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Writer's pictureHaymarket Dental Care

The age-old debate; root canal versus extraction

Endodontics or in particular the root canal procedure has unfortunate connotations; this is particularly true in those with an aversion to dentistry who find the concepts surrounding this treatment disturbing. This has pushed people into insisting on having a tooth removed rather than treated. But this dentist in Haymarket is here to take a stand for all those teeth that need not be pulled! Let's compare the procedures and explore the pros and cons.

The underlying problem


Whatever the treatment, the cause is almost always the same; dental abscess. How it started is not always clear, perhaps a slightly receding gum along with food entering between the root and the bone. Or, perhaps a trauma caused a hairline crack, down to the root. There is now an infection beneath the tooth which your body has controlled by creating a sack which has now filled with pus.


As it is within the jawbone, it is both hard to medicate with antibiotics alone due to the low blood flow within the bone and is very uncomfortable, as the associated pressure of the swelling has nowhere to go.


The treatment options


Root canal


The tooth above the abscess is opened with a standard dental drill, allowing our dental team into the heart of the tooth, it's pulp and nerve. The pulp and the tooth are both cleaned out, as the infection may have travelled up the root canal. Then, we get to the canal which is normally less than a millimetre wide and is far too small to clean and fill, so we widen it with a set of flexible brushes. The roots, much like teeth, are rarely symmetrical or straight; each root can take hours for our dentist in Haymarket to clean and widen. A process that is made longer and more complex if the roots are abnormally crooked or bent.


This makes it unwise to attempt a root canal in one session, so we will spread the work over two sessions if needed. This is usually done with a temporary filling, closing the access hole between the sessions.


Once the canal is fully widened to the root tip, the infection under the tooth can be cleaned out and an antibiotic solution is applied directly into the site of infection.


A full root filling can be placed from the site of the infection up the length of the tooth and to the access hole.


The extraction treatment option


Extraction is the simpler and older treatment option.


After the application of a local anaesthetic around the tooth in question, it is extracted by the use of forceps, usually with a little pushing back and forward to widen the gum socket before being eased out. With the site of infection now visible at the bottom of the gum socket, it can be cleaned out before the extraction hole is packed by our dentist in Haymarket to prevent the formation of dry socket or a recurrence of the infection.


Which feels better?


Due to the damage that an abscess beneath a tooth can cause to nerve tissues within the tooth, a root canal is often painless, unlike an extraction. The local anaesthetic will stop the majority of the discomfort, but there will still be a sense of pressure on the jawbone and possibly other teeth.

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