The mere mention of nerve treatment or root canal sounds terribly painful. Is this so? In the majority of cases, root canal work is painless, often done under a local anaesthetic. It is the rare case when the initial treatment may cause you some discomfort or slight pain, which can be overcome subsequently with a suitable anaesthetic technique. It is therefore a fallacy to think that nerve treatment is painful, as it often is no more unpleasant than filling a tooth.
Why would someone need root canal treatment?
The pulp or nerve of a tooth is confined in a chamber and a narrow canal (or canals, in the case of molar teeth). This nerve may be subjected to a host of external detrimental factors such as decay, deep fillings and accidental trauma, such as a fall. When one or more of these factors cause changes in the health of the nerve which causes pain or discomfort, then root canal treatment is often an alternative to extraction of the tooth.
Also, in many instances, a dead tooth with an associated abscess may be painless and the patient unaware of its presence. The dentist, on discovery of such an abscess, may suggest root canal treatment in preference to an extraction.
Is it worth going through so much trouble just to save a tooth, instead of extracting it?
If, in the dentist's opinion, a tooth is a strategic and useful one, then it certainly is worth the time and expense required for root canal treatment to save that tooth. Extraction may be a quicker and cheaper alterative, but seldom is it in the best interest of the patient. Often times, an extraction leads to subsequent problems, in the form of teeth over growing, drifting and general instability of the whole dental arch.
Is root canal on the molars similar to that on the front teeth?
In principle, root canal work is similar irrespective of the tooth being treated. However,
molars and other teeth, which have more than one root, have corresponding multiple nerve canals, which are usually much narrower and curved, compared with the single, wide and straight root canals of the front teeth. Instrumentation and cleaning of these multi-rooted teeth therefore is more difficult and requires more time, skill and equipment.
Are x-rays really necessary during the course of root canal treatment?
Yes, if proper root canal work is to be done. As such treatment is carried out entirely within the root or roots, which are not directly visible, guess work has no place in this field. X-ray may be required before and after treatment, but is certainly required during treatment, as the dentist has to know the exact length of the tooth he is treating as well as the number of roots and the size and shape of the roots canals.
After the first visit, when the pain has disappeared, can I just leave the root unfilled since it is not bothering me?
No, an unfilled root canal or canals, which may have been cleaned, is only treatment half done. The unfilled root canal predisposes to re-infection or a worsening of the condition of tooth and will definitely cause problems sooner or later. This is because seepage of fluids from the surrounding tissues into the unfilled root canal results in stagnation.
This fluid will eventually breakdown producing irritating by-products that prevent healing of the surrounding tissues. It is therefore important that you have the tooth root filled completely, even if it entails several visits to the dentist.
After a tooth has been root filled, with its nerve taken out, does it mean that I shall no longer feel any more pain from that tooth?
As the tooth no longer has a nerve supply within itself, you will not feel any pain or sensitivity from that tooth to such stimuli as cold, heat, sweet and sour. However, do not forget that the tooth is still supported by tissue and bone, which are very much alive. Hence, any infection of these supporting tissues will still enable you to feel pain or discomfort to such stimulus as pressure from touching or biting. In addition, infection of the gums surrounding that the tooth will also lead to a painful and sore tooth.
Will it be just as strong as my other teeth and can it decay just as my other teeth can?
If your root filled tooth has been well restored or filled or better still crowned, then it certainly will be as strong as other teeth in your mouth. It can and should function also as well as any normal live tooth but unfortunately can also decay just as any tooth can. Of course, there will not be the initial sensitivity or pain as the decay progress, the absence of which may be misleading. It will therefore be just as important to maintain and treat non-vital teeth as you would your other teeth, as these teeth have a vital role to play in your mouth.
How much does root canal treatment cost?
The fees vary with the nature of the tooth and the complexity of the case.
It may vary from about $200 for a simple front tooth to about $800 for a molar or back tooth.