Until the last century, a decayed or infected tooth was pulled without any thought to saving it. If it wasn’t yanked out, an abscess formed. The pus pocket of poisons caused tremendous pain and could even damage the jawbone. When the abscess broke, the toxins were released into the bloodstream, causing illness. Root canal therapy basically consists of replacing a tooth’s dead nerve and diseased pulp. That means the dentist does not yank out the tooth, he just cleans out the inside of the root.
Once a tooth pushes through the gums and is fully grown, neither the nerve nor the pulp is vitally important to the tooth’s health. The only function of the nerve is to impart the awareness of hot or cold. When the diseased nerve cannot repair itself, it dies no longer feeling any sensation. The pulp is soft tissue full of nerves and blood vessels. It fills the pulp chamber, which is below the tooth’s crown. It also fills the roots and root canals.
A tooth requiring root canal therapy has such extensive decay that the dentist must put a porcelain crown over the exposed tooth. Depending upon how many teeth are involved and where they are located, he may also discuss the need for a bridge or an implant.
To start the root canal therapy, the dentist will inject a numbing agent near the tooth. Theoretically, the nerve is dead so anesthesia should not be necessary, but most dentists don’t want to take a chance of a patient suddenly jumping in pain. A patient should be totally relaxed and free of pain because the delicate surgery requires minute precision.
It is critical that all the decay and infection is cleaned out of the canals of the root. The dentist drills a hole through the crown of the tooth to gain access into the pulp chamber. He then pulls out the pulp and dead nerve, and refills the chamber and canals with medication that will kill all the bacteria.
On your next visit, the doctor fills the tooth’s pulp chamber and root canals with a rubbery material, then permanently seals the tooth closed with antibacterial cement. Last but not least, he caps the tooth with a crown, usually made of porcelain. The crown is virtually undetectable from the teeth adjacent to it.
People tend to cringe when they are told they need a root canal because the procedure used to have the reputation of being painful. Modern dental technology and new anesthetics, however, mean todays patients do not have to feel pain. If the tooth was infected before surgery, it may ache mildly for a couple of days. That discomfort will be relieved with over-the-counter painkillers such as aspirin or acetaminophen.
Many teeth that underwent root canal therapy can easily last a persons lifetime, but the procedure is expensive. The costly investment is worth protecting with at-home oral hygiene and regular dental checkups.
If your dentist is bent on saving and repairing your tooth with root canal therapy, don’t be afraid. A root canal is not scary if you know what to expect (and if you know that it wont involve a lot of pain). Express any concerns or questions you have with your dentist so he can reassure you.