|What causes tooth decay or dental
|The main cause of dental decay is dental plaque,
a thick sticky substance that collects on the surface of the
tooth. Dental plaque is made up of large amount of bacteria,
food particles and salivary products. If food, especially those
rich in sugar/starch is left in the mouth, bacteria act on it,
breaking it down into acids. These acids then soften and dissolve
the minerals of the tooth, producing microscopic cavities on
the surface. Over a period of time, with repeated acid attacks,
a chalky white spot develops (first visible sign of decay).
Eventually the spot develops into a cavity. This cavity will
collect more food particles and lead to further destruction
and larger cavity.
|Does every decayed tooth/cavity need
|If left untreated, a cavity would continue to
enlarge in size (both width and depth). In time, bacteria will
reach the tooth pulp causing toothache and infection. A cavity
has to be filled in the initial stages to preserve the remaining
healthy tooth and prevent complications. If left untreated,
a root canal treatment may become necessary to save the tooth,
or in rare cases, the tooth may have to be extracted.
|What conditions necessitate a Root
|Dental decay, fracture of tooth or loss of filling
could lead to contamination of the dental pulp by bacteria.
Dental pulp is a small chamber that contains the nerves and
blood vessels of the tooth. A bacterial invasion will affect
the blood flow to the tooth. In such situations a root canal
procedure is carried out to clean the pulp off the bacteria,
and to fill the pulpal space with special filling material.
The aim of root canal therapy is to save the tooth in which
the pulp has been damaged. The alternative would be a tooth
extraction (removal) and replacement of the tooth with an artificial
|What are the symptoms that indicate
the need for root canal treatment?
|| Moderate to severe lingering tooth
ache when having hot or cold foods.
|| Tooth ache that worsens in the night or while
|| Pain in the tooth or in the gums when chewing
or biting (sometimes pain spreads to other areas of the jaws
|| Swelling of the gums and tenderness of the tooth
|| In extreme cases, a severe infection may result
in high temperature and/or red and extremely painful swelling
of the face.
|| In rare cases, there will be no visible or obvious
|How is a Root Canal treatment done?
|First, the pulp chamber is accessed by making
a hole in the tooth. In case of painful teeth, the area is anaesthetized
before the procedure. Next, very fine, delicate and sterilized
instruments called files are used to clean and shape the root
canals. Then, the shaped, sterilized canals are filled using
a biocompatible, inert material and the hole on the tooth surface
is sealed. Finally, the treated tooth is crowned to prevent
further damage. In most cases, the treatment is completed in
a single sitting. In cases where the root canal is severely
infected, a medicated dressing is placed in the pulp canals
to disinfect the same. Such situations may call for two or three
visits to the clinic.
|Is root canal treatment painful?
|The actual procedure in itself is not necessarily
painful. In cases with hypersensitivity/ symptoms the procedure
is done under local anesthesia, wherein a local anesthetic is
injected to numb the area that is being treated. This ensures
that the patient feels nothing. In cases of severe infection,
antibiotics are prescribed to control the same and consequently,
the pain. Usually, pain, if any, is felt only before treatment,
caused by the infection, rather than during the procedure. For
a few days after treatment, the tooth may feel sensitive, especially
if the infection had been severe. If so, painkillers or even
antibiotics may be prescribed.
|What is root canal re-treatment and
why is it done?
|In some instances, infection remains in the root
canal system even after a root filling has been performed. In
such cases, a root canal re-treatment may become essential.
The existing root filling is removed and in its place, a new
and better root filling is placed to eliminate any spaces.
|In rare cases, root canal treated tooth may get
re-infected due to the following reasons:
|| Filled root canal is exposed to
bacteria and saliva due to new decay or a loose/broken filling
causing an infection.
|| Root canals are complex and often there is more
than one canal in each root. Some canals are extremely difficult
to reach and may be missed even with sophisticated instruments
leading to infection.
|| Tooth with curved roots or with very narrow
root canals, may pose difficulty in cleaning the canal and sealing,
rendering it susceptible to re-infection.
|| Root canal treatment may fail if the treatment
has pitfalls in cleaning and sealing procedure.
|For re-treatment of a root canal, the tooth is
reopened by removing the old filling and the canals are re-cleaned
and refilled. Some cases may require surgical intervention in
case of non-possibility of sealing the canal adequately.
|Teeth, which are extensively damaged by decay,
excessive wear or fracture, need to be brought back to their
correct shape to facilitate function. For instance, a root-canal-treated
molar tooth, which aids in chewing, is crowned so as to avoid
further damage by fracture. This is achieved by remaking the
outer portion of the tooth with an artificial material. This
“total covering” of the tooth using artificial material
is termed as a crown. A crown can be fabricated with different
materials depending on the patient’s need, area in question
and the function. The common materials are metal free ceramic,
porcelain fused to metal, or full metal.
|In cases where one or more tooth is missing,
a bridge is fabricated to replace and rehabilitate the missing
teeth. A bridge is therefore a fixed artificial teeth prosthesis
(which cannot be removed by the patient), which is supported
on either side by strong, healthy teeth. Basically a bridge
has two or more crowns, attached to adjacent healthy teeth and
artificial teeth known as pontic.
|What are the symptoms of gum disease?
|| Gums which bleed either spontaneously
or when brushed and/or flossed (Healthy gums DO NOT bleed).
|| Swollen, red or puffy gums (Healthy gums are
firm, pink and adhere tightly to the teeth and bones).
|| Bad breath or a constant bad taste in your mouth
(Diseased gum tissues release volatile sulfur compounds which
contribute greatly to halitosis).
|| Tartar build-up on the teeth.
|| The gumline going down towards the root surface.
|| Loose or shifting teeth and a change in the
way the teeth fit together.
||Mild, disturbing pain in the gum with occasional
swelling in the gums.