Much more involved and expensive treatment is necessary if the decay is allowed to progress through the enamel and into the “pulp” of the tooth. The pulp of the tooth contains the nerve and small capillaries. A healthy tooth is considered vital because of the circulation which occurs within the pulp. If bacteria reach this area of the tooth it will require a “root canal.” This consists of removing the soft tissues of the nerve and capillaries, sterilizing the inside of the hollow tooth and filling that area with a rubber or resin which isolates it from the bacteria. It is usuallythe case that after a root canal, the tooth still needs to be restored to its original shape and that takes a crown.
The last five years have brought interesting changes to the success of root canals. The evolutions of microscopic cameras and scopes used in arthroscopic surgery have been adapted for use in root canal therapy. The extremely small camera lenses can be inserted into teeth and magnify the images so that additional nerve canals can be found, and cracks in teeth can be diagnosed. Before this technology, the anatomy of teeth was assumed to be fairly uniform for each type of tooth i.e. lower molar, anterior incisor, maxillary bicuspid etc. Technology has proved that our tooth anatomy is actually quite varied and microscopes allow the visualization of additional nerve canals to be spotted and treated. The microscopes also allows for cracks to be spotted within the root structure. This is very important because any tooth that has vertical fractures in the root can not be saved whether they are root canalled or not. This technological advance prevents patients from getting root canals that are destined to fail anyway.