A root canal treatment is recommended when the pulp tissue, (nerve, blood vessels and tooth cells) inside the tooth become significantly damaged, infected or actually die. The pulp tissue fills the internal chamber of the living tooth, the pulp canal which extends from the inside of your tooth all of the way down to the tip of your tooth. The pulp represents the living tissue inside of your tooth, keeping it healthy and vital. When you have a deep cavity, or a fracture or even some serious trauma to the tooth, the pulp tissue may degenerate, die and become infected. This degree of damage is usually a result of cracked tooth enamel, a deep cavity, or trauma (including from repeated dental treatments). The dental drill creates heat and trauma to the nerve of the tooth, and while normally any inflammation or pain from dental treatment is temporary and general resolves on it’s own in a few days, repeated trauma from dental treatment can lead to death of the tooth pulp. A root canal treatment involves drilling into this pulp chamber in the tooth and then cleaning and disinfecting the canals in the roots, hence to common term “root canal” for the procedure, and finally these canals are sealed with a material, with gutta percha (surgical rubber) and cement being the best time tested material. The tooth is then restored with a crown or crown-like restoration. While the tooth is no longer vital, it remains functional and the ligaments connecting it to your jaw bones remain alive. Teeth with a root canal treatment can provide functional use of your tooth for many years and even a lifetime.
Why a patient may need a root canal?
Whenever a tooth experiences significant trauma, the pulp tissue becomes inflamed. If this inflammation is reversible, the pain associated with it will be temporary and slowly resolve. Often times this pain may linger for days to weeks, even months, but slowly improves and finally goes away. If the inflammation reaches a point where it is not reversible, and the pulp tissue cannot recover, one of two things happens. Typically the pain continues and increases in intensity and the tooth may even become infected. But generally the pain is significant enough that the patient seeks treatment. Less frequently, the pain may originally be somewhat severe, but then suddenly stop. And the patient thinks everything is fine, not realizing that their pulp tissue has actually acutely died. The tooth may be asymptomatic for weeks to months to even years. But eventually bacteria in the body find this dead pulp tissue and the patient wakes up with an abscessed tooth and a swollen face overnight. So, anytime your pulp tissue in a tooth can no longer heal and recover from any trauma, a root canal procedure is the recommended treatment.
What are my alternatives?
There are a limited number of alternatives to having a root canal procedure. But the concern is eliminating the infection, often called root canal toxicity. This can be accomplished only two ways, by either removing the dead pulp tissue source of the infection with a root canal procedure, or by extracting the tooth. Sometimes the tooth has either so much damage from decay, fractures or bone loss, that the tooth is no longer salvageable, even with a root canal procedure and must be extracted. Lost teeth can be replaced with dental implants, and fixed or removable bridges.
Are holistic alternatives effective?
Some people are looking for holistic alternatives to root canal procedures. Some of these treatments involve using ozone or calcium hydroxide as a disinfectant. But most holistic dentists recommend against a root canal procedure and prefer extraction of the tooth being then restored with a dental implant.
Misconceptions about root canals
I’ve heard horror stories about root canals, are they true? We’ve all heard the stories, and people saying it was so painful and they would never have another one. If you have an infected or abscessed tooth, with swelling, it can be very painful. But the pain is really from the infection and not from the root canal procedure. Generally root canal procedures are done under local anesthesia and the patients experiences very little or no pain at all. Times have changed and techniques are always improving, some of those stories just no longer apply to what’s possible today.