The very word "Root Canal treatment" invokes images of pain, discomfort and long drawn out procedures in the minds of most people. However, most of these fears and misconceptions are unfounded and not relevant in the modern day scenario. As with any field of medicine, with advancements in science, technology and materials, there's been a vast improvement and turnaround in simplifying erstwhile complex procedures.
The author will attempt to address and answer a few common questions which most people have, and often get confused when faced with the information:
- WHAT IS ROOT CANAL TREATMENT?: To understand this question better, one must attempt to understand the basic anatomy of the tooth. The tooth comprises of an extremely hard outer layer, mostly without nerve end innervation, called as Enamel. Enamel is the thickest at the cusp, the chewing table of the tooth, at approximately 2-3mm. It thins out near the neck of the tooth near the gum line. The enamel layer covers the bulk of the tooth structure, called the Dentin, which houses the nerve endings from the pulp of the tooth, and a combination of organic and inorganic tissues. The whole complex covers the vital heart of the tooth, which is called as the Pulp, and in the truest sense its the heart of the tooth, comprising all the vital cells, nerve supply and blood supply to the tooth. The Root portion of the tooth, which lies in bone, is not covered by enamel, but by a layer called Cementum.
- Root canal treatment is recommended when the pulp of the tooth gets compromised, either by way of infection arising from decay in the tooth, or when trauma to the tooth results in devitalization or death of the delicate pulp tissue. Contrary to popular opinion, decay can affect teeth at ANY stage of life and not only adults! In fact, people look aghast when root canal treatment is indicated for children. Saving the milk teeth is as important for the growth of the jaws in children, as it is for the functional efficiency in an adult. Premature removal of the milk teeth often upsets the whole alignment of the permanent teeth,and thus compromising growth.
- ROOT CANAL TREATMENT IS VERY PAINFUL AND TIME-CONSUMING: Again, a far cry from the truth. In the olden times, when techniques were not as refined, as also the instrumentation, Root canal treatment used to be a struggle both for the patient as well as the doctors. With the introduction of the "Crown-down" technique, and rotary files, The back fill technique for final fillings, better quality and biocompatible sealants, the treatment time gets considerably shortened. Modern and vastly improved local anaesthetics , make the treatment seamless and virtually painless. As a matter of fact, it is extremely unlikely that you will feel any pain during the procedure! Magnification by use of loupes or Operating microscopes open up a whole new visual fields for the doctors, thereby making the outcome much more predictable.
- ROOT CANAL TREATMENT IS VERY EXPENSIVE, WHY CAN'T I EXTRACT THE TOOTH?: Yes, like any other specialized treatment or procedure, Root canal treatment, when done by a trained specialist, is expensive since it involves skill, time , state of the art materials and technology and above all, knowledge! Extraction is always the last resort for the conservative dental surgeon, since its always easy to destroy, rather than conserve. Extraction of salvageable teeth will invariably have cascading detrimental effects on the masticatory system.
- DO ALL ROOT CANAL TREATED TEETH NEED POSTS/ CROWNS? As a rule, most root canal treatments are rendered for teeth which have decayed, thereby causing extensive loss of tooth structure. In order to restore such teeth structurally sound enough to withstand chewing forces, a Post and core, followed by a crown or onlay, restores the tooth to near normal function. Having said that, advances in adhesive dentistry, has precluded the inevitable crown, in select cases,and based on operator skills.
- WHAT IS THE LIFE OF A ROOT FILLED TOOTH? For any treatment rendered, there is a finite life for the restoration. However, the serviceability and longevity of the restored tooth dramatically improves when proper attention and home care is bestowed on it! A large part of the success of ANY treatment rests in the hands of the person who has undergone the treatment. Root canal treated teeth can decay too, only difference being the absence of pain, since the nerve or pulp is removed. So, proper oral hygiene habits, effective brushing and flossing, and more importantly, regular follow-up visits are imperative to ensure longevity of the treatment.
There is an idiom "You will never realize the value of what you have, till you lose it" ! The same applies to any part of the body, and overall health! Every tooth in our mouth plays an important role in our overall well being, and should never be sacrificed at the altar of The Extraction God, unless absolutely inevitable!