RCT treatment

RCT treatment

Most people indicate that toothache is the most unbearable, dramatic, and undoubtedly the worst pain they have ever dealt with… After labor pain, of course!

The excruciating pain that numbs your nerves makes you unable to talk and just rush to the dentist.

Mostly in such instances, the dentist will perform a root canal treatment for you. After the procedure is over, you head back home, relaxed and assured that the pain would not return. You promise yourself regular dental checkups to never face such blinding pain again.

But slowly and steadily, the pain surfaces again. The same trauma, and again you visit your dentist, more discouraged this time.

Is it a stage of recovering from root canal treatment?

You question him, how is this possible?

Well, there are a multitude of reasons for that!

Firstly dental pain is a typical onset after an RCT treatment. Minor sensitivity and discomfort is not an unusual incident. However, if the pain resides for more than a week, then you have a reason to worry about it.

The ‘return of your pain’ may be due to a variety of reasons.

Post-operative pain can be irksome for both the patient and the dentist.

The goal of endodontic treatment is to seal the tooth to avoid the entry of bacteria. Pain and flare-up ( inflammation after an endodontic procedure) are commonly experienced in many patients.

However, severe pain after root canal treatment can be a sign that all is not right.

The integral part of endodontic treatment is the prevention and management of any post-operative pain.

Studies reveal that the frequency of severe pain after RCT ranges from 1.4% to 16%. It may go up to even 50%

Fact- The degree of preoperative pain majorly dictates the occurrence of your post-operative pain!

Reasons for severe pain after root canal treatment

Tooth pain after root canal treatment can further be subcategorized into;

  1. Chemical factors-
  • Overextended filling material

Overfilling the material in the canal induces irritation to the tissue. It also hinders the repair of the periapical tissue( tissue surrounding the apex of the tooth).

Another problem caused by overextended filling is when it hits the opposite tooth with constant force. In this case, your dentist has to remove the ‘high points’ of the tooth.

  • Irrigants-

The standard irrigant used by dentists during an RCT treatment is sodium hypochlorite. It has antimicrobial properties that help in cleansing and disinfecting the root canal. In rare cases, the solution may leak out and reach your root tip, causing you pain.

  • Intracranial medicaments-

There has been worldwide use of calcium hydroxide as a medicament during endodontic treatment. Calcium hydroxide has the caliber to inactivate the bacteria that is infesting in your root canals.

However, the researchers now believe that patients given calcium hydroxide during the treatment show aggravated pain levels after the procedure.

  1. Mechanical factors

  • Missed canal

The canals present in the tooth are incredibly minute. They can be challenging to detect, especially the ones of the molars.

There is a possibility that the dentist may overlook one of these infected canals, leaving behind a few nerves or a pocket for the bacteria to enter.

After the procedure, you might feel sensitivity to hot and cold as it was preoperatively( if nerve endings are left behind). In case of bacterial infection, there will be sensitivity to pressure.

  • Infection in lateral or accessory canals

The curved and narrow canals that branch out of the primary root canal are the accessory or the lateral root canals. During the procedure of RCT, these canals are challenging to detect due to their minute and complicated network of branches. If your dentist suspects an accessory canal, he may go for a more detailed CBCT test instead of the standard X-ray to detect the presence of these canals.

If the infected accessory canals are overlooked and not cleaned, this may cause postoperative pain.

  • Extrusion of debris

Endodontic instrumentation can cause extrusion of debris in the apical region(dental shavings, microorganisms that get accumulated in the root apex during the shaping of the canal).

Studies revealed the real cause of the inflammatory reaction is due to the instrument design and the type of movement done.

  • Infection in root canal

At times, the filling might leak, allowing the bacteria in your saliva to infest on the edges of the filling. When the bacteria makes its way inside the root canal, an impending pain is caused within a few days after the procedure.

  • Cement or air present in the root tip

Due to overfilling of the material, the cement may ooze out of the root tip.

If before the RCT treatment, the root tip was not infected, the settling of the cement now will cause pain.

In rare cases, air may be forced down into the root tip, causing pain and pressure.

  • Over instrumentation

Inflammation may occur as a result of the root canal files. If the dentist pokes the area way beyond the tip of the tooth or if the file breaks and gets lodged in the canal, this can be a cause of pain.

Also, if the surrounding tissues are traumatized with the use of the instruments, an inflammatory reaction is a common sign. A good dentist, however, does everything in his control to prevent this situation.

  • Improper removal of pulp

A standard root canal is 15 mm to 25 mm in length. But, some canals may be as deep as 30 mm. Reaching to such levels can be really difficult and needs the help of special instrumentation. If your canal is treated short of its actual length, then the diseased pulp is not entirely removed, and since the sealant is applied directly over it, this might be why few patients register pain.

  1. Microbial factors

Microorganisms are regarded as the most common cause of pain after an RCT treatment because flare-ups mainly occur in necrosed tissues rather than in vital cases.

