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Root Canal Treatment

What is root canal treatment?

A tooth contains pulp tissue; which is composed of blood vessels, nerve fibres and other cells.  This part of the tooth may become inflamed or infected from dental caries (decay), cracks, large restorations and/or trauma. Once this occurs the tooth needs to have root canal treatment which removes this inflamed and/or infected tissue.  The treatment involves disinfecting and filling the root canal system in order to prevent future infection.     

Do I need to have root canal treatment?

Once the pulp chamber of a tooth becomes infected it can lead to a combination of problems ranging from no symptoms to severe pain and swelling.  The correct diagnosis is based on clinical and radiographic (x-rays) signs and symptoms.  Once infection of the pulp chamber space occurs the treatment options are limited to root canal treatment or removal of the tooth.  There is no alternative way to remove the infection such as antibiotics.

Do I need to see a specialist for my treatment?

Root canal treatment involves cleaning, disinfecting and filling of the root canal system of a particular tooth.  The root canal system of each tooth is variable; it can range from one root canal to multiple root canals within the same tooth, curved roots, sclerosed canals and other complexities.  Successful healing will be determined on how well it is carried out.  A specialist endodontist is a dentist who has completed a specialist training programme in root canal treatment.  This means he/she has the relevant training, experience, materials and equipment in order to deal with the complexity of the root canal system as well as to determine the most appropriate treatment. 

How do I know if I need to have this treatment?

Diagnosis is based on examining the tooth clinically and taking a radiograph (x-ray).  Inflammation or infection can cause sensitivity, discomfort to chewing or in some cases it can occur without any symptoms.  It is therefore important to have an assessment carried out to determine the correct diagnosis and hence the most suitable treatment for the individual.

Why can't I take antibiotics?

The root canal system is complex and antibiotics will not eliminate the cause of the infection, as they do not reach the appropriate areas.  There may be temporary relief however the infection will recur.  Taking repeat antibiotics has been shown to lead to more resistance and possible allergic reactions.  Research has shown the only way to eliminate infection of the root canal system is by endodontic treatment carried out to a high standard.

What does endodontic treatment involve?

The tooth is anaesthetised with local anaesthetic.  Once adequate anaesthesia has been achieved a dental dam covers the tooth: this is a small sheet that isolates the tooth and prevents contamination from saliva as well as improving your comfort. 

Drilling a small hole in the tooth accesses the root canal system, once this access is complete there is no further drilling. The cleaning and disinfecting of the root canal system is carried out by the use of endodontic files and appropriate disinfecting agents. A dental microscope is used to improve vision, as the root canal system can be complex.  Only when the root canal system is adequately cleaned and disinfected that it is then filled with an appropriate filling material.  A provisional restoration is placed in the access and your own dentist will replace this once symptoms have resolved.

Radiographs are taken only as required to make sure all parts of the root canal treatment have been carried out to the highest standard.  A copy will be sent to the referring practitioner. 

Will it hurt? 

No, the treatment is carried out with anaesthesia and is comfortable.  The treatment will not be continued if you are not comfortable.

As with all procedures some individuals may experience tenderness or swelling after treatment.  This is usually controlled with anti-inflammatory medication (painkillers).  It may take a few days to completely settle.

How long will treatment take?

Treatment times vary from 60 to 90 minutes depending on the complexity.  In some complex cases more then one visit may be required. 

Will treatment work?

Root canal treatment has shown to be effective in over 90% of cases.  However healing will depend on many factors such as the response of the individual, the degree of infection, the amount of suitable tooth structure remaining and many more.  This is why each tooth will be assessed and if endodontic treatment is not deemed suitable then alternative options will be discussed.

What happens after root canal treatment?

A provisional restoration is placed on the surface of the tooth.  Teeth can be fragile and at risk of fracture and so you are advised to take care with biting on it until you can see your dentist.  The dentist will place the most appropriate final restoration on the tooth.



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