A Means of Saving a Dead Tooth

Teeth are alive. Therefore, teeth can die. Root canal therapy (endodontics) can reclaim teeth after they have died. In order to comprehend this concept, you must first understand the anatomy of a tooth.

The upper third of the tooth that is visible in the mouth is referred to as the crown, while the part of the tooth that is embedded in the bone is known as the root. All teeth are composed of three layers. Enamel is the outside covering of the crown, and cementum is the outside covering of the root. Both of these layers are calcified and hard. Found directly under these layers is the dentin. The soft pulp comprised of blood vessels, nerves and connective tissue, is located beneath the dentin and gives life to the tooth. Sometimes the pulp is referred to as the "nerve." In actuality the nerves and blood vessels enter the tooth at the apex (tip of the root) and follow a space within the hard structure of the tooth. The space within the root is called the canal and the space within the crown is called the chamber. 

When the pulp is injured or infected to the point that it cannot repair itself, it dies. The most common causes of pulp death are physical trauma to the tooth, a cracked tooth, or a deep cavity. When the pulp becomes infected by invading germs, pressure from liquid, pus and gases builds up within the canal and chamber causing pain and swelling. Left untreated, the infection will continue into the bone, causing an abscess (pus-pocket).

Typical treatment involves from one to three dental visits to medicate, clean out and seal the root canal. This is accomplished by making an opening through the crown to create access to the pulp chamber and canal. Several X-rays are necessary for measurement and checking the results. In between visits a temporary filling is placed.

After the infection is controlled and the root canal is sealed, the coronal (crown) portion of the tooth will be restored with a filling or artificial crown (cap). If much tooth structure was lost, it may be necessary to replace the missing tooth structure with a restoration that may include a post cemented in the root canal to anchor it. This procedure can give the tooth a second chance to last a lifetime.