Once upon a time, if you had a tooth ache caused by a diseased nerve, you would probably lose that tooth. Today, root canal therapy has given dentists a safe way of saving the tooth.

The most common cause of pulp death (a diseased nerve) is a cracked tooth or a deep cavity. Both of these problems can let germs (bacteria) enter the pulp. Germs can cause an infection inside the tooth. Left without treatment, pus builds up at the root tips in the jawbone forming a pus pocket called abscess.

An abscess can cause damage to the bone around the tooth. If the infected pulp is not removed, pain and swelling can result. Certain byproducts of the infection can injure your jawbones. Without treatment your tooth may have to be removed.

Root canal therapy is recommended when the blood and nerve supply of the tooth (known as the pulp) is infected through decay or injury. You may not feel any pain in the early stages of the infection but in later stages the pain may become very severe.

Root canal treatment

In some cases, your tooth could darken in colour, which may mean that the nerve of the tooth has died (or is dying). This would need root canal treatment.

What does root canal treatment, involves?

Treatment often involves from one to three visits. During treatment, the dentist or endodontist (the dentist who specialises in root canal therapy) removes the diseased pulp. The pulp chambers and root canal of the tooth are then cleaned and sealed.

How is your tooth saved through treatment?

1. First, an opening is made through the crown of the tooth.

2. An opening is made through the crown of the tooth into the pulp chamber.

3. The pulp is then removed, the root canal(s) is cleaned, enlarged and shaped to a form that can be filled.

4. Medications may be placed in the pulp chamber and the root canal to help get rid of germs and prevent infections.

5. A temporary filling will be placed in the crown opening to protect the tooth between dental visits. Your dentist may leave the tooth open for a few days to drain and settle. You might also be given medicine to help control infection that may have spread beyond the tooth.

Temporary filling

6. At the next visit, the temporary filling is removed and the pulp chamber and root canal are cleaned and filled. In the final step, a gold or porcelain crown is usually placed over the tooth to protect the treated tooth. A local anaesthetic is used during treatment and it should not hurt.

Your restored tooth could last a lifetime if you continue to care for your teeth and gum. As long as the roots of a treated tooth are nourished by the tissue around it, your tooth will remain healthy. However regular dental check-ups are necessary.

Dr Dennis Jones is a dentist in private practice; email: yourhealth@gleanerjm.com.