Root Canal Treatment
Root canal treatment can save your tooth.
Pain is usually the first sign of an infected tooth, this is when the nerves and “pulp” contained within the tooth is decaying and can cause severe pain which needs to be attended to immediately. A diseased tooth pulp may cause inflammation or infection. The symptoms of a damaged or diseased tooth pulp may include:
- Unprovoked or spontaneous pain
- Sensitivity to hot and cold drinks and foods
- Pain when biting or chewing
- Loosening of the tooth
- Swelling of the gum near the affected tooth
- Oozing of liquid surrounding the affected tooth
- Facial swelling
Sometimes, tooth pulp may become damaged or diseased without presenting any symptoms. In these cases, the problem is usually diagnosed by special tests or x-rays during a dental check-up or treatment for other dental concerns.
Our dentist will listen to your symptoms, examine your teeth and other special investigations including taking digital x-rays. These x-rays also help the dentist to plan for the root canal treatment by revealing the number, size and curvature and depth of the roots. This will help to determine the complexity of the case.
The optimal long-term result is to save the tooth and prevent it from future infection, giving you a tooth that is strong and that will last as long your other healthy teeth. This is achieved by:
- Removing all of the damaged and decay inside the tooth
- Cleaning, sterilising the area
- Filling and sealing this space with advanced materials and hardware
The visible face of the tooth can then capped with a crown or complex filling depending on the strength of the remaining natural tooth structure and your requirements.
Why have Root Canal Therapy?
Keeping your natural teeth for as long as possible is important for your overall health, wellbeing and enjoyment of all types of food. Root canal treatment allows you to maintain the structure of a natural tooth and regenerate healthy bone structure. If the infection is left untreated, complications could include:
- Spreading infection Once the pulp becomes infected, it loses its ability to fight the spread of the infection. If bacteria find their way into the pulp chamber, the bacteria will multiply unchecked. This can cause a severe infection or an endodontic abscess when it spreads into the surrounding bone (a pocket or ‘blister’ of pus).
- Localised bone loss The infection may spread around the ends of the infected root canal and cause bone loss in the jaw leading to more complex surgery.
- Loss of tooth The tooth may have to be removed, which interferes with your ability to bite and chew. Tooth replacements such as dentures, bridges and dental implants may not be possible or may not be tolerated. They may be more costly and involve other issues that also need to be considered.
If you have an infected tooth, bacteria from the mouth can enter the bloodstream and cause infections in other parts of the body. People who have a hard time fighting off infections may need to take antibiotics before and after a root canal. Such people include those who have artificial heart valves or were born with heart defects.
If you have a severely decayed or infected tooth, you may not want to go through the expense and discomfort of a root canal and crown fitting. Instead, you may choose to have the tooth removed (extracted). The space can be restored with an implant or bridge. These options will be discussed with you during your personalised consultation.
The Process and Timing
The treatment requires a number of appointments over a few of weeks, due to the need for healing time and external lab work for crowns. Generally, our typical root canal treatment includes:
- The procedure is usually performed using local anaesthetic.
- The affected tooth is wrapped in thin rubber (called a ‘rubber dam’) to prevent contamination of the root canals.
- The decayed portions of the tooth and any affected filling are removed.
- The pulp or pulp remnants are extracted.
- Our dentist uses a special drill and small instruments to thoroughly clean and shape the root canals and to remove bacteria, pus and debris. The root canals may need to be shaped or hollowed out to ensure a smooth interior surface.
- The interior of the tooth is flushed with medications, disinfectants and then dried.
- If the root canal is not infection free, it may be medicated and the tooth sealed with a temporary filling material. You may have to wait a few weeks, or even months, before the pulp canal is filled. If the dentist feels bacteria are still present at your next appointment, the cleaning procedure may be repeated and the tooth once again packed with medication. This stage will continue until the tooth is free from bacteria.
- The infection-free root canal is then sealed with long-lasting barrier materials (the root filling), usually a rubber-based material called ‘gutta-percha’.
- The tooth then undergoes restoration and the biting surfaces need protection – an artificial biting surface for the tooth is fashioned out of filling material.
- In many cases, where there is considerable loss of the tooth structure, there may be a need for an artificial crown made from porcelain, alloy or other materials.
A normal tooth with a healthy pulp is yellowish-white in colour. A pulp-free tooth may, in time, turn grey. The dentist can advise you on appropriate aesthetic (cosmetic dentistry) procedures.
Longevity of Solution
The treated tooth should last a very long time, provided that you maintain good oral hygiene and generally look after your teeth. Of course, no therapy or replacement will last as well as a healthy tooth. The procedure does mean that the tooth is less strong and therefore may require a crown to maintain its long-term strength and ensure the cracks and decay do not form in the future. To determine the success or failure of root canal treatment, the most relied-upon method is to compare new X-rays with those taken prior to treatment. This comparison will show whether bone continues to be lost or is being regenerated.
Our success rate is extremely high as we have invested in specific training in Endodontic treatment. Our practice has also installed new tools and equipment that allow our dentists to perform advanced diagnosis and treatment as each case is quite different:
- Digital Xray to understand your canal shape and depth
- Laser tools to remove bacteria
- “Apex Locators” to ensure the entire root is cleaned
- High quality files that are sharpened and sterile
- Adequate time is allocated to ensure a positive outcome
For very complex cases where the canals are twisted and deep we do refer our patients to our specialist partners who can ensure that the treatment is successful. You can then return to our practice to finish the procedure with options such as strengthening crowns and other options.
After Your Visit
During treatment you may be provided with a temporary crown or filling. After treatment your tooth will be strong and ready for use. Your lips and gums may remain numb for a few hours until the anesthetic wears off. Later you may have throbbing pain, which you can treat with pain medicines, such as ibuprofen or a stronger prescription painkiller. The pain usually lasts only a day or two and we can discuss any pain with you during our follow up calls.
Damage to the pulp may be caused by untreated dental decay, decay beneath a filling, tooth damage due to trauma, tooth grinding (bruxism) or gum disease. Preventative measures such as regular checkups and diagnostic xrays can reveal issues before they erupt into larger problems.
Further Information on Tooth Structure
A tooth is mainly made of a hard material called dentine. Enamel is the surface layer that protects the visible part of the tooth (crown). The part of the tooth that sits beneath the gumline is called the root. The root is the ‘prong’ that helps anchor the tooth into the jaw. Generally, front teeth have only one root, while molars have several. There may be several root canals in one root. The hollow centre of a tooth is called the pulp chamber. This area contains the blood vessels, nerves and pulp. The pulp is a sensitive tissue that provides oxygen, nutrients and feeling to the tooth. The main function of the dental pulp is to regulate the growth and development of the tooth during childhood. The pulp extends from the roof of the pulp chamber down into the bottom of each root canal. Once the tooth is fully formed, nutrition for the tooth comes from the tissues surrounding the root. Therefore, a tooth can function without its pulp and, in the majority of cases, can be kept indefinitely. After endodontic treatment, the tooth is ‘pulpless’, but it is not a dead tooth.