Root Canal Therapy or RCT as its called could be a fairly familiar term to most of you. The procedure is also called endodontic therapy. Some of you might have undergone this treatment procedure for your teeth. Your dentist would have explained the procedure to you before carrying out the treatment. With advancement in aesthetic procedures, advanced equipments and improved clinical skills over the years, RCT is a painless procedure. Still, some of you may still have your doubts and apprehensions about RCT.
Here is a complete guide on the RCT
What is Root Canal?
The tooth can be classified in its structure as the crown and root for the sake of understanding. The crown is the portion of the tooth that is seen in the mouth. The root is the portion of the tooth that lies within the bone covered by the gums. The entire length of the tooth has a hollow portion called the pulp chamber in the crown and the root canal in the root portion of the tooth, within which lies the pulp.
The pulp contains the nerve endings and blood vessels. This gives the tooth its life.
Why will I need a Root canal treatment?
Bacteria in the plaque produce acids that attack the teeth and cause a tooth decay. When the decay is limited to the enamel or dentin a filling can be done and the tooth is restored. When the decay progresses beyond the dentin into the inner most layer, the pulp, infection of the soft tissue sets in. This causes pain and swelling. At this point the pulp chamber and the root canal has to be cleaned to relieve you of the pain and swelling.
What are the steps in the procedure?
The process of RCT can be done in a single sitting or may require a couple of more sessions depending on the infection control in the tooth.
Step 1: Cleaning the root canal
The pulp chamber is not directly accessible for cleaning. Hence, an access has to be created in the tooth. Once this is created, the pulp chamber ( in the crown of the tooth ) and the root canal ( pulp in the root of the tooth) are cleaned and irrigated with disinfectants. This procedure is done under a local anaesthetic. This is PAINLESS.
Step 2: Filling the root canal
After the canal is cleaned, the diseased pulp and the debris is removed. Then the area is dried. It is filled with a medicated cement and a biocompatible material. The tooth is now “dead” with no nerves and blood vessels.
Step 3: Adding a crown
The tooth is now a fragile structure. It cannot take the chewing forces over an extended period in time. A crown offers the protection to the tooth. Until the crown is placed on the tooth you should not chew or bite on hard foods.
Is the RCT procedure painful?
The infection in the tooth causes the pain and the treatment relieves you of the pain. Your dentist may prescribe some medication before the treatment procedure to reduce infection. The procedure itself is carried out under a local aesthetic. After the procedure, you may have some tenderness in the tooth for 24-48 hrs. This tenderness generally subsides by itself. Luke warm salt water rinses help relieve the tenderness. You can take an over the counter pain killer if the pain is severe.
With advancement in technology, high speed equipments, improved clinical skills and better anesthetics, RCT procedures are a painless procedure. If you have any doubts on the outcome of the procedure, you can talk to your endodontist, who will explain the procedure to you in detail.
What other conditions need RCT?
- A fractured tooth. A tooth may fracture due to a fall directly on the face, during contact sports like rugby, Or in a road accident. At such times the tooth may become dead ( non vital ).
- Cracked teeth. When the tooth breaks for any reason, and the inner pulp is exposed.
- Deep cavity. When the initial cavity is not filled and the cavity deepens to reach the pulp.
- Loose fillings. A decay can develop under loose fillings and reach the pulp.
- Under ill maintained crowns. Since caries is a disease of the hard structures of the tooth, a decay can happen under a crown/cap.
What are the preventive measures to avoid decay and RCT?
To prevent infections, tooth decay, and gum disease
- brushing teeth last thing at bedtime and at least one other time each day
- using toothpaste that contains fluoride
- using a suitable toothbrush and replacing it regularly
- attending regular dental checkups and cleanings
- flossing to clean between the teeth and prevent the buildup of plaque
- avoiding sugary drinks and foods, and following a healthy diet.