We all know infections are dangerous and have to be treated. We’ve all probably had an infection or two, as well, so we’re accustomed to the usual treatment: a simple course of antibiotics. Maybe in some cases, a cleaning is necessary first. So why is it that an infected tooth requires an involved endodontic procedure, commonly called a root canal?
Teeth Are Unique
Your teeth are unique structures in your body. The tooth enamel is 96% mineral–it’s almost like a rock! Producing this enamel coating can take years, and our body just doesn’t have the ability to replace it. Even the dentin, the layer under the enamel, is about 70% mineral, similar to bone.
And inside this mineral shell is a compartment for the living portion of the tooth, the nerve. The tooth nerve is connected to the body’s nervous system and blood supply via narrow tunnels that run through the roots of the tooth, the root canals.
Your Mouth Is a Gateway
Another difference between infections in your teeth and those elsewhere in your body is that the mouth is an opening that allows bacteria to enter the body. In fact, it’s more than that–the mouth is home to hundreds of species of bacteria, some of them helpful, but many of them harmful. Whereas an infected cut on your skin can be covered with a simple bandage, the warm, wet environment of the mouth makes it hard to seal off an infected area.
Remember, if your body is a fortress, then your mouth is the gateway that allows everything to enter. This can increase your risk of infection here.
What Happens in a Tooth Infection
When your tooth becomes infected, bacteria have penetrated the outer layers of the tooth, the enamel and the dentin, and reached the interior nerve chamber. Once inside, the bacteria begin attacking and killing the nerve, which is why tooth infections can be so painful. They’re also painful because the normal response to an infection–swelling–occurs inside the restricted confines of the tooth, which puts more pressure on the irritated nerves.
Why Antibiotics Aren’t Enough
So, why can’t we combat the infected tooth with simple antibiotics? If you were to take antibiotics orally or even via IV, they would circulate throughout the body, but only a little bit would reach the tooth through the narrow root canals, probably not enough to kill off the infection.
And even if you did kill off the infection, either with oral antibiotics or by applying the antibiotics directly to the tooth, there would still be this big, open area inside the tooth that the hundreds of species of bacteria living in your body would just love to colonize.
A root canal is really an anti-infection treatment that’s specifically designed for your teeth. First, we clean out the interior of the tooth, the same way you might have to clean out an infected cut, removing some of the damaged tissue as well as the bacteria. Then we apply antibiotics and seal off the area. In the case of a tooth, this involves using a filler material inside the tooth as well as putting a hard bandage for the tooth–a dental crown–on top.