Root treatment involves cleaning out any infected tissue and sealing the tooth to prevent further infection.
A root canal treatment involves removing the pulp (nerve) from a tooth, and after cleaning out pulp-space (root canal) it can be filled. This is known as 'endodontic treatment'. A tooth that has been root canal treated can last many years, particularly if it is restored following treatment. Root canal treatment is necessary when the pulp in the centre of the tooth becomes irreversibly damaged such as through decay, injury, a chip, a crack or placement of an extensive restoration such as a deep filling or crown. The reason that such procedures can cause damage is that they allow bacteria to get into pulp which causes inflammation and infection.
Signs and symptoms of the pulp being damaged include:
- Prolonged sensitivity to hot and cold
- Discolouration of the tooth
- Swelling affecting the gum around the tooth
Local anaesthetic is always used to numb the tooth, which is isolated from the rest of the mouth with rubber dam (a thin sheet of soft rubber). This is important to protect you from inhaling or swallowing instruments; it allows the use of strong disinfectants to clean out root canals and also it prevents bacteria from the saliva getting into the tooth. Access is made through tooth into the root canal. To ensure that all canals are found it is essential to use a microscope, which magnifies and illuminates the root canals. Once the canal(s) have been located, small files are used to clean and shape the root canals which are rinsed with disinfectants to remove any bacteria. If the cleaning and shaping takes more than one visit, the tooth is dressed using an antibacterial paste within the canals and a temporary filling is placed.
Once the root canals are as clean as possible, they are filled and covered to protect them from bacteria re-entering. In some cases the tooth will need to be restored with a more permanent restoration, such as a crown, to again prevent bacteria getting back in and causing the root treatment to fail.
We plan for 2 x 90 minute appointments but some cases allow us to complete treatment within 1 visit.
Is it painful?
Treatment will not normally be painful but you should expect mild discomfort for 2-3 days afterwards - particularly after the first visit. This is best managed with simple painkillers, such as Ibuprofen or paracetamol.
Alternatives to root canal treatment:
There are no alternatives if you wish to retain your tooth. The only other option is to have the tooth extracted. This will leave a gap which you may be happy to accept or you may wish to look at options to fill the gap. This could include a denture, bridge or implant.
Factors which increase success:
- Treatment completed by a specialist
- Being able to find all root canals and clean, shape and fill them to the end of the roots
- Having a good quality permanent restoration placed as soon as possible after treatment. In the case of heavily filled back teeth, a crown is the restoration of choice. This increases the chance of success by 6 times.
Factors which decrease success:
- If there is a radiolucency (dark shadow) on the x-ray associated with the tooth
- If there is a swelling (gum boil) associated with tooth
- Where the root treated tooth is used to support a denture or bridge.