Mark came in with a severe tooth ache, and after an examination, I could see the tooth was severely broken down. The basic options were to either save the tooth – going through root canal therapy and finishing with a post and crown restoration, or to remove the tooth and restore with a dental implant and crown. “Should I save my tooth, or should I pull it!” This is the eternal question!
Root canal therapy (also known as endodontic therapy) is a procedure of treatment for the pulp of a tooth once it has become infected – the inner pulpal material must be removed, in order to protect and decontaminate the tooth from future microbialinvasion to the jaw bone. Once a root canal procedure is performed, however, the lack of nutritional supply in the tooth (once the organic tissue is removed from the tooth during the procedure) will render the tooth brittle, the weakened tooth should be reinforced and restored properly, with a post and crown.
Root canal treatment does have a bad reputation due to the pain and the stigma associated with the procedure. Often times, a patient will have a root canal performed and think the procedure was a success, only to have pain and infection return several years down the line. The complexity of the anatomic root variation could be an obstacle and techniques can often be tedious, which is why specialized service is usually performed by a highly trained dentist or endodontist. Special tools like microscopes are also often necessary for a successful procedure. Advanced instrumentation and technique will ensure long-term success.
Regular dental checkups are vital to properly maintain your dental health. If the unhealthy dental condition requires a root canal treatment or an extraction, have your dental professional explain the pros and cons of each option, then make an educated decision. If there is a mystery pain, a 3-D image (Morita Survey of CT scan) would be invaluable for proper diagnosis. Regular dental x-rays are not capable of capturing images of a cracked tooth nor accessory root canals (which are small and difficult to see). These tiny cracks or canal issues can lead to prolonged discomfort, which you may have thought was a figment of your imagination! If the prognosis was poor, or a tooth has broken down so much that it has become unrestorable, extraction and a dental implant might be a more sustainable investment to you dental health. Prevention is always the best treatment! Brush and floss your teeth twice daily and after meals. If you have any dental pain, schedule an appointment with your dentist sooner rather than later.