Root Canal

By: Dr. Cook
Endodontics, the technical name for the procedure commonly known as a root canal, becomes necessary when a tooth is infected. A tooth is made up of three basic parts. The enamel covers the outside or crown of the tooth. The hardest substance to occur in the human body, the enamel protects the tooth and provides strength for chewing. The layer called dentin, which is softer than enamel but still quite hard, lies within the enamel. The center, or core, of the tooth is made up of a complex, loose connective tissue called the pulp. Within this connective tissue core are the blood vessels, lymphatic’s, and nerves, which supply nourishment and sensation to the tooth. When the pulp is damaged or invaded by bacteria, the limited blood supply coming through the tip of the tooth root does not supply enough white blood cells to fight the infection and the pulp dies. A dead pulp soon disintegrates and becomes food for the invading bacteria and the space becomes filled with suppuration, a polite and scientific way of saying "pus". The waste products of these bacterial populations are gases and liquids, which cause the pressure and pain of a toothache. Endodontics are simply a way to remove the infection and what is left in the pulp space without removing the entire tooth with it.
After opening the tooth into the pulp space, mechanical instruments, and antibiotic medicaments are used to clean the inside of the tooth all the way to the tip of the root and a filling material, usually gutta percha, is used to seal the canals so that bacteria can not re-enter the tooth. What caused the pulp to die? In one word, trauma. That trauma can be in the form of a physical blow to the tooth, but more frequently it is in a form of caries (or decay) that is allowed to advance near or into the pulp chamber itself.
"Is this going to hurt?" This is another frequently asked question. Most of the horror stories related to endodontic therapy are hold-overs from a time when antibiotics were not used as liberally as they are today. With proper anesthesia and an adequate antibiotic regimen prior to treatment, almost all root canals can be performed completely without pain. There was a time when a dental infection involving a tooth invariably meant the loss of that tooth. With endodontic therapy and the appropriate restorative procedures to support the tooth thereafter, many times the tooth can continue to be used and enjoyed for life.