Root Canals are the Last Resort to Saving a Tooth
Teeth are made up of three layers. There is an outer white enamel layer, a middle yellow dentin layer, and an inner hollow space where the nerve and blood supply of the tooth reside. We can restore teeth with fillings or crowns when the tooth decay is limited to the exterior enamel and dentin layers. But when the tooth decay spreads to the inner hollow space of the tooth, the only possible treatment is endodontic, or root canal therapy.
Root canals are a complicated procedure that must be done very carefully and meticulously. It generally takes between one and two hours to complete the procedure. A lot depends upon the complexity of the root system and the number of canals. Usually teeth in the front have one canal, premolars often have two, and molars often have between three and five canals.
There are many steps in order to successfully complete endodontic therapy
Completely remove tooth decay
Bacteria causes tooth decay and tooth decay is progressive. So the first step is to completely remove all of the tooth decay. This is hugely important because if any decay remains the root canal will eventually fail. Its also necessary to make sure that the tooth will be able to be restored following the root canal.
Access and identify the canals
The top of the tooth that covers the hollow inner space needs to be removed in order to access the canals. Its important to do this step slowly and carefully because enough tooth needs to be removed in order to see all the canals but not too much so that the tooth is not weakened. The canals are identified. If there is any nerve pulpal tissue it should be removed.
Irrigate the canals
The next step is to use a very strong chemical that will obliterate any bacteria in the canals. This will be repeated often throughout the endodontic procedure.
Straighten and enlarge the canals
The canals are initially very tiny and irregular. At this point we use files which gradually enlarge the canals and taper them so that they are wider on the top and smaller at the root tips. This taper is very regular and calculated.
Seal and fill the canals
The final step is to seal the canals so that bacteria can not grow and move about the hollow spaces. We use a material called gutta percha to fill in the canals and a resin to seal the canals shut.
Once the root canal is completed, we are able to restore the tooth. Sometimes we will put posts in the canals in order to build up a broken down tooth. It’s almost always necessary to put a crown on the tooth for strength. This video does a good job of visualizing the treatment.