canals shaped and the space sealed, so that bacteria is prevented from gathering and causing infection.
Indications for Root Canal Therapy
There are a number of situations where root canal therapy is indicated. If a tooth is sensitive to touch or biting pressure, sensitive to heat or displays swelling in the gums, root canal therapy may be indicated. There are also occasions when there is no pain associated with the need for treatment. If the nerve in the root is damaged, bacteria may gain entry to the nerve and cause an infection. White blood cells, that fight infections, cannot access this space and bacteria will infect the entire pulp.If the nerve is not treated, pain and swelling may result. Infection can continue and cause destruction of surrounding bone, forming an abscess. Continuing destruction may result in loss of the tooth.
Success of Endodontic Treatment
The success rate for endodontic is approximately 95%. If a tooth requiring Root Canal Treatment is left untreated, bone loss and infection can occur. This may be very painful. This tooth may be replaced with a bridge or dental implant. But these options may be more expensive and time-consuming than treating the offending tooth. Root canal therapy is a way to retain teeth that may otherwise require extraction, allowing you to eat the food you want and have a healthy smile.
Steps in Root Canal Therapy:
- Local anaesthesia (dental freezing) is administered.
- Accessing the pulp space is accomplished by creating an opening through the crown of the tooth and into the pulp chamber, so instruments can be used to shape the canals.
- Tiny files are used to clean and shape the canals. The files are in varying diameters that gradually clean the canals. A disinfectant is used to irrigate the canals and keep them free of debris. X-rays are taken during treatment to measure the canal length and to ensure proper cleansing to the tip of the tooth.
- The material used to fill the canal, Gutta Percha, is tried into the canal. The fit is checked and adjusted as required.
- Filling the canals is completed by using Gutta Percha with a cement to seal the tooth to the apex. Additional Gutta Percha material will be added until the roots are completely sealed, eliminating any space where bacteria can gather and cause infection.
- The tooth should then be restored with a permanent restoration. It may be possible to place a filling, but in many cases a crown should be placed. A crown will provide strength to the tooth. Some teeth may also require a post with a core foundation, prior to placing a crown, depending on the amount of tooth structure remaining.