The Crucial Role of Endodontics in Saving Teeth

Guest Post by Dr. Josh Williams

What is Endodontic Treatment?

Endodontics is literally the study of the inside of teeth. Most of us don’t even think about there being anything inside of our teeth. But, like most things in life there is a lot going on behind the scenes which is also true within our teeth. Inside each of our teeth there is a network of interwoven nerves and blood vessels that give life to our teeth. These nerves and blood vessels are located directly in the center of the tooth that we refer to as the Dental Pulp. The nerves extend all the way down the roots of the teeth within the root canals. The nerves inside our teeth have multiple functions. They have immunological properties that help fight off infection. They have a variety of receptors that help feel things that are hot or cold and help us from biting down on something that could cause further damage like a hard popcorn kernel. 

The Process of Endodontic Treatment

If the nerves inside our teeth are damaged, exposed, or inflamed then necrosis can occur. If necrosis or the death of the pulp occurs then bacteria from our mouth or bacteria from a cavity can enter the inside of the tooth which can cause an infection. Infections inside our teeth if left untreated can cause an abscess in the bone that can sometimes result in swelling inside and/or outside of the mouth and pain. Tooth pain is no joke and unfortunately a “root canal” sometimes is synonymous with tooth pain which can be excruciating. The reality is the root canal procedure is a dental treatment that alleviates the pain caused by inflammation or infection of the tooth. During the root canal procedure we clean out the necrotic or inflamed pulp and remove as much bacteria as we possible so that your immune system can clear the infection. Remember fighting infection is one of the roles of the dental pulp. So, if it can no longer do that we must give your immune system a fighting chance. After a root canal the bone around the teeth can regenerate and you can use the tooth like before. 

The “root canal” procedure can really be broken down into two main parts. We must first clean the inside of the teeth and then second, fill the inside space that was previously occupied by the nerves and blood vessels inside the teeth. In order to clean the inside of the teeth we use small flexible files that help us remove bacteria that stick to the walls of the root canals. We also use different antimicrobial irrigants that wash and clean the inside of the teeth. Depending on the tooth you may have one to six canals that need to located and cleaned. Some of these canals are smaller in diameter than .06mm which is similar to a strand of hair on your head. In modern dentistry we are much more aware of these small intricate spaces inside our teeth because of advancements in technology like 3-D X-ray machines and microscopes. After a thorough cleaning of the root canal system we fill the teeth with gutta percha which is an inert almost rubber type of material with a liquid-type sealer that sets over time. 

*If you like this blog post, you might also like to read What is a Trial Smile? Enhancing Your Smile Through Customized Treatment Plans.

Pain Management

Some common misconceptions about the root canal procedure are that it is a painful procedure or that we are removing the roots of the teeth. The truth is with proper anesthesia the root canal procedure can and should be painless. Also, if the pulp is necrotic there actually isn’t much  feeling left in the tooth anymore and so anesthesia is administered to help numb the gums and surrounding bone for further comfort during the treatment. During the root canal procedure the roots stay intact however the canals or space inside the roots are cleaned and filled keeping the entire tooth sound and functional. Another common misconception is that we remove all the bacteria from the inside of the tooth. There are over 300-500 species of bacteria in our mouths at any given time without disease. The root canal procedure is a method to help us remove enough bacteria that our body’s own immune system can do the rest. This means those with compromised immune systems may have slower healing and also require more in depth cleaning of the root canal system. 

Conclusion

Patients today have more options than ever before to treat their teeth. Understanding your choices and their impact on your future dental health and lifestyle is important. Saving a natural tooth through endodontic treatment should always be the first choice for the best health and cosmetic results. There are many advantages to saving your natural tooth including efficient chewing, normal biting force, so you can continue to eat your favorite foods. More advantages to saving your natural teeth include maintaining a natural appearance and limiting the need for more costly, ongoing dental work. If you are given a choice between root canal treatment or tooth extraction, always choose root canal treatment. Dentistry has yet to produce a denture, bridge or implant that looks, feels and functions as well as a natural tooth. Sometimes teeth need to be extracted because of root fractures, cracked teeth, and too large of a cavity to restore the tooth. But, many times teeth can be saved and the root canal procedure is crucial in this process. (AAE 2013)