The right diagnosis of the case for root canal treatment is very important before proceeding ahead. It can be done by 2 ways namely Subjective Symptoms - As told by the patient him/her self or by Objective Symptoms or Signs - As found by the dentist by various examination tests. These diagnosis symptoms of root canal treatment are discussed in detail as under:
Persistent Toothache Is a very common feature. The infected pulp might be painless in the beginning but can lead to severe pain and abscess thereafter if not treated. When injury to a tooth lies only in enamel it causes no pain. When it reaches dentine may be associated with pain on exposure to heat, cold, or sweet. If left untreated or injury occurs directly in pulp it causes inflammation of pulp called pulpitis. Pulpitis begins as reversible pulpitis in which the tooth can be saved by simple filling, it becomes irreversible as swelling inside the hard covering of dentine compresses the blood circulation leading to degeneration and predisposing to infection which can only be treated by root canal treatment and a crown or extraction.
Reversible Pulpitis - The pain of reversible pulpitis is usually associated with sensitivity to cold goes after the removal of the stimulus within 1-2 sec.
Irreversible Pulpitis -The pain becomes spontaneous and lingers on for long even after the removal of the stimulus. It’s difficult to localize the origin of pain by the patient and the pain subsides after few days when the pulp becomes completely necrotic. When the puss develops below the root tip the tooth rises in the socket and patient feels high on biting. Also it is very tender to pressure and tapping.
Swelling is seen in the gums neighboring the tooth. The swelling comes due to pus getting accumulated below the tip of the tooth in the gums. This may lead to formation of a small pinhead sized opening (gum boil) on the gums outer surface. This opening can come and go. The opening leads to drainage of pus from the infected tooth and is a course of bitter taste in the mouth along with bad breath.
Patient may have fever, general discomfort, uneasiness or ill feeling. Pain when chewing and the pain may wary with postures.
Swollen glands of the neck. Also seen is the swollen area of the upper or lower jaw which is a very serious symptom.
A dentist can perform various tests to find out the tooth needing root canal treatment.
Visual Examination - The dentist may be able to see what a patient was not able to find just by looking at the involved area, like a persistent and reoccurring pimple on your gums (gum boil) may only be detected by a dentist, an exposed pulp or a tooth which has suffered trauma might only be recognized by a dentist.
A dentist may inspect the tissues around the tooth and lightly tap on it for seeing the symptoms.
Mobility – Teeth with severe mobility are treated only when pressure on the surrounding fibers has been removed. Mobility also occurs in cases of tooth abscess.
Thermal Tests for Hot & Cold - The dentist may place one or more cold objects against a tooth, the purpose will be to determine whether it is more or less sensitive than the normal tooth. A response to cold indicates that the pulp is alive and not necrotic whether or not it’s normal. A response to heat indicates a pulpal or periapical problem requiring an endodontic treatment.
X-Ray – X-ray is taken to view the bone around the tooth. If a wide black space is seen around the tooth or a dark spot is present at the root tip dentist will recommend a root canal treatment.
Pulp Vitality Test - If more information is needed the dentist may go for an electronic device called the electric pulp tester which sends a small electric current down the tooth, this dentist to decide whether the pulp is alive (if a positive response comes) or dead/necrotic (if no response comes). This test does not cause any pain or shock. Only a tingling sensation is felt which goes when it is removed from the tooth. It should not be used in case you wear cardiac pacemaker or any electronic life-support device.
Front teeth have fewer canals then the back teeth making the treatment easier in the front region.
The success rate of the treatment decreases each time it is repeated in a tooth.
Complications might be rare but do tend to occur.
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