Wednesday 18 June 2014

IS ROOT CANAL THERAPY A COSMETIC PROCEDURE?

Rukoma 2014
There is misconception among policy makers and general health stakeholders including patients that root canal treatment is an aesthetic, reconstruction and replacement procedure aiming at just improving the appearance of the affect tooth. It is forgotten that teeth serve more function than appearance; to mention a few, mastication, cutting and speech. It is likely that, the misconception is derived from the fact that most teeth which need root canal treatment are badly destroyed by decay or fracture or are discolored. These destructions, when they occur in the anterior segment of the dentition, they lender the teeth unacceptable appearance. The action of rebuilding the affected tooth to regain its full form and functions has been mistakenly taken as replacement of the whole tooth (artificial tooth). This is attributed to crown used to acquire perfect coronal seal and tooth strength following RCT. This misconception has lead to some health insurance companies’ reluctance to cover for root canal treatment especially those associate with crowning. This is a result of failure to understand that adequate coronal seal is a prerequisite for a successful root canal treatment and that it can be attained only by crowning the remaining part of natural crown and or root. The cost associated with treatment as also contributed to this scenario. The fact that, the tooth is an anatomical structure consisting of root and crown has been ignored, to the extent that replacing the crown or part of it is taken as replacing the whole tooth! Root canal treatment is aiming at maintaining natural root as there is no artificial root which will exactly mimic natural ones. The introduction of implant to replace the missing tooth roots can help to explain the importance of roots. An implant is a natural artificial root made from titanium which helps replace lost natural root and on which the artificial crown is placed. While implant is integrated into supporting jaw bones by osteointegration, the natural tooth root is joined to supporting bone by means of periodontal ligaments; thus, the proprioception function of periodontal ligaments is missing in implants. If maintaining natural tooth is expensive, remove it and try artificial one. People have turned into regular dental clients not because of routine checkups as it is supposed to be but rather because of everlasting problems associated with artificial teeth especially removable dentures. From this it can arguably be concluded that, root canal treatment and associated crown rebuilding is treating and maintaining of natural tooth as opposed to implant which qualify to be called artificial tooth and thus, root canal treatment should be included under primary health care procedures and be given the priority it deserve.
Rukoma AM, (DDS, MDent)