What is the root canal in a tooth?
In the centre of each tooth, under the outer layers of enamel and dentine, is a collection of nerves and blood vessels called the dental pulp. The vessels of the pulp enter the tooth through a hole in the root tip, or root apex, and run along the root canal to a space in the centre of the tooth crown called the pulp cavity, or chamber.
The function of the pulp is to:
- Supply the cells that create dentine with oxygen and nutrients.
- Detect stimuli such as pressure or temperature which could damage the tooth.
If the pulp dies it will decompose and leak out of the root causing the bone around the root apex to become inflamed, especially if the dead pulp is infected with germs (bacteria). The body's immune system will attempt to heal the bone but will not be able to cure it completely because the dead pulp will continue to leak out from the root canal and cause further damage.
The only way to effectively treat dead or dying pulp is to remove it. This can be achieved by:
- Root canal treatment (RCT), or having a root filling: this procedure aims to remove the dead pulp and any infection from inside a tooth and then to place a filling within the root canal system that prevents future bacterial growth/spread within the space.
- Tooth extraction: once the tooth containing the dead pulp has been removed, your body will itself be able to deal with any residual infection.
The main benefits of RCT over extraction are that your smile and ability to chew food will not be compromised by missing teeth.
What symptoms show that I might need root canal treatment ?
Your dentist may suspect that you have a dead or dying pulp if you have a combination of any of the following symptoms:
- Discolouration: a front tooth with a dead pulp will often turn grey or brownish, possibly over the course of several years.
- An abscess or a small persistent small hole on the gum: it may look like a pimple.
- Signs or symptoms of a spreading dental infection: high temperature (fever), tender or swollen lymph nodes under the lower jaw or upper neck area, or swelling of the soft tissues of the face and under the lower jaw.
- Recent toothache: severe throbbing tooth pain of irreversible pulpitis and/or pain on biting. When the pulp has died the throbbing toothache may stop completely.
- A history of trauma to the tooth: the dental pulp of front teeth is more likely to die from trauma while for back teeth, tooth decay or deep fillings are the more likely cause.
- Pain which lasts more than three days after dental treatment: especially if it involved dental work close to the pulp.
Further reading and references
Root canal treatment - site includes 'find a member' function; British Endodontic Society
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