If a tooth is repeatedly traumatized or gets infected too deeply by bacteria, the nerve tissue and blood supply start to die off within the tooth. When this happens the infected and dying tissue can cause significant pain and an abscess (the body cannot fix the dying tissue inside the tooth, so tries to reject the tooth). To correct this, either an extraction or a root canal treatment is performed. This treatment involves removal of the dead and infected tissue and sealing of this space, usually with a rubber material and special cement or sealer. Although root canal treatments are rather successful, like all things, there is a failure rate. The anatomy of teeth is so complex that in some cases diseased tissue is missed either due to difficulty in finding it, or its inaccessibility, despite the skill of the dentist. When these treatments do fail, re-treatment can often be done to find what was missed, or even surgical treatment is done to seal the root tips. And in other cases, the tooth is just extracted. To minimize the risk of a failed root canal treatment, treatment should be performed prior to the formation of an abscess. Once an abscess is present, the environment around the root tip is a lot more complex and less predictable for complete healing.
For many, the thought of a root canal brings about images of intense pain. Fortunately, this is not always the case. The sooner a tooth is treated, the more comfortable it is, and more successful. Once an abscess sets in, it can be harder to freeze the area and maintain comfort during the procedure. In general, most root canal treatments performed at My Family Dentist have a similar comfort level to that of having a filling done. And in cases where the tooth was dying and causing a lot of pain, root canal treatment can bring about very quick relief.
Resin Fillings
Initial Root Canal Treatments
To understand root canal treatments more, let's look at a straightforward example. This patient had a dying tooth that was starting to cause some pain. Fortunately, root canal treatment was able to be performed before a full-blown abscess kicked in. To do the root canal treatment a hole is drilled through the top of the tooth to gain access to where the nerve tissue and blood supply is. This space is called the pulp chamber. The first picture on the right shows the hole drilled in the top of the tooth to access the pulp chamber and the 4 channels of nerve tissue this tooth has.
Once the channels of nerve tissue are found, various files and cleaning solutions are used to clean out the dead and dying tissue and disinfect the area. Once thoroughly cleaned, the empty channels are filled with a heated rubber material and special cement or sealer. In the x-rays to the right, note how the darker lines inside the tooth (nerve channels) are filled in with white in the after shot (radiopaque rubber material).
Although root canal treatments are often very successful, in some cases problems can occur. The anatomy is very complex and there can be channels of tissue missed, or insufficiently cleaned enough to allow for complete healing. When this happens, the tooth can sometimes be retreated to find the offending tissue and complete the cleaning process. In other cases, a surgical approach or extraction are the options.
