Root Canal Treatment

This interview appeared on the website, Bizymoms, was given by Dr. Shukla to explain root canal treatment in simple terms.

Q. What is root canal treatment?

A. A tooth is made up of different tissues, with the hard enamel being the outermost, and a soft “pulp tissue”, also known as  ‘the nerve’ being the innermost living soft tissue, and a ‘sensitive’ dentin tissue in between the two. When untreated dental decay reaches this pulp tissue, it causes severe prolonged dental pain, and the tissue eventually dies (dental abscess). To save this tooth, which would otherwise be lost, a “Root Canal Treatment” is necessary. In a RCT, the inner infected pulp tissue is removed, the canal space is cleaned and disinfected, and filled with an inert filling material. A filling is then placed to bring the tooth in full function. Often a crown is required to prevent the tooth from chipping or cracking, or for cosmetic reasons. A root canal treated tooth is not a “dead tooth” because it still is retained in living bone and supplied by nutrients from the bone surrounding it. It feels like a normal tooth in function and feel, and can last a lifetime with proper care. An RCT is a predictable and definitive means to save teeth that would otherwise be needing removal.

Q. What does treatment involve?

A. Usually 2 appointments are needed. In the first appointment, (under adequate local anesthesia), the abscessed tooth is opened and the infected pulp (nerve) is completely removed. The inside of the canal space is cleaned, disinfected and an antiseptic is packed in, with a temporary filling on top. Most patients feel miraculously better after the first sitting. The second appointment is usually a few days later, when we re-enter the tooth, clean and shape the canal system, and fill the canal spaces with an inert filling material. A permanent filling is usually also done on top of it to bring the tooth into full function. Unlike popular urban myth, a ‘root canal’ is usually painless. We use sophisticated diagnostic and endodontic rotary systems to perform a root canal treatment, and are trained in advanced techniques to save teeth.

Q. What are the signs of needing endodontic treatment?

A. A patient usually presents with a swelling or severe pain (or both) or often just a discolored tooth is the first sign. Most pain is of the throbbing variety, and does not go away with painkillers. Often a tooth with a large old silver amalgam filling also ends up needing root canal treatment from ‘marginal leaking’. Athletes may end up taking a blow to the face, and if the tooth is not completely knocked out, it usually has a significant trauma that ends up causing the tooth to die. Hence the need for dental sports guards to be worn.

Q. Are pain pills and antibiotics an acceptable substitute for root canal?

A. No. Painkillers and antibiotics offer only a temporary relief from the infection.

Q. Are there alternative treatments for root canal?

A. The only substitute to a root canal is extraction. No tooth, no abscess, no pain.

Q. How much will the procedure cost?

A. The cost depends on the number of root canals in a tooth. Also varies on complexity. Costs can vary from approx. $300 to $700.

Q. Will the tooth need any special care or additional treatment?

A. A root canal treated tooth feels and looks like a normal tooth, and can last a lifetime with proper care, i.e. regular brushing and flossing. Often a crown (a cap) is required to prevent the tooth from chipping or cracking, or for cosmetic reasons. An RCT is a predictable and definitive means to save a tooth that would otherwise be needing removal.