At the center of each of your teeth is a hollow space occupied by nerve and blood vessel tissue called the dental pulp. This tissue was important to the tooth while it was forming providing nutriment to the developing tooth. Once the tooth was formed, however, the pulp is not a necessary part of a functioning tooth.
SOURCES OF TOOTH DAMAGE
If a tooth is subjected to trauma, damage can occur to the pulp. The sources of damage include the following:
Severe tooth decay.
Trauma to the tooth or its supporting bone. The tooth may be fractured or broken. Even if the tooth is not visibly damaged, the shock of trauma is often enough to injure the pulp.
Severe wear of tooth surface through attrition, abrasion or erosion.
Advanced periodontal disease.
Severely damaged pulp will die. The dead cells provide what is commonly called a pulpal abscess. Often times it will be accompanied by pain. A damaged pulp can also be sensitive or painful. Discomfort is not always immediate and symptoms differ for a live injured pulp or dead pulp. Information you provide us in conjunction with an examination and x-ray will provide the diagnosis in most cases.
Except when a fracture of the affected tooth makes it unrestorable, these injured teeth can be saved potentially for the rest of your life. To do this, the damaged pulp is removed from the tooth in a process call endodontics therapy or root canal therapy. When it is deemed necessary in order to preserve a tooth, this can be accomplished with little or no discomfort to you.
ROOT CANAL THERAPY
To treat a tooth with root canal therapy, a hole is made in the center of the tooth to allow the dentist access to the damaged pulp. Small instruments, called files, and a solution used to dissolve tissue is used through this access cavity to clean out the pulpal tissue that could provide nourishment to germs. Once the pulp has been removed to the tip of the root, the space previously occupied by the pulp is filled with cement, an inert material designed to prevent germs from accessing the tooth, which could cause future infection. In some instances, these steps may be carried out in a single office visit. Often, though, two, three, or more visits are required.
FEES FOR ROOT CANAL
Fees for root canal are determined by the number of roots in the tooth. This fee only covers the root canal therapy and does not cover the cost of restoring the tooth.
RESTORING THE TOOTH
Endodontically treated teeth all need to be restored following treatment. In some instances, this will be limited to a bonded filling in the access cavity. Often, the damaged tooth will require an inlay or crown to restore it to normal appearance and function. The American Dental Association recommends that all endodontically treated back teeth be protected with a crown or inlay because of the high incidence of fracture. In all cases, the restoring of the tooth is a separate and distinct portion of treatment from the endodontic therapy provided.
Dr. David Brother, DMD, FAGD
Lexington Dentist , Smiles By Design
57 Bedford Street, Ste 110,
Lexington, MA 02420