Root Canal Therapy

By Dean Mourselas, DDS

I think one of the scariest phrases used in my office is a root canal. It has become such a dirty word. Sometimes I think I would be better off telling people their puppy just died. I joke, but every day I see patients make poor decisions for their health needs over nothing more than fear of the boogie-man. So what is this horrible beast that we are all terrified of? Actually it is a body part, or a part of our teeth.

A root canal is just what it sounds like, a canal, or hollow tube, inside the roots of our teeth. All our body parts need to receive a blood supply for nourishment of the cells in that particular structure. And yes, believe it or not our teeth are no different in that regard. At the end of our roots the is a small hole in which blood vessels and nerves enter and exit, this brings nourishment and sensation to the cells inside our teeth which we call pulp tissue. Many dentists will commonly call this the “nerve” of our teeth, but as you can see it is much more than that. Differing teeth have different numbers of root canals. Our front 6 teeth, which are our four incisors and two canine teeth, usually have 1 root and 1 canal. Whereas, our back teeth can have 3-4 canals in one tooth, these are just variations in the sizes and forms our different teeth have.

So the big question is…what is root canal treatment, and why would I ever need it? We perform root canal treatment basically to remove the pulp tissue in teeth and seal the inflamed, dying, or dead tooth off from the body. This can happen from a deep cavity or a fracture that introduces the bacteria in our mouths into the pulp of our teeth. At that point a toothache usually starts, although sometimes the pulp tissue dies. Once this happens the bacteria then have direct line access to our jaw bone through the root canals and an infection or abcess can start. A dental abcess is in third position, after child birth and kidney stones for most painful conditions. Not to mention the fact that this infection can spread throughout the head and neck and can even be life threatening. Another way for the pulp to die is as a result from trauma, like a blow to the face and teeth. This can be from a car accident for example. In this case the nerve usually dies without the person knowing and will eventually abcess if untreated. In either case, the aggravated tissue dies from some sort of stress whether bacterial or traumatic. Anytime any part of our bodies endure physical stress the result if inflammation. For example if you cut your finger the area will usually swell, become more red, and even painful. This is a natural response from our bodies to send more blood and thus more immune cells to induce healing for this traumatized area. Unfortunately with teeth, the small opening in the end of our roots and the hard nature of teeth is not an optimal environment for healing and this is why when traumatized the pulp dies so easily.

This is why it is necessary to perform this procedure, in fact the only other viable option is to extract or remove the tooth all together. However, modern techniques have made this procedure much quicker and painless than in the past. There are many reasons, most of which is that local anesthetics today are much more effective. The procedure entails, accessing the pulp, cleaning the canals with specially shaped instruments to fit in the canals and then filling, or sealing, them from the tip of the root up. The most common filling material used is a product called gutta percha. This is essentially a natural rubber that is biocompatible to induce healing in the bone around teeth and prevent further inflammation. In most cases this is done in one visit and in about 1 hour. Once this is done, your dentist may place you on an antibiotic regimine if an infection is present. From that point on the tooth is restored either with a filling or a crown depending on how much tooth structure is missing from the decay or trauma.

Modern root canal treatment is actually a painless and effective procedure that prevents serious infection and maintains our teeth. Millions of people worldwide have had this procedure done and it actually has a very high success rate, in comparison to other frequent dental, and even medical procedures. Sure this is something that no one really wants, but it prevents a much worse scenario. I find in my practice an understanding of the unknown is the best way to combat the fear around this highly dramatized procedure. So don’t let the boogie-man control you and cause you pain and infection, keep your mouth healthy with good decisions.