Our teeth are hollow and at the center of your tooth is pulp, otherwise known as the “nerve.” The pulp is a collection of blood vessels that helps to grow the surrounding tooth. It is comprised of blood vessels, lymphatic systems, innervations, and connective tissue. Without these tissues, teeth would never form. Once your tooth is formed, however, the pulp serves no developmental function. Yes, that is true. You don’t need the nerve to keep your tooth. Its real job is to tell us when we have damage to the tooth or the pulp itself. The health of a tooth does not depend on a living pulp. It depends, instead, on a healthy and living attachment (the periodontal ligament) to the surrounding bone.
Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature and biting, or spontaneous throbbing pain radiating to other parts of the jaw and facial structures like your ear or your temple. Root canal treatment successfully replaces the damaged delicate root canal system with an inert pulpal filling material. The damaged pulp is microscopically removed and the canals are prepared with measurable precision, disinfected with multiple irrigating solutions, and then freshly sealed with an inert three-dimensional filling material.
With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or continue to cause pain. This may occur from a new cavity approaching the root canal filling, a crack in the tooth, missed anatomy, anatomy that is physically impossible to mechanically cleanse, or a resistant infection. Sometimes, the pain may occur months or years after treatment. If so, endodontic retreatment may be needed. The existing root canal filling is microscopically removed and rechecked for any missing anatomy, re-disinfected with multiple irrigating solutions, possibley medicated, and then sealed with new filling material. This may be a frustrating event but it is a successful way to save your tooth from extraction.
Generally, a root canal or root canal retreatment is all that is needed to save teeth with an injured pulp from extraction. Occasionally, a nonsurgical procedure will not be sufficient to heal the tooth and surgery may be recommended. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on X-rays or under the microscope but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection. The root tip and attached infected tissue is physically cut off, removed, and then sealed microscopically. The procedure is similar to gum surgery or a surgical extraction.
Internal bleaching is a technique that is used to whiten the appearance of teeth from the inside of a tooth. Internal bleaching is conducted under the direction of a dentist.The process for an internal bleaching involves the insertion of a bleaching agent inside the crown portion of the tooth. A root canal is necessary for internal bleaching. The agent is left in the tooth for up to two weeks, and then replaced with more bleaching agents until the tooth achieves the level of whiteness desired. Once the series of treatments are complete, the hole is filled, ensuring that foreign matter will not be able to invade the tooth. It is a conservative way of improving the esthetics of your front teeth without crowns or veneers.