Root Canal Therapy
Root canal therapy falls into a larger category of treatment referred to as endodontic treatment. These terms are generally interchangeable, although there are some subtle differences. This type of treatment can be an alternative to extraction but not always.
Traditionally, if the nerve of a tooth became damaged through trauma or disease/decay/infection, the tooth was removed. It has since become possible – provided there is sufficient tooth tissue – to remove only the nerve of the tooth responsible for dental pain, and backfill the resultant space with an inert filler.
However, the tooth will be more brittle than before as it has been hollowed out and no longer has a nutrient supply. The thought behind this is that the tooth without a nerve will feel like any other natural tooth in the mouth. This may sound simple but is arguably one of the most complicated and least successful types of dental treatment. Root canal therapy is therefore undertaken with the careful consideration of possible failure.
The nerve system of a tooth can vary immensely and resembles the root system of a plant. Interconnected with this, is a network of tiny canals that connect the root surface to the nerve system. The average tooth has three miles of these canals (called dentinal tubuoles) that are impossible for a dentist to access but which bacteria can easily colonise.
Only the main nerve branch is generally accessible to the dentist and this can vary in number, shape and size and may require a specialist to be able to best track these nerve configurations. These specialists are called Endodontists and access to them is via a referral. Each case is different and the success rates are by no means guaranteed, even with a specialist. Your dentist will be happy to help you decide on which course of action to take.
FAQs for root canal therapy
Keep the affected tooth as clean as possible. Use a fluoridated toothpaste twice daily and floss in between your teeth.
The process of root canal treatment can be lengthy so bear in mind that you will need to sit still longer than the average filling. Some dentists will break up the treatment into two or more manageable stages. Each stage cannot be rushed so ensure that you have arrived on time for your appointment otherwise we will need to reappoint.
If you lose a part of your temporary filling whilst going through root canal treatment, contact the surgery at the nearest opportunity and let us know this has occurred. Sometimes it is necessary to place a new one.
Infection present in or around of the tooth worsens the prognosis of treatment as there are sites in a tooth that bacteria can grow but where a dentist cannot treat.
Host immune system is also important. Even the best root filling in the world will not access every canal in the root system and any colonised bacteria sites are kept in check by our immune system. Many root filling flare ups occur when we are run down or taking medication that alters our immune system.
The type of bacteria that have infected the tooth. Some strains of bacteria are more virulent than others, added to which people’s immune reactions to these bacteria differ also with some adequately dealing with their presence whilst others don’t at all.
The anatomy of the tooth. Root canal number, shape, size directly play a part in the tooth’s ability of being hollowed out. If the areas of a tooth normally accessible to treatment are not, then the prognosis of the tooth is poor.
Fractures in the tooth. Generally, fractures above the gumline are more successfully treated than below the gum line. Bacteria can colonise these areas and risk the success of the root treatment. Vertical fractures are incredibly difficult to treat successfully and often lead to the need for extraction.
Age of the patient. As we all age, our nerve system in our teeth diminish in size making the identification and treatment of the main canals more difficult. Past certain ages, our immune system diminishes and the chance of fracture line in our teeth increases.
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