Root Canal Therapy
Root Canal Therapy is a sequence of treatment for the pulp of a tooth whose end result is the elimination of infection and protection of the decontaminated tooth from future microbial invasion.
Root Canal Problems
What happen if you leave a tooth with cavity untreated? The cavity will get bigger and bigger, spreading from the surface enamel layer to deeper dentin layer, then eventually into the pulp space. Does it hurt as the cavity spread, you may wonder? It may or it may not! Many patients with cavity that affects the dentin layer will experience sensitivity when they eat sweet stuffs or when they drink cold liquids. However, equally many patients presented to me with huge cavity, which has affected the pulp, did not have any pain or any symptoms at all!
Why different people response differently? I don’t know. It may be related to the strength of the immune system the individual has or it may depend on how an individual responses to pain. Many people have the idea that if nothing bothers me now, why should I go to see the dentist? This is one of the reasons why you need a regular checkup, as cavity may not give you any symptoms. As I mentioned earlier, if cavity just affects the enamel and dentin layer, a direct restoration (a filling) usually suffices. However, if cavity has got so big or so deep that it affects the pulp, a filling will not be enough. Why? It is because the pulp has the blood vessels and nerve. When the pulp is affected, it will go into a chain of reactions what we call inflammation. Think about when you hurt your finger by carelessly stabbed it with an object and it got red, swelling, pain, and quite hot around the area. That is inflammation. When inflammation happens, blood supply to that area will increase, so you’ll see red and hot area (because of the blood), swelling because blood and body liquids accumulate, which builds up pressure (that gives you pain). Now let’s bring the picture of inflammation in the dental pulp environment. When you just remove the cavity and filled the hole with a filling, while the pulp chamber inside the tooth core has inflammation. Blood is gushing into the pulp but it has a limited space! Pressure will go up, and up, and up until the pressure is so high that it pinches onto the nerve in the pulp. That is why dental pain can become so excruciating! Sometimes it is less painful if the cavity is bigger that it actually creates a big hole to let the pulp communicate with the surface of the tooth.
Procedure for Root Canal Treatment
So now, what are the treatment options? One is to take out the tooth completely (extraction) as so commonly practiced in the third world countries or poor populations because it is the cheapest and quickest option. The other option is to carry out a procedure called root canal therapy. How do dentists perform root canal therapy? In brief, they drill a hole from the surface of the tooth into the core of the tooth where the pulp is located. Once they get an access to the pulp, they can clean up all the tissues there, including the nerve, the blood vessels. Now the pulp space becomes hollow and clean, ready to be filled with some rubbery material called gutta percha.