Root Canal Treatment
It is a dental procedure that involves treating the deeper tissues of the tooth; the pulp and the root canal system, which make the centre or heart of the tooth.
In Root Canal Treatment, the pulp is accessed, cleaned and disinfected. Then the space is filled to prevent re-colonisation with bacteria.
Root canal treatment is also called Endodontic therapy.
Teeth are made of crowns (above the gum line) and roots (below the gum line and inside the jaw bone). Deep inside the crown and roots, underneath the hard mineralised surface, lies the pulp; a complex internal system, which contains the nerve and blood supply to the tooth. This complex pulp system extends from the crown to the roots’ tips inside the jaw bone.
When is Root Canal Treatment needed?
Root Canal Treatment is needed when the pulp of a tooth is:
- Infected (bacteria from the mouth gets inside the pulp), and/or
- Inflamed (bacteria in a very close proximity to the pulp).
Infection or inflammation of the pulp usually follows:
- Deep decay.
- Crack or fracture of the tooth.
- Leaking restoration or a crown (poor fit).
- Advanced periodontal disease (Gum disease).
- Previous trauma: even if no visible damage can be seen.
- Repeated dental procedures on a tooth can lead to its death.
- Elective root canal treatment may be required in severely sensitive teeth that do not respond to other management options.
How do you know if you need Root Canal Treatment?
You may suffer from:
- Pain: severe, constant and throbbing, made worse by biting on or touching the tooth.
- Swelling: associated with a tooth, with or without pus.
- A routine dental exam may reveal an asymptomatic abscess (silent abscess with no pain).
- Change in tooth colour (teeth getting darker).
- A large cavity in a tooth.
However, only a dentist with a thorough examination and with special investigations may give a definitive diagnosis and inform you if you really do need Root Canal Treatment.
How is Root Canal Treatment Performed?
The first stage is the Cleaning and disinfection stage:
Using special solutions and fine instruments the tooth and its pulp are cleared of decay, debris and infected tissues.
This step can be performed in one or more visits (usually two are required). If more than one visit is required, the tooth will be dressed between the visits with a combination of anti-inflammatory, antibiotics and steroid paste to control the pain and kill the bacteria inside the tooth and its root canals.
The second stage is the filling and Restoration stage:
Once the tooth is cleaned and disinfected and the patient is not experiencing any symptoms; the root canals are filled and the tooth is restored to its natural shape and function.
Is Root Canal treatment Painful?
Contrary to popular believes, Root Canal Treatment is no more unpleasant than a normal filling.
The patient is anaesthetised so no pain or discomfort should be experienced.
Infected and inflamed teeth can be more difficult to be numbed; however, the treatment will only be carried out once the patient is comfortable.
What is next?
Root filled teeth are effectively “dead” teeth with no blood or nerve supply to them, they are more brittle and are prone to fracture.
Therefore, a crown placement on root filled teeth is strongly recommended to protect them from fracture and prolong their life span.
How successful is Root Canal Treatment?
When Root canal treatment is performed for the first time; it has a very high success rate (+90%)
If a root canal treatment needs to be repeated due to unresolved and persistent infection, the success rate is much lower (60%).
The success rate is also influenced by the how soon the tooth is treated following diagnosis, the sooner the tooth is treated, the lower the infection and the higher success rate.
My dentist told me I need Root Canal Treatment, can I leave the tooth un treated?
If you do leave an infected/inflamed tooth in the mouth, you are at risk of not only pain and localised abscess and swelling, but also at risk of spreading the infection to the rest of the mouth and the body.
The alternative to Root Canal Treatment?
The only alternative to Root Canal Treatment is extraction.
Infected teeth do not respond to antibiotics alone, and if we are to rid the body of the source of infection (the tooth) we either have to go in the treat the tooth or we have to remove the it.
The options following an extraction to fill the space can be: