Getting to the root of the problem...
Posted on 8th May 2019 at 08:20
Sadly, all too many people view their six monthly check ups at the Dentist with a certain amount of apprehension. Will anything be found and, if so, how much drilling is it going to involve? And that’s assuming they’re not one of the sizeable minority of people who don’t go to the Dentist for years – or even decades…
Given this, it’s not surprising that most people’s attention is firmly fixed on the likely pain associated with any dental work, such as fillings, rather than the procedure itself. As a result, it’s taken time for the potential dangers of amalgam – mercury – fillings to become better known and for people to consider the alternative of white composite fillings. While these may not be perfect – and don’t tend to last so long – they are now considered a safer alternative by many dentists. We wrote a blog post about mercury back in July 2015, which can be found here.
However, there’s another dental procedure that’s causing increasing concern and we’d like to focus on today. Root Canal Treatment. And, if the mere mention of that doesn’t make you squirm, we’d be very surprised!
While this treatment may be needed after trauma to a tooth – perhaps from a fall or a leaky filling – in the vast majority of cases it’s required because of an infection deep within the tooth.
It often surprises people to find out that teeth aren’t a solid as they thought. While the two outer layers are very hard – the enamel and dentin below – the innermost part of a tooth is very soft. Known as the pulp, it’s made up of connective tissue, nerves and blood vessels, all which help nourish the tooth.
And, as an aside, if you’d like a piece of trivia to drop into conversations, tooth enamel is the hardest tissue in the body. Given the pressure exerted on teeth when we chew even the softest food, this really isn’t very surprising.
As a physical barrier, the enamel protects the pulp from damage. This may be from the things we eat or drink – as well as their temperature – whether hot or cold.
However, where the tooth is physically damaged – perhaps by decay or a leaky filing – it’s becomes much easier for bacteria to gain access to the pulp. Once there, it provides a very hospitable home. Warm, dark and protected, with a plentiful food supply on tap courtesy of the tooth’s own blood supply.
And if you’re wondering where these bacterial come from, there are several different sources. Not only from food and drink, but also from the air we breathe.
Once any bacteria have settled in, they quickly multiply, causing damage to the pulp. As the infection takes hold, the pulp begins to die allowing the bacteria to spread further. With all this happening in a relatively small and contained area – and one that’s not immediately obvious until the infection has really taken hold – it’s easy to see why tooth infections are so deep seated and painful. And why drastic action can be required to remedy them.
What does Root Canal Treatment involve?
Without going into too many gruesome details (!), it starts with drilling through the flat crown of the tooth to gain access to the pulp. This is then removed and, if you’re unlucky enough for it to have gone as far as a dental abscess, it’s drained at the same time. The tooth is cleaned and its roots drilled out, so they can be filled more easily.
This work is done over several appointments, with the tooth being protected with a temporary filling between treatments to prevent any further damage. Finally, a permanent root canal filling is inserted and, if necessary, the top of the tooth may be protected with a crown. With a filled tooth being less robust than a healthy one, a crown is often needed to strengthen the tooth; particularly the bigger molars and premolars at the back of the mouth which are used to grind food.
Why are there concerns about this treatment?
Leaving aside its invasive – and painful – nature, the structure of a tooth makes it very difficult to ensure that the infection has been completely removed and the tooth is sterile BEFORE it’s filled. Depending on the tooth involved not only may there be several roots but these, in turn, have many miniscule tubules and side canals branching off them.
If any infection does remain, then it can quietly continue – usually without any symptoms, as the nerve is also removed during the root canal treatment – and then pass into the tiny blood vessels surrounding the tooth’s root. Once in the bloodstream, it enters general circulation and can then spread round the body. Unfortunately, antibiotics can’t help address this, as the tooth’s direct link to the bloodstream has been removed with the pulp during treatment.
While this can all sound rather “doom and gloom”, it’s often not appreciated just how adaptable bacteria are in response to changing conditions. They can shrink to fit into small areas, survive on tiny amounts of food and mutate so as not to require oxygen to live. This adaptability means that a treated tooth doesn’t pose much of a problem for them.
It’s now suggested that many chronic degenerative diseases may be linked to earlier Root Canal Treatment. These include joint problems, particularly Arthritis, as well as circulatory and heart disease.
What does this mean for Root Canal Treatment?
Well, as always, it’s about being aware of ALL the pro’s and con’s of ANY treatment before making a decision. While it may not be the preferred option, there is always the alternative of having a tooth completely removed.
And, if you suffer from a chronic degenerative disease, don’t forget to look at WHEN it started – or became worse. While symptoms don’t usually start to appear for a while after treatment, it’s amazing how often we hear clients saying that they haven’t felt 100% – or something seemed to change, even if they can’t put their finger on exactly what it was – since they had some dental treatment.
As always, the choice is yours.
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