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Sunday, September 18, 2005

Dental Q&A: Do you really need a root canal?



Editor's note: Summit Daily News provides the Rocky Mountain Remedies section for health care providers who advertise in the health section; it is a venue for them to share personal and professional viewpoints and tips.



Q: What is a "root canal" and why is it necessary?

A: A "root canal" is a dental procedure used to save an injured or infected tooth. This problem can appear due to deep dental caries (a large cavity), a fractured tooth, a fractured root of the tooth or long-term wear on a tooth. Typically, this leads to the inner part of the tooth, consisting of the nerves and blood vessels (the pulp), becoming infected by bacteria.

Years ago, a badly infected tooth was doomed to be pulled. Today, that is the last resort. Root canal treatment consists of: 1) the removal of the infected pulp that lies within the canal of the tooth's root, 2) cleaning and disinfecting the inner canals of the root and 3) sealing the root canals to prevent further bacterial infection. Usually, a tooth that has had a root canal will require a crown (cap) to help strengthen it.

Removal of the pulp from the tooth does not produce a "dead" tooth. It remains very much alive and functional because it still has a functioning blood and nerve supply on the outside of the tooth that comes from the surrounding "bone and gums," or periodontal ligaments. The tooth will have no sense of feeling because the nerve has been removed, but the tooth itself will be fine. If properly cared for, it should last as long as any other tooth in your mouth. Contrary to what many people think, the root of the tooth is not removed, only what is inside the root is removed.

For a short summary and illustrations of root canals, visit www.dentalreview.com/ Root_Canal.htm.



Q: What are the risks?

A: If a dentist suggests root canal therapy, then it is important to have a tooth treated as soon as possible. An infection that is allowed to continue will probably result in the formation of an abscess at the root of the tooth. This will lead to destruction of the underlying bone tissue and may make it impossible to save the tooth; in addition, the infection can spread to adjacent teeth and can result in blood poisoning, fever and swelling in the face and neck.

A root canal is usually painless while it is in progress. Any discomfort is typically due to infection that is already outside of the tooth because of the invasion of bacteria. Once the infection is under control, there is usually no further discomfort. This is why it is important to see your dentist at the first sign something may be wrong - to help minimize any possible infection that is likely to get worse.



Q: Why not just "pull" the tooth?

A: If the removed tooth is a back tooth, a permanent bridge or an implant, it will cost two to three times (or more) to replace the tooth, in comparison to the cost of saving the tooth. If the removed tooth is not replaced, the adjacent teeth will collapse into the space, creating teeth malpositioning, chewing problems and potentially, tempromandibular joint (TMJ) problems. If it is a front tooth that is removed, again the cost is higher to replace it - otherwise, you are left with a gap in your smile. Saving your tooth with a root canal is the best way to go.


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