Tooth aches, cracks or any dental issues are uncomfortable that can make you fail to eat or even sleep, before you think of making a decision on whether to remove, fill your teeth, or opt for a root canal, it’s advisable to see a dentist for guidance.

Doctors say that root canals are needed for a cracked tooth from injury or genetics, a deep cavity, or issues from a previous filling.

Dr AbduKadir Mamataliev, a dentist at Deva Medical Center-Nyarutarama says that root canal therapy, also known as endodontic therapy, is a dental treatment for removing infection from inside a tooth. It can also protect the tooth from future infections.

He says that the process is carried out in the pulp of the tooth, which is the root canal and root canal treatment has a false reputation for being painful.

"A root canal is not a treatment, but part of a tooth. It is the hollow section of a tooth that contains the nerve tissue, blood vessels, and other cells, also known as the pulp. 

A tooth consists of a crown and roots. The crown is mainly above the gum, while the roots are below it. The roots attach the tooth to the jawbone,” he says.

Mamataliev states that the root canal therapy is done in three steps, and it takes between one and three sessions to complete.

The first one is ceaning the root canal where the dentist removes everything that is inside the root canal. With the patient under local anesthesia, the dentist makes a small access hole on the surface of the tooth and removes the diseased and dead pulp tissue with very small files.

He adds that the next step is filling the root canal, the dentist cleans, shapes and decontaminates the hollow area, using tiny files and irrigation solutions. Then, the tooth is filled with a rubber-like material, using an adhesive cement to seal the canals completely. After root canal therapy, the tooth is dead. The patient will no longer feel any pain in that tooth because the nerve tissue has been removed, and the infection has been eliminated.

And lastly, adding a crown or filling, here, the tooth will now be more fragile than it was before. A tooth with no pulp must receive it’s nourishment from the ligament that attaches the tooth to the bone. This supply is adequate, but in time, the tooth will become more brittle, so a crown or filling offers protection. Until the crown or filling is complete, the patient should not chew or bite on the tooth. Once there is a crown or filling is done, the person can use the tooth as before, he adds.

The dental expert notes that treatment often takes only one appointment, but if there are curved canals, multi-canals, or large infections, this could take one or two additional appointments.

How painful is it?

Mamataliev carries on that one of the great fears about this kind of treatment is that it will be painful, but the treatment that is carried out by a trained dental surgeon should be relatively painless. The pain that is felt comes from the infection and not from the treatment. The treatment does not cause pain; it helps to alleviate it. The dental surgeon will relieve the pain of the procedure by numbing the tooth and surrounding area with local anesthesia.

He says, after the treatment, some tenderness is normal. It is temporary, and over-the-counter (OTC) pain medication may be enough to relieve it. If needed, prescription drugs, such as codeine, are available. The dentist may prescribe an antibiotic to treat or prevent infection.

Who needs a root canal procedure? 

The dentist stresses that if the pulp becomes injured or diseased, it cannot repair itself, and the tissue dies. If there is a deep cavity, a cracked tooth, or a loose filling, bacteria can enter the pulp. The bacteria will eventually destroy the pulp. If the bacteria penetrates through the root openings, it can cause an infection in the bone. An infection will weaken the bone and break it down. The ligaments around the tooth will swell, and the tooth will become loose.

He explains that a pulp injury will make the tooth sensitive to high and low temperatures. There may be pain when chewing, and some people have a continuous, throbbing pain. Without treatment, the infection will spread. Eventually, the tooth will become loose and need extracting. Some patients opt for extraction, especially if it hurts a lot or if the tooth cannot be restored, for example, if there is large decay, trauma, or loss of bone due to periodontal, or gum, disease.

However, for him, removing a tooth may mean that the surrounding teeth start to move and become crooked. This can look unsightly, and it can make it hard to have a good bite. Root canal therapy will usually save the tooth and eliminate the pain.If the tooth cannot be saved, the next best option is an implant but saving the natural tooth is best, if possible, because nothing functions as well as a natural tooth.

Complications

Mamataliev adds that just like any procedure, complications can occur. Sometimes the dentist only finds three root canals in a tooth that has four. If one canal remains untreated, the infection might continue and spread into the bone. The dentist must also make sure the filling material goes far enough into the canal, to fill it up. If the root canal is not properly sealed, the infection could return.

He highlights that during the procedure, the root of the tooth may crack, or the instruments can break in the canal or perforate the canal. This makes it hard to fill the tooth effectively. If complications occur, a specialist can try to correct the problem and complete the root canal. To avoid complications, patients should always follow the dentist’s instructions. If an antibiotic is needed, it is important to finish the entire prescription. It is also essential to have a permanent restoration placed, such as a crown, once the root canal therapy is complete.

Prevention

Dr Gilbert Nuwagaba, an Adult and Paediatric Dentistry specialist says that good oral hygiene is necessary to keep teeth and gums healthy, prevent tooth decay and gum disease. This can be  through habits such as brushing twice a day and having regular dental checkups.

He urges brushing regularly and gently since brushing too hard or using a hard-bristled toothbrush can damage tooth enamel and the gums. 

He also notes that using fluoride helps prevent cavities, this is a common ingredient in toothpaste and mouthwash.

Nuwagaba adds that flossing at least once a day can remove plaque and bacteria from in between the teeth, where a toothbrush is unable to reach and removes food remains thus averting bad breathe.