Root Canal therapy

 

The aim of root canal treatment (also called “endodontic” treatment) is to save a tooth that has been badly damaged due to decay, disease or injury.

 

Many millions of teeth each year are saved from extraction by having a root canal treatment.

 

Most people prefer to save their tooth because it will generally function better than an artificial tooth.

 

Your own tooth is usually stronger and more efficient for biting and chewing. Cleaning and maintenance of a natural tooth are much easier. However an good artificial tooth can be, it will never be more than just substitute for a real tooth.

Problems with biting, chewing and oral health are associated with losing a tooth.

For example, nearby teeth can move out of their normal position and tilt into the space left by a missing tooth. This can make chewing and biting difficult, and can lead to further decay and gum disease around the tilted teeth.

 

Root canal treatment is successful in most cases. If you take good care of the treated tooth, it may last for many years and possibly the rest of your life.

Your tooth will not be treated unless the treatment is likely to succeed. Root canal treatment may not be appropriate in some cases, and extraction may be the best  or only option.

 

Infection of inflammation of the pulp

Infection of inflammation of the pulp can be caused by:

  • Repeated dental work to the tooth

  • Breakdown of a filling or crown

  • A deep cavity

  • Trauma

  • Gum disease

  • Crack or chip in the tooth

  • Extreme wear

Symptoms may include pain, sensitivity to heat or cold, tooth discolouration, and swelling or soreness in the gums surrounding the tooth. If the pulp cannot repair itself, it will initially become inflamed. If it is not treated, it will die and become infected. Root canal treatment is then needed to save the tooth. To improve the chances of success, root canal treatment should start as soon as possible. All root canals in the affected tooth must be treated. The front teeth (incisors) have one or two root canals. Premolars (bicuspids) typically have one or two root canals. Molars usually have three or four root canals.

If the pulp of the tooth is not treated quickly, severe pain and abscesses (infections at the ends of roots) can occur. If an abscess is left untreated, infection can damage the bone surrounding the root. If the tooth does not have endodontic treatment, it will have to be removed.

 

Our dentist  will examine the tooth and take a radiograph (X-ray film). A local anesthetic will usually be given to block pain. A thin sheet of latex, called rubber dam, is used to isolate the tooth and keep it clean and dry during treatment.

To reach the pulp, an opening through the tooth is made with a dental drill. Using special instruments called files, our dentist  will remove the inflamed or infected pulp.

Each root canal is cleaned, enlarged and shaped. Anti-inflammatory and anti-bacterial medicines may be put inside the root canal to help stop the inflammation or infection. If a severe abscess has formed at the root tip, oral antibiotic tablets may be needed to help treat infection.

You may need to make several visits to the dentist  to complete the treatment. A temporary filling will protect the inside of the tooth between visits.

Pain or discomfort, if any, usually lasts no more than a few days, and will not be experienced by every patient. Some people may want to take a mild pain reliever .

our dentist  will take several radiographs to check the shape and length of the root canals and the success of the treatment.

After the pulp has been removed, the tooth is not “dead”. The tooth can survive without the pulp because it is nourished mostly by the tissues around it.

Removal of the root end: In a small number of cases, the end of the root may need to be removed to help treat an abscess. This is called a root-end resection . Rarely, a major portion of the root may need to be removed, which is called a root resection.

If you need a root –end resection or a root resection, our dentist  will provide more information about the treatment.

 

Completion of root canal treatment

To protect the inside of the tooth and prevent further infection, the root canals are filled and the pulp chamber is sealed. A post may be inserted inside the tooth if it lacks enough structure to support an artificial crown. As the jaw bone surrounding the treated tooth takes some time to heal completely, follow-up visits may be needed to see if healing has been satisfactory. This is usually checked by examining the tooth and gums and by taking a radiograph. To help the healing process, you should continue to practice good hygiene, including brushing, flossing and regular check-ups.

 

Fitting and artificial crown:   Usually an endodontically treated tooth is at increased risk of fracture without the protection of an artificial crown, so one should be fitted soon after treatment.

Usually made of porcelain or gold the artificial crown is needed to:

  • Protect, strengthen and further seal the tooth

  • Restore normal occlusion (the way the upper and lower teeth touch each other during biting and chewing)

  • Restore an acceptable cosmetic appearance

 

Possible side effects of root canal treatment

As with all dental and medical treatments, root canal treatment has risks. The following list of possible side effects intended to inform you about some of the potential problems. As other uncommon complications may occur, the list is not complete.

If you have any concerns about possible risks or complications, always ask your dentist .

Loss of tooth: While root canal treatment can save most teeth, your dentist  cannot guarantee that it will be successful in every case. It is not possible to predict how long the treatment will last, but it should last for many years.

Success may depend on a patients general health, age, capacity to heal, oral hygiene, and many other specific factors affecting the tooth, particularly the amount and strength of the remaining tooth structure. A very important factor is the final restoration. Be certain to have your tooth restored completely. Otherwise, bacteria can re-enter the tooth and cause another infection.

Infection: Infection in the damaged tooth is likely to resolve completely once treatment is undertaken. The risks of re-infection are low. However, if the infection occurs again, the tooth may have to be treated again or removed.

Discolouration: in some cases, the treated tooth may lose its original whiteness and become darker. If a front tooth is affected, the person may feel unhappy about the tooth appearance. Discolouration can be treated by bleaching, or an artificial crown or veneer can be fitted.

Pain or discomfort:  some people may continue to have pain or discomfort around the tooth during and following treatment. Your dentist  may recommend a pain reliever. If the pain is sever or lasts more than a few days, tell your dentist . Additional treatment to the tooth may be needed.

Weakness: An endodontically treated tooth may not be as strong or as durable as a normal tooth. This is especially true for the back teeth (molars), and this is why a crown is usually recommended.

Altered feeling: During and after treatment, the tooth may feel slightly different from the other teeth. This should disappear gradually. If the difference in feeling persists, inform your dentist  as further treatment may be needed.

File fracture: Special metal files are used to clean the inside of the root canal. These instruments are very fine and occasionally may break during use. Special procedures may be needed to remove the broken portion of the file, or you may be referred to a specialist. In some cases, it may not be possible to remove the fractured portion of the file; the long-term effects of this will depend on many factors, such as whether the canal was infected and whether it had been cleaned before the file fractured. Your dentist will  discuss this with you in more detail if a file fracture occurs.

Re-treatment: Pain or infection may occur months or years after a tooth has been treated. This is usually due to further decay, trauma, a cracked tooth or a crack in a filling that allows bacteria to enter the root and cause the infection. More endodontic treatment may be needed to save the tooth.

 

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