Few other factors responsible for pain are

  • Gender

Women are considered to suffer from post-endodontic pain more than men. Studies show that female patients are more sensitive in receiving a root canal treatment. The reason is due to the difference in fluctuating hormones like cortisol, serotonin.

  • Type of teeth

The incidence of pain after RCT is higher in mandibular( lower jaw teeth) than maxillary teeth( upper jaw teeth).

This happens as the mandible has a lower density trabecular( interconnecting plates found in spongy bones) pattern, causing reduced blood flow, more localization of infection, and delayed healing patterns.

  • Negligence of patients

It is of immense importance that proper oral hygiene is maintained after an RCT treatment. All the advice given by the dentist has to be followed precisely. If oral health is not maintained, there is a chance of postoperative pain due to bacterial infection again.

Another potential cause of pain is when there is a crack in the RCT tooth. After the procedure, the tooth in which the RCT has been done is quite brittle as the blood supply to the tooth has been filled in. If caution is not taken and there is a forceful impact on the tooth, then a crack may develop.

  • Talk to your dentist!

Facing the same dilemma of pain postoperatively can be very apprehensive. It is essential on your part to maintain good oral hygiene and follow all the said advice of your dentist.

When it comes to the mechanical fault of a dentist, you can now put all your worries aside because, at Cosmodontist, we make sure that you do not have to face the same pain again.

To get rid of your pre or post-operative pain. Call us right away at +8368774211!

RCT Treatment

RCT- The best way to save your tooth!

Awareness is the key to progression.’ The general outlook of every individual today is that they are either too caught up in their work or reluctant to visit their dentist every 6 months. But, the truth be told, this is a highly derelict step that one can take for himself.  

From time and again, the banner of awareness for dental health care and hygiene has been put up. Free dental camps are organized to get a complete diagnosis done to help maintain good oral hygiene. However, people have still turned a ‘bind eye’ to the dangers that a minor toothache can cause. Yes, the teeth are present in a very small area in our body. Moreover, ‘a problem area,’ in one of those teeth, becomes even more meager, for our attention to getting drawn there. But, gear up; it is time that you yet again know what an aggravating toothache brings for you.

Did you ever feel the excruciating pain that runs from the sides of your jaw, all over, reaching to your head? The radiating, throbbing pain!  That is just the ‘real beginning’ to it. A tooth pain that is ignored for a long time tends to spread the infection to the jaw bone or even the brain! So, let’s face it, a minor toothache has the potency to make you undergo surgery, which of course, will not be a pocket-friendly step for you( the trauma of surgery kept aside).

What can be done then? Well, it is as simple as it sounds, visit your dentist to avoid the spread of infection up to that extent.. 

Understand your tooth-

The teeth comprise majorly of three layers… The enamel, dentin, and pulp. If infected, the bacteria in the teeth slowly sloughs away the enamel. You may not feel any pain at this step; after all, the enamel is the hardest substance in the body! But, as everything grows, the bacteria, too, proliferates into the dentin. This is when we experience what we commonly term as tooth sensitivity. Small problem! So we subside it and carry on with the everyday work. But, stop and take a look into it. Your tooth has been infected, and it has been washed away from its primary protective layer. Now is the time to talk to your dentist. When the bacterial attack is at the dentin level, we go for a restoration, i.e., excavating the bacteria out and then sealing it with restorative material like amalgam or composite.  

Sadly, most people do not take this step. They forbid themselves from going to a dentist which ultimately,  results in the growth of the bacteria deeper into the pulp.

 Did you know, pulp consists of nerve endings and blood vessels making it a vital part? 

The leaching of the bacteria to this layer now causes acute or chronic pain in patients, depending upon the time the bacteria has been infesting upon your tooth. Not only pain but sensitivity to both hot and cold water. Gradually, the pain gets to a level where it cannot be endured. Patients now go and knock on the door of a dentist. Yes, already enough damage has been done, but unaware of that, few patients worsen the situation by opting for an extraction. Well, that is a different picture altogether. But, before going there, let’s ‘fill your ears’ with the benefits of root canal treatment( suggested by dentists and the preferred treatment for you).

What is root canal treatment? 

Rct or root canal treatment is when the tooth is excavated, taking out the debris, bacteria, the infected pulp through the help of different sized files and then finally sealing it with cement to restrict the entry of bacteria again. 

Fact: Microscope is used at times during Rct. This is done to see the complex anatomy of root canal opening.

Rct is that intricate as a procedure. This does not make the work of the dentists any easy, but it is recommended only for the betterment of the patient!

So next time your dentist suggests RCT treatment, know that you need it.

Afraid of RCT instruments?

To access root canals, to work precisely on small areas, dentists use tools that are efficient to function minutely. 

Often, hesitation towards dental treatment may come from the drilling noise of the aerator or the sharp instruments. 

The instruments are made in such a way that they work at micron levels. Since the canal openings are very tiny, the tools required to access them have to be precise. This time before panicking, seeing the tools, know that they are manufactured to clean and shape your root canals!

