A trip to the dentist’s office is not always something you look forward to. Many people have been diagnosed with extreme anxiety on the onset of such a visit. Whether the problem is psychological or not, you need to gather courage to avoid future heartache courtesy of dental and oral health decline.Anxiety happens to the best of us and a recent root canal treatment led me to ask several questions about the procedure, general practices, implications, facts and myths.

What is root canal treatment?

Pulp found in root canals can be infected as a result of severe tooth decay. Pulp is basically what keeps the tooth alive because it is constituted by nerves as well as blood vessels. When infection is evident the recommended treatment will be endodontics commonly known asRoot Canal Treatment. It is the removal of the pulp and replacement of a substance that will ward away future re-infections. Because of cutting edge technology in dental equipment and practices, the procedure will not leave teeth darkened unlike in the past.

The procedure will therefore see the tooth preserved for cosmetic reasons. The alternative is to have the tooth extracted but this should only be considered when no other option is forthcoming.

Benefits of the procedure will include not having the tooth removed as well as prevention of further infection and problems with the tooth.

However, after all is done, a dentist will recommend crowning the tooth to reinforce it. A tooth without a root canal will be weaker than healthy teeth and for this reason, crowns will be good options. According to Dr. Wambugu of the PCEA Kikuyu Hospital Dental Clinic in Kenya, a crown can preserve a tooth for a life time.

There are several root canal myths to be dispelled in society as follows;

• A root canal is painful. This common myth has its roots from ancient days where the procedure was done using non-advanced methods unlike today. This has been highlighted by the American Association of Endodontists. The administration of general anesthesia will numb the area and the procedure will be painless; it was for me.

• Another common myth is that all root canals must be done in several appointments. This is not the case because the procedure can be completed in one or two appointments. However, there are several factors that will dictate the number of appointments including;

a) Need for referral

b) Tough root canal

c) Extent of infection

Let your dentist recommend the number of appointments after having considered your case.

• Another common myth is that a root canal treatment can cause illness such as arthritis, heart and kidney disease. Research has shown this NOT to be the case. This myth has sprouted from research done almost 100 years ago by Dr. Weston Price. In his research of 1910 to 1930, Dr. Price claimed that illness can emanate from the procedure due to infections. His claims have been refuted by modern research because there is no medical evidence to prove the same.

• Another common myth is that a tooth has to hurt to qualify for root canal. Dentists can discover teeth that are dead and recommend the treatment however painless. Therefore, screening to check the status of the tooth by the doctor is advised. Tests that are employed to check dead teeth include;

a) Percussion testing

b) Use of a pulp vitality machine

c) Percussion testing

• Finally, some people believe that benefits of a root canal treatment don’t last. This is owing to consequent breaking of teeth after treatment. According to veteran dental experts, this is not the treatment failure but rather the failure in restoration or construction of tooth. Breakage mainly happens to those who fail to get crowns. Therefore, the benefits can last long.

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Root canal headaches can be extremely painful; so much so that they may deprive you of your sleep. They are mostly caused due to a flawed root canal treatment, or any new infection that sets in after sometime since placing the crown/completing the root canal treatment. Often, in order to stop the pain, you are forced to resort to a regular dose of pain killers for some relief. However, it is best not to consume pain killers for too long and you should seek medical attention quickly.

To further understand how root canal headaches are caused, here is a brief look at the cause and procedure of root canal treatment itself. Root canal – as the term indicates – is a treatment methodology to cure the infection that sets in the canal of a human tooth. The damage can be the result of an untreated cavity, gum disease or trauma to the tooth, but if left untreated, the infection could affect the nerves and kills the dental pulp, and spread to the other parts of the mouth, destroying the jaw bone and leading to other complications, even to a life threatening extend. If you do not do a root canal treatment, there is not other choice left, but to remove the damaged tooth.

