Root Canal Treatment
Root Canal Treatment is also known as ‘Endodontics’.
What is root canal treatment and why is it carried out?
Root canal treatment is carried out when the pulp (nerves and blood vessels within the tooth) have become infected by bacteria (germs). These germs cause pus to form at the tip of the root, in the jawbone, this is called an abscess. Symptoms one might expect when this occurs are sensitivity to hot drinks/food, unable to bite on the tooth, a dull ache or severe throbbing pain and sometimes one may have a facial swelling. There are times when no pain is experienced; this is because the abscess is dormant.
The pulp (root canal) becomes infected for the following reasons:
- the tooth is decayed
- the tooth has a large, deep filling or a crown
- there is a crack in the tooth
- if the tooth has been subjected to trauma
What is the purpose of root canal treatment?
The purpose of root canal treatment is to remove the infected pulp. This restores the tooth and its surrounding tissues back to health. This treatment can save your natural tooth and prevent the need for an extraction and replacement with bridges, implants or dentures.
There are cases when the tooth has already had a root canal treatment and has become infected again. In this instance the root canal treatment can be repeated.
An alternative option for root canal treatment is an extraction (the tooth is removed). Please be aware that antibiotics do not ‘cure’ the infection.
What does root canal treatment involve?
The aim of root canal treatment is to remove the infected pulp. The infected pulp is accessed through the tooth and is cleaned out using fine instruments. The space is then filled with a rubber-like material called gutta percha. All treatment is carried out using local anaesthetic.
Generally, the front teeth have one canal and the back teeth have 3 or more canals. These canals may be curved or blocked. For these reasons, root canal treatment can be complicated and may take two or more visits, although sometimes it may be completed in one visit. The duration of each visit is one and a half to two hours long.
Is the treatment painful?
Root canal treatment is performed using local anaesthetic so one should experience little or no discomfort during treatment. Every possible effort will be made to ensure your comfort throughout the procedure.
What to expect after root canal treatment?
It is normal to experience discomfort after root canal treatment. This can last from a few days to a few weeks. In cases where the tooth has been problematic for some time, it may take a few months to settle. The discomfort can be controlled with over- the-counter painkillers.
In 5% of cases, one may experience a ‘flare up’- this is when one experiences a facial swelling and pain. The problem is transient and can be controlled with a course of antibiotics. This will not affect the success of the treatment. Your dentist should be contacted should this occur.
Will the procedure be successful?
Although it is not possible to guarantee success of any medical or dental procedure, controlled studies published in dental journals have reported a success rate of 90-95% for first time root canal treatment performed by specialists. The success rate is reduced to 50-90% if the tooth has been previously root treated.
Root canal treatment is an intricate and complex procedure and rarely (in 5-10% of cases) is the treatment unsuccessful, if this occurs then further treatment and possibly an extraction of the tooth may be required.
Why does my tooth need to be crowned after root canal treatment?
Root canal treated teeth are usually very heavily restored and are at high risk of fracturing, and in some instances when they fracture, they may need to be extracted (resulting in loss of the tooth). Once the root canal treatment is completed, it is important to crown the tooth as soon as possible. A crown provides support for the tooth, prevents it from fracturing and prevents recontamination of the root canal. The long term prognosis of the tooth is better with a crown.
Your general dentist will provide you with a crown after the root canal treatment is completed.
Why have I been referred to an endodontist (a root canal specialist)?
All dentists receive basic training in endodontic procedures. However, there are dentists (endodontists) that specialise in this form of treatment. To become a root canal specialist, a dentist must complete several years of specialist postgraduate training. There are occasions when root canal treatment can be very complex and an endodontist has more training, experience and equipment to deal with difficult, complicated cases.