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Root Canal

What is at the apex of an infected tooth? Part 1.

How can a tooth ?die??

A tooth loses its vitality due to many reasons. Most often, it is due to tooth decay and bacteria reaching into the pulp chamber, causing an infection and the eventual death of the nerve.

Other reasons could be trauma to the tooth (acute or chronic), too heavy forces used while wearing braces to move teeth and severe gum disease.

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What happens if there is an infection of the tooth?

The term ?canal? gives a misrepresentation that the root canal itself is cylindrical and straight. In reality, the root canal is all-sorts wonderful: curved, branched, tortuous, narrow, bent. When bacteria reaches into the root canal, it has a multitude of nooks and crannies to hide and breed as the enclosed area of the tooth offers protection away from the immune cells of the body. This infection can also spread out of the tooth as the root canal(s) communicate with the outside area through small openings.

Depending on the bacteria and spread, it can be walled off at the tips of the root or spread away to an area wider than the root itself.

Sometimes, patients complain of a ?pimple? on the gums – this is the infection spreading from the tips of the root through to the mouth.

What is a root canal treatment?

Root canal treatment aims to remove all the dead tissue, nerve, bacteria and toxins within the root canal. It aims to remove bacteria and the environment suitable for bacteria to breed in. Also, it aims to ?entomb? any remaining bacteria that cannot or was not removed during treatment. This is done through meticulous instrumenting, flushing with antibacterial and sealing it with an inert material. Repeated courses of cleaning and re-sealing the root canals with a temporary dressing is sometimes done to ensure that all the bacteria is removed.

However, not all the bacteria can be removed as there are many sites inaccessible to cleaning i.e. the branches off the main canal.

Some research show that up to 95% of bacteria can be removed. So what happens to the remaining 5% (or so) bacteria? And what happens to the infected tissue around the roots of the tooth?

Stay tune tomorrow to find out.