To understand the procedure, you need to have some basic knowledge of the anatomy of teeth. A tooth is hollow, like our bones, and is composed of several layers.
The outermost layer (above the gum-line) is called the enamel, which is the hardest and most mineralized substance in the body.
Under the enamel is the middle layer called dentin. The dentin is about as hard as bone. Beneath the dentin lies the innermost layer called the dental pulp. This is the soft inner mass of the tooth, and is housed in a canal called the root canal.
The pulp is needed to nourish the tooth during its growth and development. After a tooth is fully mature, the function of the pulp is to let us know if it is damaged or infected, by transmitting pain.
Due to various reasons, it becomes necessary for an endodontist to remove the infected pulp, clean out the root canals, and fill that space with a sterile material to prevent further infection. This procedure is called endodontic therapy, or popularly known as root canal treatment.
At times, the patient may come to the endodontist with a tooth that has already been root canal treated, but continues to be painful or infected. In these cases, the root canal treatment has to be repeated to eliminate the infection.
If any old crown (cap) is present, it is removed.
The old filling material on the tooth is removed to gain entry into the root canals.
The old root canal filling is removed.
The canals are cleansed thoroughly to remove all infection.
A new root canal filling is placed.
The access cavity is filled with cement.
A new crown is made after ensuring that the tooth is comfortable.
If for some reason, an infection persists at the root tip in spite of conventional root canal treatment, it may be necessary for the endodontic specialist to clean out the infected root tip surgically to remove all the infection.
The tooth and surrounding areas are anesthetized. A small opening is made near the tooth by reflecting the gum tissue away from the tooth.
The infected root tip is removed. A small filling is placed at the root tip to seal it. The opening in the gum is closed.
If you have been given an appointment for a root canal treatment, kindly observe the following guidelines to ensure your comfort:
After a root canal treatment has been completed:
An access opening is made in the tooth to reach the root canals. The root canals are shaped and cleaned to remove all inflamed or decayed tissue.
The root canals are filled with a bio-compatible material (Gutta percha or Resilon) to prevent reinfection. The access cavity is restored with composite resin. Occasionally, a fiberglass post is used to aid in restoring the tooth.
After a gap of one week, a cap is placed on the tooth to prevent it from fracturing.
