Unfortunately, sometimes teeth die. What causes teeth to die? The most common culprits are: deep decay, a crack/fracture, or trauma. Signs that a tooth might be dying: a toothache that is keeping you up at night or waking you up at night and/or swelling. When we suspect that a tooth may be dying or is dead, we will perform several tests to determine the status of the living part of the tooth (the pulp). We want to find out if the pulp is alive, dying or dead. This determines what treatment the tooth will receive. If the tooth is alive, we can often use a filling or crown. If the tooth is dying or dead, root canal therapy will need to be completed to save the tooth.
Teeth have anywhere from one to three roots. Front teeth have one root and back teeth have two to three roots. Canals run in the roots of the teeth. The canal spaces carry the nerves and blood vessels that supply the tooth. The “root canal” is an anatomical structure. It is the canal of the root that houses the nerves and blood vessels. When root canal therapy is performed, the nerves and blood vessels are removed, the canal space is cleaned, shaped and then sealed.
If root canal therapy is performed on a back tooth, (premolars or molars) the tooth must be crowned in order to keep it from breaking and needing to be extracted.
On front teeth, if the access to complete the root canal therapy is small and the tooth is otherwise intact, there is often no need for a crown. However, if the tooth has other large restorations, it may need to be crowned to prevent it from breaking.
Deep decay on this tooth reached the living part of the tooth. Root canal therapy was needed to remove the living part of the tooth and to clean and shape the canal space to eliminate the bacteria. A crown was then needed to prevent the tooth from fracturing.