Root canal treatment

Saving damaged teeth

Root canal treatment (endodontic treatment) is performed to save a tooth badly damaged from decay, disease or trauma. It is preferable to save a tooth because generally it functions better that an artificial tooth, your own tooth is better for chewing and eating, cleaning around a natural tooth tends to be much easier. Once a tooth is lost the adjacent teeth can move or tilt from their normal position into the space which has been left.

In most cases root canal treatment will be successful, provided you take good care of the treated tooth it may last for many years. Root canal treatment is not indicated in all cases and extraction may be the best or only option, your tooth will not be treated unless it is likely to succeed. All general dentists are able to perform root canal treatment but some difficult cases may be referred to a specialist dentist or endodontist.

Signs that a tooth will need root canal treatment may include pain, hot/cold sensitivity, tooth discolouration and swelling or soreness in the gums around the tooth. All these are likely to be caused when the pulp (nerve) becomes severely inflamed or infected. This can be caused by deep decay, trauma, a crack in the tooth, breakdown of a filling or crown, gum disease, extreme wear and extensive dental work to the tooth.

Ideally root canal treatment should be started as soon as possible, teeth may have multiple root canals and all need to be treated, if the pulp is not treated quickly severe pain and abscesses at the root tips can occur.

As part of root canal treatment your dentist may have to take x-rays of the tooth, local anaesthetic is given to block the pain and a sheet of latex (rubber dam) used to isolate the tooth and protect you during treatment. A small opening is made through the tooth will a dental drill to give access to the pulp/root canals, special files are used to remove the infected pulp and for cleaning/shaping, medicines with antibiotics and pain killers may be put inside the root canal and then sealed with a temporary filling inside the tooth for a few weeks.

You may need multiple visits with a few weeks between them. The temporary filling and medicine will help to ease some of the symptoms or pain from the tooth but mild pain relief may be required, like paracetamol or ibuprofen. The root canal is filled to protect the inside of the tooth and prevent further infection. Your dentist may require several x-rays to check the length of the root canals and the success of the treatment. Sometimes follow up visits are needed to confirm healing of the jaw bone surrounding the treated, this healing can take months.

The tooth will be permanently sealed by filling the pulp chamber above the root canals and placing a filling. Your dentist may suggest an artificial crown for the tooth to protect, strengthen, restore normal function and reduce the risk of tooth fracture in the future.

Complications which can occur after root canal treatment include the loss of the tooth as success cannot be guaranteed in every case, re-infection of the tooth which can lead to re-treatment, discolouration (darkening), persistent pain or discomfort around the tooth, the tooth is likely to be weaker compared to a healthy tooth, the tooth can have altered feeling, fracture of the special metal files used during the procedure and surgery of the root tips to remove resilient bacteria in an abscess or cyst.