What is Root Canal Therapy?
Root canal therapy refers to the treatment of the inner aspects of a tooth, specifically that area inside a tooth originally occupied by the tooth’s “pulp tissue”. Most people would probably refer to a tooth’s pulp tissue as its “nerve”. While a tooth’s pulp tissue does contain nerve fibers it is also composed of arteries, veins, lymph vessels, and connective tissue. We will use the terms “nerve” and “nerve tissue” to refer to a tooth’s pulp tissue.
Where in a tooth is the nerve?
While teeth are hard calcified objects, they are not completely solid. In the innermost aspect of every tooth there lies a hollow space which, when a tooth is healthy, contains the tooth’s nerve tissue. Dentists use the following terms to refer to various portions of this nerve area:
The pulp chamber.
This is a hollow space that lies more or less in the center of the tooth.
The root canals.
Each tooth’s nerve enters the tooth, in generalities, at the tip of its root(s). From this point, the nerve then runs through the center of the root in small “root canals” which subsequently join up with the tooth’s pulp chamber.
Functions of a tooth’s nerve tissue?
You might think that a tooth’s nerve tissue is vitally important to a tooth’s health and function, but in reality, it’s not. A tooth’s nerve tissue plays an important role in the growth and development of the tooth, but once the tooth has erupted through the gums and has finished maturing the nerve’s only function is sensory (it provides the tooth with the ability to feel hot and cold).
In regards to the normal day to day functioning of our mouths, the sensory information provided by a single tooth is really quite minimal. Dentists realize that on a practical level it is pretty much academic whether a tooth has a live nerve in it or not. If a tooth’s nerve tissue is present and healthy, wonderful. But if a tooth has had its nerve tissue removed during root canal treatment that’s fine too, you will never miss it.
Why is root canal therapy applied?
You could say that the purpose of root canal treatment is to create an end result where the tissues surrounding a tooth’s root will maintain a healthy status despite the fact that the tooth’s nerve has undergone degenerative changes. Specifically, we mean that the tissues surrounding a tooth’s root are not affected by bacterial infection and/or irritating substances leaking from those inner aspects of the tooth originally occupied by the tooth’s nerve tissue.
Our bodies as a defense mechanism will initiate an “inflammation reaction” when irritants have injured or destroyed body tissues. Root canal treatment is the treatment of the inner aspects of a tooth, to provide an environment where the tissues surrounding a tooth’s root are free of, and will likely to continue to be free of, the presence of inflammation.
Steps of root canal therapy:
A) Placing a rubber dam around your tooth.
After numbing your tooth but before beginning the actual process of performing the root canal treatment, your dentist will stretch a sheet of rubber around your tooth. Dentists call this sheet of rubber a “rubber dam”. It is held in place by a small clamp that grasps your tooth.
The purpose of a rubber dam is as follows. Since one of the fundamental goals of root canal therapy is to clean bacteria out of a tooth, and since saliva does have bacteria in it, the placement of a rubber dam allows the dentist to keep your tooth saliva free so it doesn’t get re-contaminated with bacteria while your root canal treatment is being performed.
B) Getting access to the nerve area of the tooth.
Now the process of performing the root canal can begin, we will get access to that area inside the tooth that needs to be cleaned. This is accomplished by using a dental drill and making an access hole which leads to the pulp chamber of the tooth. On back teeth, this hole is made on the chewing surface of the tooth, on front teeth the access hole is made on the tooth’s backside.
C) Cleaning the tooth out.
The next step of the root canal treatment process is to clean out the interior of your tooth, this cleaning process will remove any bacteria, toxins, nerve tissue, inside your tooth. The cleaning process is accomplished by using “root canal files”. These objects look like straight needles but if you take a closer look you will find that their surface is rough, not smooth similar to a file, They are literally files and are used as such. We will work with a series of root canal files, each one increasing diameter. We will go up and down in your tooth and also we will use a use a twisting motion. This action will scrape and scrub the sides of the tooth’s (root canal(s)), cleaning it out. As part of the cleaning process, we will wash your tooth to eliminate any bacteria.
Traditionally root canal files are manipulated by a dentist by the use of the fingers. There are, however, special dental drills (dental drills are called “handpieces”) we have chosen to do this with a special handpiece that makes the procedure faster, holds and twist the files.
D) Placing the root canal filling material.
Once the tooth has been thoroughly cleaned we will fill in and seal up its interior by placing root canal filling material. The most common root canal filling material being used by dentists now days is a rubber compound called gutta percha. Gutta-percha comes in preformed cones that are sized to match the files which have been used to clean out the inside of the tooth.
A root canal sealer (a paste) is usually used in conjunction with gutta-percha cones.
After finished the filling and sealing aspect of the root canal process they will place a filling in the access hole they created at the beginning of your treatment. The individual steps of performing the root canal treatment have now been completed.