The majority of patients are content knowing that an infection is involved in causing the pain in their teeth and is advancing their decay. When you’re received by an endodontist following a referral from a general dentist, we work to ensure that we determine which of the techniques at our disposal are appropriate for treating your concern. This requires an understanding of the source of your symptoms and the specific details of your infection. Here we’ll explore some pulp-affecting conditions and the treatments we use to manage them.
The Paths Taken By Infection To Get Into The Pulp
There are numerous strains of bacteria that can be found in our mouths, each of them having a different relationship with the environment they live and die in. Some of these bacteria actually work to protect our teeth, while others are neither harmful nor helpful. The remaining, mostly streptococcus mutans, play a direct role in the advancement of tooth decay and conditions like gingivitis. Regular dental hygiene, along with visits to your dentist twice a year, can generally keep these pathogens under control.
When trauma, poor dental hygiene, or an aggravating medical condition allows these bacteria to get into your pulp, an infection can form. Treating these infections can be particularly difficult due to the tenacity of these organisms and the ease with which they can reinfect. Without treating the conditions surrounding the infection can lead to tooth and bone loss, and the infection can even move into your bloodstream. Infection most commonly gets into your pulp through the following avenues:
- Dentinal Tubes: Lesions that form in the mouth due to the development of cavities can give bacteria access to the porous dentin beneath the enamel. This material has tubules in it known as dentinal tubes that provide access to the sensitive pulp within your teeth.
- Open Cavities: When trauma or cavities result in openings in the tooth, the protection provided by enamel and dentin is compromised. Bacteria will therefore have direct access to the sensitive inner pulp.
These are the two primary ways by which bacteria can get into the inner tooth and cause the pulp to become diseased. While a general infection is the most common ailment that affects our dental pulp, there are a collection of others that may require an endodontic specialist. These diseases include:
- Reversible Pulpitis – This refers to general inflammation of the pulp, often causing pain or discomfort when eating things that are at an extreme temperature or are very sweet. This condition can advance to an abscess if left untreated, which generally requires a filling. While good dental hygiene can reverse it in some cases, more care is often needed.
- Irreversible Pulpitis – When the inflammation of the pulp becomes severe, it often reaches a point where it becomes untreatable by conservative means. It also can put you at risk of infections of the connective tissues and gums that can become widespread. A root canal treatment is the most frequently used procedure in addressing this condition.
- Dental Pulp Calcification – This condition involves the gradual hardening of the pulp tissue until it begins to compress the nerves within the tooth. This can result in extreme pain and hypersensitivity due to the compression of the nerves. A root canal treatment is typically necessary to remove the hardened tissue.
- Dental Pulp Exposure – This occurs when the enamel and dentin of the tooth become cracked or fractured. The previously protected pulp is now exposed to environmental factors, including acids from foods, temperature, bacteria, even wind from breathing. Each of these and more can result in extensive pain and may require a root canal treatment to address.
While there are multiple conditions that cause some of the above dental problems, all of them share one thing in common. The exposure of the sensitive inner pulp to environmental factors or bacteria results in excruciating pain for the patient. In the best case, the infection can be addressed and the tooth repaired without impacting the integrity of the pulp. When that is impossible, it’s necessary to take more aggressive action, often starting with a root canal treatment.
What Is A Root Canal Treatment? How Does It Help Pulp Conditions Like These?
In cases where the pulp cannot be returned to a healthy state and the tooth sealed to protect it, the only option is to remove the offending tissue. Without doing so, the infection can spread to your other oral structures, ultimately impacting the integrity of your teeth, gums, and even your jawbone. In severe enough cases, the infection can get into your bloodstream, which can be potentially fatal. This is what makes root canal therapy such an important method of treatment. When you undergo RCT, you can expect the following steps to be involved:
- First Visit – During your first visit, you’ll undergo an exam and imaging that helps the dentist prepare a plan to treat the affected tooth or teeth. In many cases, this will be followed by the scheduling of a second appointment to begin treatment.
- Second Visit – During this visit, they’ll remove the infected tissue, clean out and enlarge the root canal, and properly disinfect the internal area to prepare for sealing the tooth. Your tooth will either be left open to drain or will be sealed against infection depending on the particulars of your condition. In some cases, you’ll be provided with an oral antibiotic to take between visits to combat existing infection.
- Third Visit – During your third visit, a permanent filling will be put in place to seal the tooth. You may be called back for a fourth visit to place a crown to strengthen and finish out the treatment, or it may happen at the same visit as the placement of the permanent filling.
If you have any additional concerns about root canal treatments and if the symptoms you’re experiencing can be treated with one, call your endodontic specialist or dental practitioner today. They’ll provide you with a consultation that will explain the current state of your oral health and provide options for treatment.