Why Does It Happen?

The causes of damaged or dying pulp are plenty. The most common causes of pulp dying are a cracked tooth, a deep cavity requiring large fillings, or traumatic injuries to the tooth, all of which may allow bacteria and their products to enter into the pulp.

Why Should It Be Treated?

If the infected pulp is not removed, infection can spread to the tissues surrounding the root, and lead to additional pain and swelling. Left untreated, a build-up of pus occurs at the root tip in the jawbone, forming a “pus-pocket,” called an abscess. An abscess, often very painful, can injure the bone that anchors your tooth in your jaw. Without treatment, your tooth may have to be removed. There are downsides to losing a natural tooth, however. When a tooth is removed and not replaced, the nearest teeth may begin to shift from their normal positions, causing them to appear crooked or crowded. Such rearrangement makes biting and chewing more difficult, and leaves the gums more susceptible to disease because they are more difficult to keep clean than straight teeth. Replacing the tooth with an implant or bridge is usually more expensive, and can involve more extensive dental procedures.

How Can It Be Treated?

Dentists or endodontists (specializing in matters of the dental pulp) use root canal treatment to find the cause and then treat problems of the dental pulp. Years ago, teeth with diseased or injured pulp were removed. Today, root canal treatment has given dentists a safe way of saving teeth. The following steps describe how this procedure is carried out:

1. First, local anaesthesia is usually given to make treatment more comfortable for you.
2. To isolate the tooth, the dentist will use a dental dam, which is a thin sheet of latex rubber or plastic, to keep the tooth dry during treatment.
3. An opening is made through the crown, or top, of the tooth. The opening will reach down into the tooth’s pulp chamber.
4. The pulp is then removed from the pulp chamber, and the root canal(s) (between 1 and 4, depending on the tooth and individual) are cleaned, enlarged and shaped.
5. Your dentist may apply medications to the pulp chamber to help get rid of germs and prevent infection.
6. To protect the tooth between dental visits, a temporary filling is placed in the crown opening. Your dentist may leave the tooth uncovered for a few days to allow it to drain. You may also be given medicine to help control infection that may have spread beyond the tooth.
7. The pulp chamber and root canal(s) are filled and sealed.
8. The temporary filling is removed and the pulp chamber and root canal(s) are cleaned and filled.
9. In the final step, a gold or porcelain crown is usually placed over the tooth. If an endodontist performs the treatment, he or she will recommend that you return to your family dentist for this final step.
10. The crown of the tooth is then restored.