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Root canal treatment is usually required when the pulp tissue within the root canal of the tooth has become inflamed and/or infected with bacteria. This is commonly a result of decay, repeated dental procedures and/or hairline cracks or chips on the tooth (which may not be readily detectable to the human eye).
The tooth in question may present with symptoms such as sensitivity to hot/cold, swelling and/or tenderness of the overlying gum. However, it is not unusual to find that there are no symptoms at all, and the need for treatment is determined from a clinical or X-ray examination
The aim of root canal treatment is to keep the tooth healthy or to return the tooth to health, therefore allowing it to be functional. The only other viable option for a tooth requiring root canal treatment is extraction. The resulting gap may be left alone or replaced with an implant retained crown or a bridge. We like to preserve teeth when we can, and this is an opininon that we share with the Implant Practitioners in our Multidisciplinary practice.
Untreated inflamed and/or infected teeth which are which are not painful will eventually give rise to symptoms such as pain and swelling. The chances of success may also reduce the longer an unhealthy tooth is left untreated.
The success rate for root canal treatment is over 90%.
However, as with any medical procedure success can never be guaranteed no matter how straightforward the treatment is to perform. This is because healing is ultimately dependent on the response of the individual patient to the treatment carried out. The tooth may also fail because of small cracks in the root, or because there simply is not enough structure remaining to restore.
Occasionally it may not be beneficial or possible to root treat a tooth. Examples of teeth that have a poor prognosis are root canals that are not accessible (e.g. blocked by previous attempts of root canal treatment), root fractures, insufficient tooth left for a post-endodontic filling/crown.
Once the tooth has been examined and X-rays taken, a decision can be made as to whether or not the tooth can be treated. However, there are some cases when a decision on the viability of root canal treatment can only be made once treatment has been started.
No, the treatment is usually painless. However, it is not uncommon to have some pain and possibly swelling for up to a week after treatment has been completed. This pain is usually resolved with painkillers.
No. Antibiotics do not eliminate infection from the tooth, they only give temporary relief. The only way to predictably eliminate infection is to carry out root canal treatment. Furthermore, repeated doses of antibiotics may result in them becoming less effective as you may gradually build up resistance to them.
Treatment is usually carried out under local anaesthetic administered into the gum adjacent to the tooth being treated. The tooth is then isolated with a rubber sheet, which has two roles; firstly it prevents the tooth being contaminated with saliva (which contains bacteria) and secondly it improves patient comfort.
An opening is then prepared on the biting surface of the tooth to allow identification of the root canals of the tooth. The root canals are then enlarged gradually with small metal files - this creates space for disinfectant solutions to be fed into the enlarged root canals to disinfect the porous tooth structure and flush out the inflamed/infected pulp tissue.
Once the root canals have been adequately disinfected they are filled with a rubber-like biocompatible root filling - this prevents re-infection of the disinfected root canal. The opening is then sealed with a temporary filling.
Due to the intricate nature of root canal treatment it usually takes 1-2 appointments, each appointment is 60-90 minutes long. The amount of time required depends on the number of root canals identified in the tooth and the complexity of the root canal anatomy (e.g. how curved the root is, how narrow the root canal is). These factors can only be confirmed once treatment is underway.
All dentists receive basic training on root canal treatment in dental school. General dentists perform most aspects of dental treatment, but sometimes refer more complex cases to Specialists in root canal treatment (Endodontists). Endodontists spend a further 3 years in postgraduate specialising in root canal treatment.
Our Specialist Endodontist will complete root canal treatment ready for treatment to be completed by the reffering dentist. Root-treated teeth generally require restoration with crowns or other laboratory-made restorations, sometimes retained by posts cemented into the root canal. It is essential that once root canal treatment has been completed, the tooth is fully restored to finally seal and protect it.
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