The root canal treatment involves removing all the affected pulp, bacteria, puss, and any other decay from the cavities of the damaged tooth and filling the resulting space with neutral, medicated dental materials; so that, after the treatment, the tooth can stand on its own and perform almost all of its normal functions as if it were a live tooth. The entire procedure of root canal treatment may involve 3-4 sittings with an endodontist, and it may cost a few hundred to thousands of dollars, depending upon the complexity of the situation.

If everything goes fine and the root canal treatment nearly perfect, the tooth will cure within a week’s time and it will function almost normally as any other tooth. But if the dentist or endodontist, who had performed the cleaning of the canals, failed to cleanout the canals fully or missed a canal by accident, the infection or bacteria within the canals remains, and within few days, it’ll again spread to the jaw bone or nearby tooth, resulting in uncontrollable pain. If someone who has recently undergone a root canal treatment feels persisting pain in the operated tooth that increases in intensity with time, it can be a budding root canal headache, and hence must consider consulting a specialist immediately.

The treatment for root canal headache includes antibiotics to kill the inflammation and pain, and a second root canal treatment to cleanout the newly set in infection.

Tail Piece: Root canal headache is more of a common man’s slang than a technical term. Medical science often refer it as the headache due to a miscarried out root canal treatment.

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The pain sensation of a root canal is generally the pain brought on by the infection which the procedure is designed to eliminate. Root canal treatments tend to be an extremely effective method of preserving your tooth from an infection and in the long run removal. Together with today's technology and resources there is not any cause to worry about a root canal. However, permanent root canal care is a debatable topic within the alternative dental care community. It is understood that it's extremely hard to completely sterilize the canals inside the teeth knowing that a number of microorganisms will continue to be within the very small tubules within the system.

Root canal treatments are generally costly, and really should only be taken modestly upon which only need the procedure. Ahead of when any kind of treatment is to occur, the dental practitioner will initially request you to have an x-ray from the imputed row of teeth prior to when the treatment commences. Root canal methods are highly effective in over 95% of treatments but in rare circumstances, an unseen impaired canal offshoot can go undetected, resulting in the problem having to be addressed on more than one occasion. Typically, root canal methods are carried out employing a microscopic lens. Research has disclosed that surgical effect shows improvements with increased strength of magnification.

The teeth which end root canal procedures typically demand a crown. This particular treatment course will assist in alleviating discomforts. It will also act as a preventative measure given your teeth on both sides of a removed tooth will quickly fail in to the vacant areas, as well as the teeth below or above your tooth having been removed will start to over-erupt. It is recommended to consult with your own dental professional the particular ramifications associated with teeth removal, along with the longer term implications involving extracts, and also alternatives like the best way to populate such a space by making use of bridges, detachable prosthesis, or even dental implants if recommended by your dentist.

Teeth utilize their neighbors to help reinforce their strength, plus, with a particular tooth absent, they will begin to "collapse". Over time this will worsen the bite resulting from changes in reaction to pressure applied. This could certainly bring about issues with your entourage jaw, for example. Teeth which has experienced a root canal procedure frequently need a crown to shield them against further damage.

Infections inside of the teeth tend not to react to prescription antibiotic medication. The soreness bought on by the problem limits the tooth's blood flow, therefore medicines within the circulatory system can not get to the problem effectively. An infection of the pulp is often attributable to injury towards the teeth, strong corrosion, splits and chips, as well as repetitive dental care treatments. Warning signs of the problem is often recognized as noticeable damage or inflammation in the teeth, level of responsiveness to hot and cold temperature, or discomfort within the teeth coupled with gums. In the event that you are experiencing some of these tooth discomforts, it is quite possible that you may benefit from a root canal procedure.

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Facing a root canal is already stressful for some patients, even though this minor dental surgery does not cause pain, it relieves it. However, most people see an endodontist (a dental surgical specialist) when they're facing complicated issues such as multiple restorations, symptoms masked by analgesics, or calcified canals. Root canals are one of the most common dental surgeries performed, but when lesions are also present, that can cause a big problem. If they're radiopaque, radiolucent or a little of both, that tissue can end up looking cloudy in digital images and make the corrective process more difficult.

