Root canal treatment is an effective solution method for treating tooth infection and saving the tooth. It is performed when there is inflammation in the root of the teeth, and applied to save the teeth at risk. It is performed under local anesthesia, thus it is not a painful procedure. After infection-causing bacteria are cleared up during treatment, root canal is filled and the tooth is crowned. Canal treatment is usually performed by an endodontist or a dentist, on 2 or 3 appointments. It takes 1 hour on average. A root canal-treated tooth can be used for a lifetime, but may be more fragile than natural teeth. It is necessary to avoid hard or hot foods to prevent from damaging your sensitive teeth during and after the treatment.
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Root canal treatment is performed to prevent the removal of a damaged or inflamed tooth, and to repair it. It is the process of clearing up the inflamed canals inside the tooth root and preserving the tooth. There exists a vascular-nerve tissue (pulp-tooth extract) inside the root. It nourishes the tooth extending from the top of the tooth (crown – the visible part of the tooth) to the tip of the tooth root. Pulp is the tissue responsible for the development and protection of the tooth and it is also the tissue giving the tooth vitality. (1)
Bacteria can enter in the tooth when it is cracked or has a deep dental cavity. Due to untreated tooth decay, the pulp gets inflamed and begins to die because of the bacteria infestation. As a result, the tooth is lost. With the root canal treatment, the inflamed tissue is cleared up, the root canal is shaped, cleaned and then filled with filling. Then, the tooth is crowned to maintain its full function and restore it.
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The root canal system is filled with soft dental pulp. This pulp consists of nerves and blood vessels helping the tooth grow. Recovering a natural tooth in the event of a damage or inflammation is usually the best option. The root canal treatment is the treatment of choice.
Alternatives of root canal treatment are the removal of the damaged tooth and the replacement of it with a dental implant, bridge or removable partial denture. However, these procedures are more expensive than the root canal treatment. They usually require more time and additional procedures to treat surrounding teeth and tissues. (2)
The root canal treatment protects the tooth and the bone around it, and this is the most important advantage of the root canal treatment. It is generally successful in killing the infection and rescuing the tooth. After the treatment, the tooth can normally function over the years. (3)
If left untreated, the infection inside the tooth can cause tooth loss. If it spreads to the ends of the root canal, it can erode the jaw bone (localized bone loss) or even become life-threatening. However, there is still a risk of recurring of the infection in the long term even though the correct treatment is administered.
Antibiotics used to treat bacterial infections are not effective in the treatment of the root canal infections. In some cases after the treatment, the tooth may become slightly discolored or yellow spots may appear on the inner surface of the tooth. However, it can be whitened by internal bleaching.
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Before the treatment, an X-ray of the affected tooth is taken to clearly see the root canal and assess the level of damage. Next steps are as follows: (4)
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Depending on the condition of the tooth, the root canal treatment can take between 1-3 visits. For an infected tooth, several visits may be required to completely eliminate the infection.
An uncomplicated root canal treatment is usually completed in a single visit. Infected dental pulp is removed in the first visit. In the second or third visit, the root canal is cleared up, filled and crowned. Each visit takes about 90 minutes. Drugs can be placed in the root canal to kill the bacteria. This is done when there is inflammation at the root tip.
In order for this drug to be effective, it is necessary for the drug to remain in the canal for at least 5–7 days. During this time, the tooth is covered with temporary filling.
In children, it is necessary to preserve milk teeth in front area up to 6-8 years old, and the ones in back area up to 12 years old. During this period, if there are cavities in the milk teeth, they are filled. If inflammation develops and cavity enlarges, the root canal treatment is required. (5)
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There may be mild pain or sensitivity in chewing for the first few weeks after the treatment. Your tooth may be more sensitive, especially if there is pain or infection before the procedure. This condition can be resolved with over-the-counter or prescription drugs.
If the pain continues, the root canal filling may be incomplete or insufficient. In this case, a process called retreatment is performed. In this process, the root canal filling is removed, and then the root canal is cleared up and refilled. If this treatment gives no results, tooth can be treated with a surgical method called root tip resection.
The cost of the root canal treatment varies depending on how much the tooth is affected. Most of the dental insurances partly cover endodontic treatment. In general, endodontic treatment and restoration of natural teeth are cheaper than tooth removal.
The removed tooth should be replaced with an implant or bridge to restore the chewing function and prevent the adjacent teeth from shifting. These procedures cost more than the endodontic treatment and proper restoration.
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