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What is Root Canal Therapy?
By Dr. Tareq Khalifeh, DDS

In the old days of dentistry, if you had an infected tooth, your dentist had little recourse but to pull it out. That’s why so many pictures of relatives from the 19th and early 20th century showed smiles with big gaps in them.

Thank goodness, modern dentistry can usually eliminate infection while saving the problem tooth. If antibiotic therapy doesn’t stop the infection, the next line of defense is root canal therapy. In a root canal, we actually remove the soft pulp within the tooth to eliminate the infected material, clean and medicate the surrounding tooth, tissue, and bone, and then seal and cap the tooth with a gold or porcelain crown.

 

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How Infection Occurs

The most common cause of infection in the soft tissues of the tooth is a cracked tooth or a deep cavity left untreated. These conditions allow bacteria to get into the vulnerable pulp, the soft tissue inside the tooth that contains nerves, blood vessels, and connective tissue. The pulp chamber goes all the way from the crown of the tooth to the tip of the root in the jawbone. When bacteria enter this area and cause infection, the pulp dies, and the growing infection creates a pocket of puss at the root tip.

Such an abscessed tooth causes considerable pain and swelling and can be dangerous to the patient. Left untreated, it will destroy the tooth and surrounding bone, until the only option is removal.

Tooth fractures are more common than you might think. Accidents, tooth grinding uneven chewing pressure, too much exposure to temperature extremes, and even chewing on hard objects like nuts or ice can lead to a crack. If you have a cracked tooth, you will probably experience pain on biting and sensitivity to hot, cold, and sweets. You may have difficulty isolating which tooth hurts. But even the most microscopic crack lets bacteria enter the pulp.

Hairline fractures in the tooth are often invisible even on standard X-rays. That is why we now use digital radiography, which provides a higher resolution image. We may be able to bond the crack if it is caught early, before infection can begin. When root canal therapy is required, it usually requires between one and three visits. We make an opening through the crown of the affected tooth, remove the pulp, and clean and shape the remaining chamber. Antibiotics are usually placed within the chamber to stop existing infection or prevent infection from occurring. If the tooth is severely infected, the tooth may be left open for a short time after the first visit to allow the pus to drain. Otherwise, a temporary filling is placed in the crown and the tooth is sealed.

The final step in root canal therapy is to place a permanent crown over the tooth. By this time, the infection has been eliminated. With proper care of surrounding teeth and gums, the restored tooth should last a lifetime without presenting further problems.

We all hope we won’t lose teeth or have to undergo significant oral surgery, such as a root canal. The best strategy is prevention. If you play rough sports, wear tooth guards. Ask your dentist about night guards if you tend to grind and clench your teeth in your sleep. And be cautious how you use your teeth when eating hard foods. Don’t expose your teeth to sudden temperature swings from very hot to very cold. And see your dentist regularly. If you detect discomfort anywhere in your mouth, schedule a visit for your dentist to check it out. With early diagnosis and treatment, infection can often be stopped before it starts. When in doubt, check it out.

Dr. Khalifeh’s practice, Philmont Family Dentistry, can be reached at 518-672-4077 or online at www.philmontfamillydentistry.com.

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