I am a firm believer that Root canal treatment does not always have to be associated with pain and discomfort. As an endodontist i strive to provide my patients with a comfortable and painless RCT experience usually completed in a single sitting.
The purpose of a root canal treatment is to save a tooth which is badly infected or decayed. In this case although the tooth is non-vital it is retained and saved rather than extracting it.
Dental decay or caries when left untreated spreads further into the tooth structure reaching the pulp or nerve of the tooth. This leads to pain and discomfort for the patient. Whenever a patient complains of pain in a carious tooth it indicates the pulp or nerve is involved. In such cases a simple filling is not sufficient and is indicative for a root canal therapy.
If such cases are left untreated than the decay or infection spreads deeper into the tissues from the pulp to the surrounding periodontium. This includes the gums, periodontal ligaments and the alveolar bone. This causes severe pain and swelling in the gums and causes abscess formation, with pus drainage in some cases. In extreme cases dental infection can spread to the jaw bone and cause a fistula or sinus through the skin or a space occupying infection in the head and neck region.
Hence it is very important to treat a dental infection at the earliest to avoid further complications.
This procedure involves the removal of dental caries or decay followed by removal of pulp tissue. This is accompanied by cleaning of the pulp chamber and root canals with instruments and chemical solutions. It is very important to completely clean and remove any necrotic or inflamed pulp tissue. If necrotic or infected tissue is not removed completely and the canal is not adequately sterilized it can lead to reinfection and discomfort. This is followed by shaping or enlarging the root canal to receive the root filling. The cleaning of the canals involve using solutions and medicaments which are bactericidal or antiseptic in nature. The filling material is made of gutta percha which is an inert material ideal for root filling. This provides strength to the root canal structure and saves the tooth.
It is very important to make the RCT as painless and comfortable as possible. As most patients are very apprehensive about this treatment. With the correct use of anesthesia and a thorough cleaning and removal of the pulp tissue it ensures that the treatment is comfortable for the patient The root canal filling should be accurate extending the complete length of the canal. It is very important to compact or press the filling well into all the lateral or accessory canals to prevent any kind or reinfection. It is also important not to overfill or under-fill the canal as this can lead to pain and sensitivity with time. Extrusion of intracanal medicaments and filling materials is a common source of discomfort for the patient. Also high points on the tooth structure after the root canal filling can be painful while biting and chewing food. So if all these factors are taken into consideration an RCT can be made a relatively painless and comfortable experience.
A root canal treated tooth should always be restored with a prosthetic crown or cap to protect the tooth structure. This ensures complete protection and strength to the tooth structure and improves the prognosis of the treatment.