Root canal treatment
Root canal treatment, also called ‘endodontic’ treatments, can save a tooth whose pulp has been badly damaged due to decay, disease, or injury. Having a root canal treatment means not having a tooth extraction. Many prefer this over having an artificial tooth which won’t function as well as your actual teeth.
Root canal treatments are successful in most cases and if you take care of the treated tooth, it can last for many years and even for the rest of your life. However, if your dentist finds that this treatment may not be appropriate for you, extraction may be the next option.
All general dental practitioners are trained to perform root canals but some patients may be referred to a specialist called an ‘endodontist’ who has special training and qualifications.
Infection or inflammation of the pulp can be caused by:
- Breakdown of a filling or crown
- Deep cavity
- Gum disease
- Crack or chip in the tooth
- Extreme wear
- Extensive dental work to the tooth
- Sensitivity to heat or cold
- Tooth discolouration
- Swelling and soreness in the gums
If the pulp of the tooth is not treated quickly, severe pain and infection can occur. The infection can damage the bone surrounding the root and the tooth will have to be removed.
Your dentist/endodontist will examine your tooth and take an x-ray. A sheet of latex, called rubber dam, is used to isolate the tooth and keep it clean and dry during treatment.
To reach the pulp, your dentist/endodontist drills an opening through your tooth. The inflamed or infected pulp is then removed using special instruments called files. Each root canal is cleaned, enlarged, and shaped. Anti-inflammatory and antibacterial medicines may be put inside to help stop inflammation and infection.
Several visits may be required so your dentist/endodontist will place a temporary filling to protect the inside of your tooth between visits.
After the pulp has been removed, the tooth is not ‘dead’. It can survive without the pulp because it is nourished by the tissues around it.
Completion of treatment
To protect your 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. Your dentist may recommend that your tooth requires an artificial crown. Follow-up visits may be needed to confirm satisfactory healing of the jaw bone surrounding the treated tooth. Continue practicing good oral hygiene to assist the healing process.
- Loss of tooth – depending on your general health, age, capacity to heal, oral hygiene, and other factors affecting the tooth
- Pain or discomfort
- Weakness – especially for the molars so an artificial crown is usually recommended
- Altered feeling
- File fracture – special metal files are used to clean the root canal and may break during use
- Special procedures may be needed to remove the broken portion.
- Re-treatment – if there is further decay, trauma, or infection more endodontic treatment may be needed
- Non-healing – in some cases, tissues around the end of the root canal may not heal well following treatment due to resistant bacteria, a cyst, or a reaction to materials. If this occurs, apicoectomy (a minor surgery to remove the affected tissues or end of the roots) may be needed. In rare cases, root resection may be needed.