For many, visiting the dentist is highly dreaded, even for routine procedures such as SCALING AND POLISHING. In some families children are sometimes coerced to behave well with threats of a visit to the dentist should they behave to the contrary. Interestingly, most people have outgrown this fear by doing the exact opposite, taking advantage of the “painlessness” (to a large extent) that’s associated with the practice of dentistry today, despite the bad press it continues to enjoy in movies and cartoons, especially of the comedic variety.
ROOT CANAL TREATMENT has played a major role in ensuring that people keep their teeth for longer in their mouth, compared to what was obtainable in the past, however most people refuse the offer, electing rather to have the offending tooth extracted, many times for reasons as ridiculous as what they’ve heard about the procedure most times from acquaintances who hadn’t undergone the treatment, to plausible ones such as cost, time factor, and then to the simple one as the right to choose, or decide what should be done to ones’ teeth.
There are two parts to a typical tooth, the part above the gum, known as the CROWN, and the part below the gum, known as the ROOT. The part above the gum is exposed to the outer environment, and the situations in the mouth, while the root though kinda protected also faces its challenges (a matter for another day), but let’s dwell on the part that’s seen before proceeding to that not easily visible.
Teeth have three layers namely: the ENAMEL which is the outer covering that’s seen in smiles, in a typical teeth that’s not been worn off to expose the second layer, the DENTINE, which becomes CEMENTUM below the gum (as part of the root of tooth). The third layer is the PULP. The Pulp is a chamber within the tooth, that houses the nerves (which receives and sends messages from and to the brain of conditions affecting the tooth via CANALS in the root) and blood vessels, which supplies nutrients to the tooth. It’s embedded within the tooth, extending down the root to connect with bundles of nerves and blood vessels from other teeth, from where they connect with major bundles from the rest of the body.
Just see your tooth as a house, and your nerves and blood vessels as wires and cables from the grid supplying your home with power, communications, internet (before WiFi) etc.
There are consequences, when any of these layers are breached. When the Enamel is breached and Dentine is exposed there might be some SENSITIVITY or HYPERSENSITIVITY (electric shock/shocking sensation on teeth as with when one drinks cold water) as the case may be, as the Dentine has tiny tubules running through it to the Pulp (where the nerves and blood vessels reside). If however, the Dentine is breached, there’s likelihood of PAIN, while there’d definitely be pain when the Pulp Chamber is breached. The breach can arise from a fracture, as a result of trauma to the teeth following a fall, an accident etc, or from a Hole or CAVITY in a tooth as a result of over indulgence in foods or drinks containing lots of sugar, without cleaning the mouth well after consuming such for instance.
A Root Canal Treatment, RCT becomes an option when this breach affects the pulp, and there’s pain, or the hypersensitivity fails to yield in the face of DESENSITIZING PASTES, or there’s now an infection because the breaches were not promptly addressed leading to swelling of the gum associated with the affected tooth. Once the diagnosis has been made by your dentist after listening to your complaints and presentations, backed by radiographs (X-ray), the alternative to the RCT is an EXTRACTION.
The side of the mouth on which the tooth to be treated is located is NUMBED using LOCAL ANAESTHETIC AGENTS like LIDOCAINE, for the scary patient an anaesthetic gel may be applied to the surface to be injected to reduce the pain from the needle. Once pain stops, the treatment can commence and it involves the following as outlined below:
– drilling into the tooth to gain access into the Pulp Chamber (third layer of tooth),
– cleaning out the pulp chamber, and using some tiny instruments e.g. FILES to clean canals extending from the pulp into the roots of the tooth, of nerve fibres, blood vessels, and other contents,
– washing (IRRIGATING) the canals intermittently after each filing,
– drying the canals with PAPER POINTS
– filling the root canals with a rubber based material known as GUTTA PERCHA, and placing a filling material, like AMALGAM (metal based for teeth at the back that can withstand the stress of chewing) or COMPOSITE (or other white or tooth coloured filling materials for teeth in front, for aesthetic reasons).
RCT’s can be completed between one and three visits, depending on the conditions associated with the tooth, for instance if the tooth had been infected, and you presented to your dentist with a swelling, he may decide to leave the access cavity open after the first visit to allow puss drain through the opening, while you use antibiotics for five days, then come for a second visit following which a temporary filling is placed till you come for a third and final visit in another ten days to finish, and have a permanent filling placed. At each visit, the canals will be filed, irrigated and cleaned with instruments that’ll remove contents of your canals and widen them to accommodate the Gutta Percha, while some substances are passed into the canals to keep the tooth “quiet” till the next visit before completion.
Doing an RCT is akin to disconnecting a house from the grid, but not pulling down the house as with an extraction, hence the tooth will remain in your mouth, and be able to function normally without the ability to respond to pain, sensitive to extremes of temperature etc, however because it lacks nutrients as there’s no longer blood supply to it, it will begin to turn darker in shade (which isn’t good news for aesthetic reasons for teeth located in the smile line) and may not be as strong as it used to be, especially for grinding teeth at the back, as it may fracture over time from pressure of chewing, hence the need for the fabrication of a CROWN (a topic for another day) on a tooth that has undergone the root canal treatment.
The good thing is, RCT affords you the opportunity to keep a tooth (in your mouth for a longer time, as much as ten years or even a lifetime), that you’d have hitherto extracted, which in most cases is best to do, for even the best type of replacements cannot be as good as your natural tooth (a contentious matter for another day.
However, a major drawback for many as regards taking advantage of this treatment besides FEAR is COST, as most Health Insurance Providers do not pay for the treatment and so you may have to bear the cost most times. It is quite an expensive treatment but the gains of doing it far outweighs that of opting for an extraction which is less expensive. Dentists are humans, and if you play your cards well, you might get a discount, or even be allowed to make payment in installments.
It is my hope that you will opt for an RCT the next time a dentist puts before you that option over and above an extraction. It is usually the best way to go.