Tooth Anatomy
To understand what a root canal is, first you need to understand a bit of dental anatomy. Your tooth is composed of 4 main layers. 1- Enamel. Enamel is the outermost layer of your tooth. It is the hardest and strongest thing in your entire body and is built to protect the inner, more sensitive parts of the teeth from cavities and infection. 2- Dentin. Dentin is found directly beneath the enamel. It is much softer than enamel, and if cavities get into your dentin, they will progress more quickly. 3- Cementum. The cementum also covers the dentin, but does so below your gums where the roots of your tooth lie. 4- Pulp. The pulp is the innermost portion of your tooth. It is where all the nerves and blood vessels are. If you have any tooth pain or sensitivity, it is because of something going on within the pulp of your tooth.
So What is a Root Canal
As we talked about above, any tooth problems that cause pain are a result of the pulp getting affected by one thing or another. If that one thing happens to be cavities reaching the nerve of the tooth, one of two things will happen. 1- The pulp will get inflamed, causing pressure and immense pain within the tooth. 2- The pulp will die, and can cause an abscess to form at the tip of the root. In either case, the tooth will need a root canal in order to relieve the pain. During a root canal, the nerve and blood vessels are removed from the tooth. The inside of the tooth is cleaned out and disinfected, so there is nothing inside to cause any pain or discomfort. The tradeoff is that the tooth is no longer considered to be alive. This means it will become a bit more brittle, and most of the time a crown is necessary to protect it from further breaking.
When the nerve is taken out of the tooth, your dentist will use several materials to make sure it is cleaned out entirely. Once cleaned and dried, a sealer material is placed to make sure that additional bacteria can’t find there way inside the tooth, and a pink plug called gutta percha is placed in with the sealer so that the tooth is not hollow and vulnerable to penetration from invaders. When completed successfully, a root canal can allow a tooth to last for many more years, when otherwise it would have had to been extracted.
Why Not just extract my tooth?
Extractions are appropriate in some cases. However, Dr. Andersen is a very conservative dentist and believes that any time he can save a natural tooth he is doing the patient a favor. That’s because natural teeth will always perform better than any dentures or prosthetics. If you extract your tooth, it is very expensive to get an implant to replace it, and implants are prone to failure at a similar rate as root canals are. If you pull your tooth without replacing it, your bone will deteriorate over time, making it more difficult for future prosthetics to be successful.
How often do Root Canals Work?
Root canals have a success rate of about 90%. Your tooth anatomy is very complex, and in some cases there are nerves and blood vessels that travel in sideways direction called accessory canals. These are impossible for the dentist to remove with his instruments so he has to rely on his irrigation solutions which won’t always get the job done. When this happens, your pain may not resolve after getting your root canal.
While it is rare, it’s important to know that it’s always a possibility. Teeth can be tricky little buggers. If a root canal is completed and pain persists, you can then consider extraction of the tooth or other surgical interventions. While possible to re-treat a root canal, the success rate drops to about 75% for 2nd time treatment and even lower for 3rd time treatment.
