Inside the hard tissue of each tooth lives the source of vitality for each tooth. There is space called a chamber inside the hard structures of a tooth, and that chamber houses the blood supply and nerve supply of the tooth. Sometimes the nerve of the tooth becomes infected and ultimately dies. When this happens, the blood and nerve supply and any infection in the tooth must be removed and cleaned out. The chamber extends via narrow canals down the tooth and into the roots of the teeth. When root canal therapy is needed, the chamber and the canals in the roots are cleaned, disinfected, and shaped so that an inert material can be placed in the canals to seal the tooth and allow any infection that may have spread into the dental bone to heal. This procedure is called a root canal therapy. It only treats the nerve and any remaining blood supply to the tooth. Once decay or infection has entered the chamber, a root canal therapy is the only way to treat this problem, other than extracting the tooth.
Sometimes there are no symptoms at all, and the infection is seen on an x-ray as a dark area at the tip of the root. Other times, there’s a toothache to deal with – there can be spontaneous pain, and pain to hot and cold and chewing. Of course we want to save the tooth, so we do a root canal therapy. But then what do we have to do for the tooth? Depending on the cause of the root canal, sometimes there is enough tooth structure remaining so that only a small filling is needed to close the opening where the doctor entered into the chamber to perform the root canal procedure. However, sometimes the tooth has died because of trauma that has fractured or broken tooth structure, or most times, the tooth has had extensive decay that entered the tooth nerve chamber and also destroyed a significant amount of the tooth. When enough tooth structure has been destroyed by decay or trauma, a dental crown is needed to restore the original form and function of the tooth.
It’s also important to note that sometimes so much tooth structure has been lost, that the dentist has to create a substructure onto which a crown can be cemented. This is called a post and core. The post goes into the root canal as a support for a core onto which a crown is fitted and cemented. When significant tooth structure has been lost, these restorative procedures are needed.
Teeth that have had root canal therapy obviously can be functional, however, they are dead. Because they are dead, they tend to be more brittle and susceptible to fracturing. This is another reason to crown a tooth after having root canal therapy – to protect it from fracture. It is a shame when someone has saved a tooth with a root canal therapy only to lose the tooth in the future because they didn’t have the tooth protected with a crown. If a tooth fractures vertically, it cannot be saved and must be extracted.
We hope this information has been useful to you and invite you to visit DrTav.com for more dental information, or call us at 973-761-5090.