What is root canal and how is it done?

Tooth structure

The tooth consists of two parts, the crown and the root. The crown is the white cap that you see in the mouth and you know it as a tooth, and the root is the part of the tooth under the crown that is embedded in the gums and jawbone to keep the crown fixed.

All teeth have three main layers:

From the outside to the inside, there is the enamel layer, which is white and completely surrounds the tooth to protect the vulnerable parts inside the tooth. Enamel is the hardest substance in the human body.
Ivory is the layer under the enamel, which is yellow in color. In places where the enamel has been lost, the crown of the tooth can be seen, especially in those who grind their teeth and grind their teeth together, dentin may be visible on the biting surface of their teeth. Ivory is softer and more vulnerable than enamel.
The pulp is the core of the tooth, which is home to the dental nerve and blood vessels that nourish the tooth. The pulp is the only living part of the tooth. When the pulp of our teeth gets infected, it must be completely drained and cleaned and filled with special materials. We call this work root canal.

When is a root canal needed?

Root canal is performed in cases where the pulp has been irreversibly damaged and there is no other choice but to drain and clean it and fill it with special filling materials. The cause of pulp damage is usually one of the following:

• Breaking a tooth during an accident such as an accident, falling, or playing.
• Deep tooth decay that has not been treated and has reached the pulp.
• Leaking old or improper fillings that have caused decay to occur underneath.

If you experience any symptoms such as toothache or swollen gums or anything else that is unusual, see your dentist to check the condition of your teeth. Also, visit the dentist regularly to check old tooth fillings so that if they are separated or cracked, they should be replaced as soon as possible.

The symptoms of dental pulp infection are as follows:

• Pain when eating or drinking, especially when the temperature is very cold or hot.
• Pain when chewing.
• Loose teeth
• An accurate diagnosis of the pulp condition can only be made with an X-ray photo of the tooth.

If the toothache is gone, does that mean I don’t need nerve extraction?

Note that as the infection progresses, these symptoms may disappear because the pulp is destroyed and the nerves no longer send messages. You may think your tooth is healed, but the infection has actually spread. Finally, the following symptoms may appear:

• Return of pain when chewing
• Swelling of the gums around the affected tooth
• Purulent discharge from the teeth
• Facial swelling
• Darkening of tooth color

Note that if you have a toothache, you must check it. An infected tooth will not heal on its own. If you leave the tooth alone, its condition will worsen and the adjacent teeth and bone will be at risk. If the infection is widespread, the chance of success of dental denervation treatment decreases.

Tooth denervation stages

To treat a dental pulp infection, bacteria and damaged tissue must be removed. If you do not reach the tooth in time, you will have to pull the tooth. Since artificial prostheses that replace teeth have many problems and constantly cost you money, it is better to keep your natural teeth as much as you can.

1. For a root canal, the mouth is first numbed.
2. The dentist then makes a hole in the crown of the tooth to access the pulp.
3. With the help of special dental tools such as drill and file, the entire pulp chamber is emptied and removed.
4. The walls of the pulp chamber and the root, especially the tip of the root, must be completely shaved and cleaned.
5. After the tooth core is completely cleaned, it is time to fill it. With special filling materials, the dentist carefully fills the entire pulp and finally seals the tooth so that there is no way for bacteria to penetrate.
6. Finally, usually the tooth should be covered. The veneer is the artificial crown that is placed on the tooth and surrounds it. In this way, there is no more pressure on the real crown of the tooth and the risk of breaking it is reduced.

Why sometimes denervated teeth need to be treated again?

It is possible that the tooth will not heal as expected and will need retreatment despite the initial treatment. The reasons for the failure of denervation can be one of the following:

• The narrowness or curvature of the tooth root canal has caused part of it not to be properly cleaned and treated in the initial denervation.
• The complexity of the anatomical structure, such as the sub-branches of the root canal, has not been identified in the initial treatment.
• Connecting the crown or other restoration on the tooth, after denervation is not done in time and is delayed.
• The restoration of the denervated tooth could not prevent the infection of the inside of the tooth with oral saliva, as a result, the infection has started again.

Also, for the following reasons, a tooth that has been successfully denervated may have problems again:

• Create new caries
• Breaking, cracking, or loosening of the tooth cover or filling (which was supposed to prevent the penetration of foreign substances, but can no longer)
• Breaking teeth
• The root of the tooth has a secondary canal, which may not be seen during the root canal and may not be treated. As a result, root canal treatment fails.

What is the secondary root canal?

The accessory canal is a part of the complex anatomy of the tooth canal that may be hidden from the dentist’s eye during root canal treatment. The root system of the tooth, which contains fine vessels, nerves and connective tissues, is very complex and precise. This root system, like the roots of plants, may have small branches that separate from the main channel. These different root branches are usually located in the areas where the roots of multi-rooted teeth join together or are located around the distal third of the root, however, they may exist anywhere else along the main root canal. Sometimes it is very difficult to identify the root canal and to clean and fill it. If tissue remains inside one of them, it can be the source of re-infection. Therefore, the diagnosis and treatment of the root canal is very important in denervation.