The ideology for root canal treatment had its base from 1600 AD. People belonging to that era cleaned the infected pulp and fill the canal using gold foil or asbestos.
The first instrument for cleaning the root canal was constructed in the year 1838 which gave easier access to locate the pulp in the canals. The safer and workable filling material ‘gutta-percha’ was introduced in the year 1847 and is still in practice.
Though they had sufficient modification in the instruments used and the filling material people feared to take up the procedure because of the pain. Only after the 20th-century development in the field of anesthesia and the use of anesthetics for a root canal was followed as a routine practice and root canal treatments became popular.
WHAT IS ROOT CANAL TREATMENT?
As the name suggest root canal is the procedure done in the canals of the teeth that contain the pulpal tissues.
The procedure involves removing the infected pulp, shaping & cleaning of the root canal with an irrigant to remove the debris containing bacteria from the canal surface. By this, the canal widens uniformly to accommodate the corresponding filling material.
HOW PULP GETS INFECTED?
As mentioned already infection of pulp results in root canal treatment. Here are the few reasons on how your pulp can get infected:
- Deep tooth caries that spread from enamel and dentin into the pulp.
- Bacteria from the infected gums reach the tip of the roots through gum inflammations forming an abscess (fluid-filled cavity).
- Fractured, broken or cracked teeth left unnoticed for a long period of time.
- Broken fillings in teeth that act as a site for food collection and bacterial activity to form secondary tooth caries.
SIGNS OF PULP THAT NEEDS ROOT CANAL TREATMENT:
- Severe toothache on chewing foods or on the application of pressure.
- Sensitivity to hot/cold substances even after the substance is removed.
- Discoloration of the teeth.
- Deep tooth caries with pain.
- Deep tooth caries without pain but cannot withstand fillings.
- Swelling or tenderness in the surrounding gum tissue even after cleaning.
ROOT CANAL TREATMENT:
This treatment is advised if any of the above-mentioned signs prevail. The procedure might be completed in multiple appointments or in a single appointment.
Multiple appointments are preferred in severely infected cases for healing. They are split into either 2 or 3 visits depending upon the dentist’s treatment plan for the patient.
- Patient is given anesthesia.
- Tooth cavity preparation of the infected teeth.
- Location of the root canal orifice (entrance of the root canal). Multiple canal orifices are located in the case of molar teeth. Care should be taken to locate all the canals.
- Widening of the root canal orifice with carbide burs for access to the instruments.
- The shaping of the root canal with files and intermittent cleaning with irrigant to wash out the debris.
- Shaping is done sequentially to have a uniform canal.
- The canal is dried after completing shaping & cleaning.
- The canal is tightly packed with gutta-percha points (material made from latex obtained from trees) coated with zinc oxide eugenol cement.
- Gutta-percha extending before the orifice of the canal is removed by using a hot instrument with care to avoid removal of the gutta-percha points from the canal.
- The prepared cavity is then filled with the following cement as per the requirements or condition of the teeth. A) Zinc oxide eugenol – temporary filling, B) glass ionomer cement – permanent filling, c) composite filling – permanent filling.
- The filling is given to build up a tooth-like structure.
- After RCT patient is advised to have crowns made for the treated teeth. Failing to fix crowns may result in a decreased rate of recovery of the teeth.
HOW TO MAINTAIN AFTER RCT:
- Follow the complete course of painkillers & antibiotics prescribed by your dentist after treatment.
- Fix crowns on the root canal treated teeth.
- Brush twice daily and promote the use of dental floss to avoid food collection in between the teeth.
- Have a follow-up visit to your dentist to check the status of healing.
- Frequent appointments for once in 6 months after the root canal treatment with crown placement for cleaning and dental check-up.
- In case of pain or swelling after a few days consult your dentist immediately.