The list of instruments used in RCT are:

  • Explorer– Root canal explorer is used to explore the tooth and to find the orifices.
  • Excavator– To take out dead tissues from inside the tooth.
  • Endodontic burs– To open the inside of the tooth so that the canal can be reached.
  • Files– It helps to open and widen the canals 
  • Reamers– It helps to remove the cement, gutta-percha during the treatment. 
  • Barbed broach– The majority of dead tissues are removed with the help of a barbed broach.
  • Drills– It opens the canal more expansively and is used mainly for the molars. 
  • Ball burnisher– Helps to seal the cement.

Root canal treatment steps-

The root canal procedure takes place by,

  • Preparing the area-

Local anesthesia is not always required when the pulp is wholly necrosed. But whatsoever, it is an important step. Anesthesia is contraindicated in acute inflammation and when the pH of the soft tissue is acidic.

After anesthetizing the area, the tooth is isolated with the help of a dental dam.

  • Accessing and cleaning the roots-

An access opening is made on the tooth, and also the flattening of the occlusal surface is done, just in case to avoid trauma( occlusal flattening is done only in a few cases).

  • Shaping the canals-

The orifices of the canal are located using 6,8,10,15 numbers of files in increasing order. As the files are already tapered, an automatic conical-shaped canal is made during the root canal preparation. 

Radiographic images are obtained at every step to prevent the perforation of the canal and see the depth of the file that has gone inside the canal. Once the file reaches the apex, the preparation is complete.

Barbed broach is used to take out the necrotic tissues of the pulp.

Irrigation of saline and sodium hypochlorite is frequently done, almost at every step, to keep the canals clean.

  • Filling the canals-

The cement, gutta-percha, is made to snugly fit the canals which have been freshly prepared. 

Fun Fact- Gutta-percha is extensively used to fill root canals. In dentistry, this cement has established itself as a gold standard. Many materials have been tested to work as endodontic filling, but none accomplished the task as efficiently.

  • Filling to the access hole-

A ball burnisher is taken and made red hot before sealing the gutta-percha into the canal

The patient is called for the next appointment, where a permanent sealant is provided.

Also, measurements for the crown are taken, which are placed over the tooth, for more extended durability.

Rct is a multiple sitting procedure, but nowadays, single sitting painless Rct is gaining much recognition.

However, patients have always been inclined towards extraction more than Rct.

Is it the correct decision or not?

Let’s break down the reality to you!

What is a better option? RCT or extraction?

People have this preconceived notion that Rct is a painful procedure. Now, reluctance has to have a direction, right? Not knowing is one thing, but wrong assumptions can have terrible consequences. Many times, patients report a dreading toothache and want to get the tooth removed. However, the truth is that Rct is a way better option than extraction. Dentists these days have gone about saying to ‘save a tooth.’ Why? Because, what can be anything better than your natural teeth? There is no perfect replacement for it! Dentists make their patients conscious of this fact every time!

Fact or Myth?

Rct is painful! 

This claim is downright false. Root canal treatment images, ads, anything can make you assume that the procedure is painful. But, this is untrue. Rct is done under the effect of anesthesia. This numbs our sensory organs, thus, making us unable to face any pain.

Extraction is more cost-effective!

Isn’t this statement ‘too good to be true?’ An extraction requires the complete removal of the tooth. When this is continued, and the person, alas, becomes ‘toothless,’ he or she has to go for a more expensive treatment plan like implant, bridges, complete dentures to enable the mastication of food.

Benefits of a root canal treatment 

  • Freedom from pain!’ 

Root canal treatment can give you a sigh of relief. Once you have taken the initiative to undergo the treatment, in just a matter of two days, the stubbing pain vanishes. Since the bacteria causing the infection is removed, there is no pressure imposed on the pulp. A crown over it acts as a barrier against the entry of more germs.

  • It is cost-effective-

In the long run, the root canal is more durable and helps retain our natural teeth. Root canals are reported to sustain for even 15 years if properly maintained! On the other hand, the gap induced due to extraction may result in more food lodgement and trauma to the soft tissues by the opposing tooth.

  • Aesthetics

Many times, a layer of yellowish to brownish tinge of color is left behind in the tooth because of the infection. A crown set up over this tooth, obviously, omits this issue entirely.

  • Prevention of the spread of bacteria-

Root canal treatment is a cure for the spread of bacterial infection to the jaw, leading to more complex dental surgeries.

Self-reflection to the problem 

Now, sit back and be a bit analytical. Isn’t taking a  preventive measure, to the very first sensitivity, the cure to the outbreak of a more deadly infection severing your jaw bone? Maintaining dental hygiene is of top-notch importance. Take care of your teeth, as you do for the rest of your body. Opt for Rct when your dentist suggests you to. After all, a flashing, beautiful smile is always welcome, isn’t it?

To get rid of the impending pain, choose a painless Rct sitting only at Cosmodontist. Call us now at +8368774211