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 for there not to be any pain from the tooth in question.
* What is the purpose of root canal treatment?
* How long will the tooth last?
* Can all teeth be treated?
* Will it hurt?
* Can you not prescribe antibiotics to cure the pain/swelling?
* How long does root canal treatment take?
* Who performs root canal treatment?
What is the purpose of root canal treatment?
The aim of root canal treatment is to keep the tooth healthy/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 either be left alone or replaced with either an implant or a bridge.
Untreated inflamed 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.
How long will the tooth last?
The success rate for root canal treatment is typically 80% - 95%, depending on the state of the tooth.
However, as with any medical procedure success can never be guaranteed no matter how straightforward the treatment was to perform. This is because healing and therefore success is ultimately dependent on the response of the individual patient to the treatment carried out.
Can all teeth be treated?
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.
Usually, once the tooth has been assessed and X-rayed a decision can be made whether 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.
Will it hurt?
No, the treatment is usually painless (just boring)! 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, which may be bought over the counter at your local chemist.
Can you not prescribe antibiotics to cure the pain/swelling?
No. Antibiotics do not eliminate the infection from the tooth, they only give temporary relief. The only way to predictably eliminate the infection for the tooth is to carry out root canal treatment.
In addition repeated doses of antibiotics may result in them becoming less effective as you may gradually build up a resistance to them.
Treatment is usually carried out under local anaesthetic administered into the gum adjacent to the tooth being treated. The tooth in question is then isolated with a rubber sheet, which has 2 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 metallic files - this creates space for disinfectant solutions to be inserted into the enlarged root canals to wash 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.
How long does root canal treatment take?
Due to the intricate nature of root canal treatment it usually takes 1-2 appointments, each appointment is 1 to 11/2 hours long. Sometimes treatment may take 3 appointments. 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 commenced.
Who performs root canal treatment?
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).
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