Many factors need to be considered when recommend this endodontic treatment. These include proper radiographic images (that need to be cloud-free), clinical testing, and of course patient history. The common symptoms associated with decay serious enough to call for a root canal can also mimic less severe issues – such as cemento-osseous dysplasia. In a case like this, simply monitoring the tooth is often the best approach.

"Lesions" for Concern

COD is the most regularly occurring type of dental lesion. It happens in teeth-bearing areas along the jaw – however, no type of COD needs treatment, as better oral hygiene, home care and regular checks should do the trick. However, the issue is in getting a correct diagnosis. If that's not done, a needless root canal and sometimes even a complete tooth extraction might be ordered.

Complaints of a toothache can mean many things, and root canal therapy is not always the best answer. However, if a reputable endodontist engages in sensible testing, the root of the problem can often be found. Lesions are a challenge to spot, especially since they can be unclear when using radiography, which is why a holistic approach to a diagnosis is so important. Diagnoses equate to the treatment recommended (if any).

Root Canal Avoidance

While lesions are usually a minor problem that can be addressed with changes in at-home care, a toothache or tooth sensitivity can prompt some patients to put off seeing their dentist. Sadly, root canals have a bad reputation that they do not deserve. Dentophobes think the procedure is painful, when that's not the case at all. In fact, they are quick, routine and not uncomfortable. Remember that a root canal is simply cleaning out and disinfecting the tooth's roots, with anesthesia, and the procedure extremely stops the current pain from continuing.

Whether a patient is facing a root canal or lesion care, it's common to put off those dental appointments. Ignorance is not bliss, especially in dentistry, and the longer a patient sufferers through the pain, the worse it will get. Being scared of a potential root surgery is not just unnecessary, but also potentially dangerous. It's crucial to figure out the cause of tooth pain as soon as possible – only then will relief be possible.

Choose an endodontist with experience and the technology for best results. Whether it's telling the difference between a lesion and a call for a root canal, or ensuring you have the best lasers for your treatment, not all endodontists are created equally – you (and your teeth) deserve the best.

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The term "root canal" is used to identify the natural cavity inside the tooth where the soft area called pulp or pup chamber is found. The nerves of the tooth whose function is sensory can also be found inside the root canal. If the pulp gets injured (repeated dental procedures, fillings, cracked or broken tooth) or infected (due to tooth decay), the pulp tissues and nerves die which could lead to sever infection when bacteria starts to multiply and therefore has to be removed. If gone untreated, the surrounding tissues might also get infected which will result in the following: tooth abscess, bone loss around the tip of the root, swelling might spread to the face, neck, or head, and occurrence of hole at the side of the teeth which may cause drainage problem into the gums, cheek, or skin.

However, unlike in the old days when a tooth had to be removed when it became infected, there is a special procedure nowdays called root canal or endodontic treatment where a tooth can be saved from extraction. Root canal therapy involves repairing and saving the badly infected tooth by removing the pulp and nerves and then protecting it by cleaning and sealing the inside of the tooth. A crown is then placed over the treated tooth to make it stronger.

Saving a natural tooth includes many advantages such as not having to wear artificial tooth / teeth, efficient chewing, prevents jaw problems, and protects other teeth from too much wear and strain.

The branch of dentistry that deals specifically with diseases of the tooth's pulp and the surrounding tissues is called Endodontics. Root canal treatment can be done by general dentists, but if the issue gets complicated or is being done a second time, patients are often referred to an endodontist. Endodontists are dentists that have gone through specialized studies and trainings that deal solely with root canal treatments.

Symptoms and signs that you might need a root canal treatment:

• A broken, decayed, cracked, or loosened tooth
• Acute, sharp, and spontaneous pain that is hard to locate and may be due to the infected pulp or formation of abscess at the tip of the root.
• Discoloration or darkening of the tooth
• Dull ache and pressure
• Pain extends to the ear, temples or jaw areas.
• Prolonged pain and sensitivity to hot or cold drinks and foods
• Recurring or persistent pimple on the gums that may discharge pus causing bad odor or taste
• Severe toothache pain when biting, chewing, or touching the tooth because of the infection or inflammation of the root tip and the application of pressure on its socket irritates the root area.
• Swelling and tenderness of the gums near the infected tooth
• Swelling of the face

However, there are instances where a tooth pulp can become damaged or infected without any of the symptoms presented. When this happens, the dental issue is often detected by X-rays or special dental tests during checkups or other dental treatments.

