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Root Canal Treatments Explained:

You may have heard about root canal treatment, or nerve treatment. It sounds like a complicated and daunting treatment to have, but is it actually? Root canal treatment may be the most intricate treatment that is almost like working a piece of art inside the tooth, so let’s take a journey into the tooth and explore the magic that happens within.

Before we talk about the treatment, let’s have a look at the structure of the tooth. What you can see is only 1/3 of the whole tooth. The remaining 2/3 is the root that is embedded in bone under the gums. Running throughout the entire tooth is a space in the middle called the pulp, where the nerves and blood vessels are. The enamel and dentine layers on the crown of the tooth offers protection for the pulp.

Time and tooth surface are the two factors that is somewhat out of our control.

The nerves in the pulp supplies sensation to the tooth. Unfortunately, unlike our skin which senses hot and cold, rough and smooth, the tooth only has one sensation: pain. When protected by healthy enamel and dentine, the nerves wouldn’t feel anything, but if outside simulation is allowed to get close to the pulp, we start having toothache.

The most common cause of toothache is dental decay, where bacteria causes loss of minerals in the tooth and forms a hole (cavity). When decay reaches the dentine layer, the tooth starts to get sensitive. This is an early signal of a problem, but at this stage the pulp is still healthy. If decay is not treated and bacteria enters the pulp causing an infection, the pulp dies and the pain changes to a dull, constant, throbbing pain. With the dead and necrotic pulp inside the tooth, the infection would grow and eventually cause an abscess.

This is where root canal treatment comes into play. The dentist will remove the dead pulp, clean out the root canal spaces, and fill them up to completely eliminate the source of infection.

So what about the pain?

Isn’t a treatment in the nerves painful?

Not at all! When you decide to have the root canal, the dentist will give you some local anaesthetic to numb you up. This will stop the toothache that you are currently having. The first stage of the root canal focuses on removing the dead pulp, which is the source of infection. Once this is removed, the pain will be gone too.

However, simply removing the dead nerve only gives you a temporary peace of mind. There is still bacteria left in the root canals, and they can still cause an infection at the tip of the roots, which again, translates to pain. The next stages of disinfecting the root canal, shaping it and filling it up are also essential. Only by finishing the root canal treatment can we ensure that this tooth is infection free and completely pain free in the future.

So why is it like working a piece of art? Each tooth is different and roots are grown in different ways. The dentist cannot see the inside of the tooth, but with the use of guides like x-rays and special instruments, the dentist navigates the root canal spaces which are as fine as a thread. This requires very fine maneuvers within a very small space, similar to producing a tiny art work. Sometimes, one tooth can have up to four root canals! The intricacy of all these means that the root canal will take a few appointments to complete. It is a lot of work, but have a look at the end result on the x-ray, isn’t it beautiful and worth all the effort?

Last but not least

Certain conditions can increase the risk of developing dental decay.

For example, conditions reducing saliva production (e.g. Sjrogen’s syndrome, radiotherapy to the head and neck) increases the risk of decay. Malformed teeth may also be structurally weaker and more susceptible. If you have been brushing your teeth well, following a healthy diet, but are still finding new caries each time you visit the dentist, it might be worth having a more detailed discussion regarding the causes of the decay. If an underlying condition is suspected, your dentist can help treat you or refer you to the right person who would be able to help.

Before Treatment

After Treatment

Are root canal treatments always successful? Well in general, the success rates of root canal treatments are around 90%, but it also depends on the condition of the tooth, and how long the infection has been present. The earlier the treatment, the higher the success rate. Hence don’t leave toothaches alone, always seek treatment early.

For optimum results, your dentist might recommend a crown after the root canal treatment, especially on the back teeth. A crown is a cap that goes over the top of the tooth, it seals up the tooth and ensures no further bacteria can enter. Root treated teeth are also more brittle and the crown will protect the tooth from cracking when you bite on it.

Some may ask, why shouldn’t I just pull the tooth out and place an implant?

Nature designed us teeth that comes in a perfectly matching set, which can last for more than 70 years if properly cared for. No technology today can match that. Implants today are great for replacing teeth, however it also requires more maintenance and cost to upkeep. Therefore, if a tooth can be kept, it’s best not to rush for the quick fix.

All in all, root canal treatments may seem complex, daunting, or even long and tiring. But it is definitely worth all the effort. If you have a toothache, don’t worry about the complexities, simply visit your dentist early, and trust that they’re there to help you return your teeth to a pain-free and healthy state.

Considering Root Canal Treatment?

Book an Appointment With Dr Li Kexin Today!

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About the Author

“Positive experiences in the dental setting goes a long way. I aim to provide quality dental care tailored to every patient’s individual needs.”

Dr Li Kexin

Dental Surgeon, NoFrills Dental

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