The tooth is a mineralized tissue of the body, which once formed completely, doesn't regenerate if it is lost due to caries or is broken. The tooth tissue once lost due to demineralization and cavitation will not be restored unless some inert and biocompatible material is filled into the cavity after removing the decayed portion and the causative bacteria from the lesion.
The tooth decay which begins as a pit and fissure caries at first is reversible and can be arrested if a favorable environment for remineralization is provided. The initial carious lesion involving enamel only or superficial layer of dentin can be restored with Glass Ionomer Cements or Dental Composite Restorative resins by simply preparing a cavity of adequate shape and size for the restorative material to remain there and function properly for a long time. If the decay is to that extent that it involves the pulp, simply filling the cavity will not eliminate the pain and halt the carious process. So, the pulpal tissue within the crown portion of tooth (the part of tooth that is seen clinically) as well as from the root canal. The canal should be cleaned up to clear all the bacteria and the root canal should be shaped and enlarged such that it can receive an inert filler into it (gutta percha) and then it can be restored to function as a normal tooth.
Root canal treatment is the best option to treat irreversible pulpitis and conserves natural tooth structure because:
- Artificial prostheses are not as good as natural dentition however close they may resemble it
- The patient doesn't have to undergo extraction (invasive procedure much feared by patients) and the need for prosthesis
- Cost of treatment is cheaper and the tooth becomes functional very early.
Hence, Root canal treatment is the best treatment plan for your severely painful tooth in which the caries has already reached upto pulp but that can be saved via endodontic treatment.