Causes of tooth pulp damage or infection:

• Abscess where a pus pocket forms around the end of the root when the pulp of the tooth dies and which can spread to the surrounding tissues and bones
• Advanced gum infection
• Bruxism or teeth grinding
• Deep tooth decay beneeth a tooth filling that gets untreated
• Deep tooth cavity
• Repeated dental procedures that can cause a lot of strain on the tooth such as drilling, filling, and crowns
• Traumatic damage to the tooth such as a chip, crack, or even root fraction where the nerve was identified at the end of the root causing it to die; this can happen immediately or years after the trauma

Diagnosis:

There are several steps your dentist will do to determine if you need root canal treatment and these will include: look for any symptoms that you might have needing the treatment, check the tooth and the gum's condition and for any dental procedure done on it before, examine the nerves and tissues on the tooth and the surrounding area by applying hot and cold substances on it, tap on the tooth gently or have you bite on something to determine if the tooth is sensitive to touch or pressure, take X-rays of the tooth and the bone around the tooth to show how the treatment will be done, and use an electronic pulp tester that sends a small amount of electric current through the tooth to determine if the pulp is still alive.

Treatment procedures of root canal:

The first step in treating root canal is taking X-rays of the infected tooth to determine the shape of the root canals and to see if there are any signs of infection and then numbing the infected tooth and the surrounding tissues by applying anesthesia.

Next, the dentist will use a dental gum (a thin sheet of rubber or vinyl) to isolate the infected tooth from the rest of the mouth and also to keep the tooth dry.

A small hole is then drilled into the infected tooth to gain access to the pulp chamber and root canals to be treated. Using special instruments like root canal files, the dead pulp, nerves, and tissues along with bacteria and other debris, are removed by flushing with water or with sodium hypochlorite.

After the root canals are cleaned and disinfected with antibacterial solutions and antiseptic, followed by painting of the canals for the root canal fillings and then washing and cleaning once more before sealing them.

At the next appointment for treatment, a rubber-like material known as gutta-percha together with an adhesive called sealer is used to fill the root canals and seal them. A crown is often placed over the tooth to avoid any infection or contamination in the future.

The final procedure may include restoration of the tooth to its full function with a crown to help prevent it from further breaking or damage. Your dentist will tell you if you need any additional dental procedure. After the treatment an antibiotic will be prescribed for you to take to prevent infection.

Alternative means to a root canal:

Taking the necessary steps to save your natural teeth is the very best alternative possible. Tooth extraction is another most illegally option. Removal of tooth / teeth means replacing the lost one / s with removable or partial denture, with a bridge, or tooth / teeth implants. However, these alternatives require more time for treatment, extra procedures to be done on nearby tissues and adjacent teeth, and more expensive.

Cost of a root canal treatment:

The cost of a root canal treatment will depend on which tooth is affected and the severity of the problem. The cost will be based on the degree of difficulty, number of canals to be treated, and location of the infected tooth / teeth in the mouth (for example, front teeth are easier to treat than back teeth). Endodontic treatments are covered by a lot of dental insurances, but it still depends on your coverage. Endodontists may charge 50% more than regular dentists.

Summary:

Root canal treatment makes it possible for an infected or diseased tooth to be saved rather than having it removed like in the past. This treatment involves removing the inflamed or infected pulp, cleaning and disinfecting the inside of the tooth, and then filling and sealing the tooth with a rubber-like material known as gutta-percha. The final step is restoring the tooth with a crown for protection against future dental issues. The root canal treatment is a highly successful procedure and can last a lifetime and the treated tooth can function like any other tooth after restoration.

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