The aim of root canal treatment or endodontic treatment is to save a tooth that has had significant damage due to trauma, decay or disease. Millions of teeth every year are saved by endodontic treatment as people prefer to save their teeth. In general a root canal treated tooth will act that same or similar to the tooth when it was healthy, thereby preserving the function of the tooth and a healthy functional dentition.
If a tooth is removed nearby teeth can move from there normal position and tilt into the space left by the missing tooth. The teeth above will move downwards because they don’t have an opposing tooth to bite on. This will cause disruption to your bite and can make chewing and biting difficult, and can lead to further decay and gum disease around the tilted teeth.
Root canal treatment has a high success rate of 90-95% in most cases. Your root canal tooth will last for many years or even the rest of your life if the proper care and maintenance is performed.
We will not endodontically treat a tooth if we feel the prognosis long term for the tooth is poor. If the root canal is very difficult we may refer you to one of a friendly specialists for further treatment.
Root canal is typically required when there is infection or inflammation of the pulp (nerve)
Infection or inflammation of the pulp may be caused by:
· Repeated dental work on the tooth
· A deep cavity or filling
· Gum disease
· Cracked tooth
· Extreme tooth wear
Symptoms may include pain, sensitivity to heat or cold, tooth discoloration, swelling or tenderness of the gums around the tooth. If the pulp of the tooth cannot repair itself it will become inflamed and some discomfort may be felt at this stage especially prolonged pain to hot or cold. If this is not treated the pulp will die and become infected causing a tooth ache. Root canal treatment is then needed to save the tooth and get you out of pain.
To improve the chances of success, root canal treatment should commence as soon as possible. All roots in the tooth must be treated, which means this can range form one root in front teeth and 3 or more in molars.
If the infection is not treated in a timely manner the infection can spread resulting in severe pain. The infection can damage the tooth and the surrounding bone and in some cases spread the soft tissues of the face and neck. In rare cases the infection can become so large and severe it will require hospitalisation.
Root canal treatment of the tooth
The dentist will first examine the tooth and take an x-ray. A local anaesthetic will be given and a thin sheet of latex will be placed over the tooth to keep it clean and dry during treatment.
To reach the pulp of the tooth the dentist will access the pulp with a drill much like a filling. Special instruments called files will be used to clean out the root canals to remove debris and infected nerve tissue.
Each root is thoroughly cleaned, enlarged and shaped. Medications will be used to disinfect and lubricate the canal during the treatment. This usually occurs during the first stage of treatment. A dressing will be applied inside the root canals which is both antibacterial and ant inflammatory. A temporary filling is usually placed after this visit to seal the tooth between appointments.
Pain and discomfort is usually mild and may only last for a few days but this is not experienced by every patient. A mild pain reliever may be of some use during this period.
Root canal filling (completion)
After the first stage is complete and a suitable period of time has lapsed the root canal can be filled. The temporary filling is removed and the dressing is washed out form the canals.
The root canals then are sealed us a gutta percha filling and sealant. This help prevent further infection of the root canal in the future.
Restoration of root canal teeth
After a tooth has undergone root canal treatment the tooth may be severely weakened due to the loss of tooth structure. In most cases these teeth require a full coverage restoration that surrounds the whole tooth to support and strengthen the remaining tooth.
In molar teeth a crown is usually required for the best long term prognosis, due to the high forces in this area. If a crown is not placed on these teeth failure rates of up to 75% at 5-7 years are experienced. Usually the tooth will break or crack and may require extraction.