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09 June 2014

I had root canal and my tooth is dark…

A tooth that has undergone root canal treatment usually turns dark or otherwise looks different from the surrounding healthy teeth because that tooth is dead already. It has been hollowed out. The pulp – nerves, blood vessels and connective tissue – within the tooth have all been removed, replaced with a gutta-percha filling material and dental cement and then sealed. Unlike the untreated adjoining teeth, it no longer has any living tissue left. It has been devitalised.

A root canal treatment involves several steps. First, a hole is drilled on top of the tooth, after which the infected and other tissues are removed. Then the empty cavity is cleaned using an antiseptic fluid that will also disinfect it free of any remaining bacteria. The cavity is usually filed and drilled to make it wide enough for proper filling and sealing. In cases where the infection severely damaged the root canal, only a temporary filling will be used to seal the cavity and keep it clean and sanitized until the next stage of the treatment. A root canal treatment typically takes at least two dental appointments to complete. Teeth have varying numbers of root canals. Front incisor and canine teeth usually have one root containing one canal while premolars and back molar teeth have two or three roots with each root containing one or two canals. The more the number of root canals to be treated, the longer the treatment time required. Once the canal is sufficiently cleaned of pulp tissue and disinfected, a permanent filling made from gutta-percha material and dental cement is placed inside, after which the treated tooth is sealed. At this point, the treated tooth will begin to look darker or different than the rest of the teeth. While it can be bleached from the inside, many dental experts believe this is not a viable option.

Usually, a tooth that has undergone root canal therapy is protected with a veneer, an inlay or onlay, or a full coverage dental crown. Since much of the tooth structure has been hollowed out, and the blood supply has been completely cut off, the treated tooth will eventually become brittle, fragile and easily break unless it is covered with some protective dental restoration work. For aesthetic purposes, the dentist will typically make the veneer, inlay or onlay, or full coverage dental crown in exactly the same shade of white as the adjoining teeth using composite resin or porcelain, unless of course the patient himself or herself prefers gold. The actual fabrication of the veneer, inlay or outlay, or the full coverage crown is usually done in an outside dental laboratory by a technician based on a cast of the patient’s treated tooth prepared by the dentist. Once ready, the dental restoration will be bonded to the surface of the tooth using dental cement. Once in place, there should no longer be any discernible difference in colourisation and shading between the tooth that has undergone root canal treatment and the rest of your teeth, unless again, you opted for gold.

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