What is Root Canal Treatment?
Root Canal Treatment Explained
When you visit us for the first time, we will normally arrange for you to have a consultation with one of our team of highly experienced Endodontists. During this consultation we may need to take a number of X-Rays so we can fully assess your condition and present you with a full range of treatment options. Once we have discussed your situation and you have decided upon the treatment option that best meets your needs, we will then arrange one or more appointment sessions in which we will carry out your treatment.
If you are nervous, or anxious in any way, please do feel free to speak to us about your concerns. We have a great deal of experience dealing with anxious patients, and can arrange additional sedation for you should you so require.
To make root canal treatment a little clearer, we have outlined some of the procedures we carry out below. Please remember, these are only a basic outline, and if you have any questions at all regarding any element of your treatment with us, our warm and friendly team will always be more than happy to answer and questions you may have.
The Normal (Healthy) Situation
The visible part of the tooth is protected by hard enamel, covering a layer of dentin. Inside the tooth is the pulp, a collection of nerve and blood vessels in a jelly-like connective tissue, extending from the crown of the tooth to the tip of the roots where it connects to surrounding tissue. This pulp, often called the nerve, is important, keeping the tooth healthy by bringing in nutrients, which helps the tooth to repair itself to some extent. The nerves act as an early warning system, alerting us to problems by causing pain
The Disease Process
Root canal treatment becomes necessary when the soft pulp inside the root canal becomes inflamed or infected, due to deep decay, cracks or fractures in the tooth, or even sometimes dental treatment such as bleaching. Symptoms of inflammation may include tenderness and pain, with sensitivity to heat and cold or pain on biting. Treatment involves removal of the inflamed tissue and generally has a very high success rate. If the damage is more prolonged or severe, the pulp can break down and bacteria can grow, causing infection and abscesses – pus forming in the bone. Treatment for this is more difficult, as very thorough bacterial control is required. Symptoms may involve pain and swelling in the nearby bone and gums.
The only other alternative to Endodontic treatment is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from moving about. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time-consuming than Endodontic treatment and restoration of the natural tooth. The bottom line is, no matter how effective tooth replacements are, nothing is as good as your own natural tooth.
Preparation of the Root Canals
Endodontic or ‘root canal’ treatment can often be performed in one or two visits. First the area is carefully numbed so you don’t feel any pain at all. A small protective sheet called a 'dental dam' is placed over the teeth to keep the area clean and dry. We will then create a small opening in the crown of your tooth to allow us to clean out the infected pulp from inside your tooth.
Filling of the Root Canals
After the space is cleaned and shaped, the root canals are filled with a rubber-like material called 'gutta-percha' to ensure the root canals are completely sealed. In most cases, a temporary filling will then be used to close the opening in your tooth. Once your tooth has been closed up you willl then be asked to make a follow-up appointment with us to check everything is as it should be. Once you are completely satisfied with your treatment with us, you must then return to your normal dentist to have the temporary filling replaced and the tooth restored to further protect and seal it from harmful bacteria. If the tooth lacks sufficient structure to hold the restoration in place, your dentist may place a post inside the tooth before the tooth is built up with a solid core.
Occasionally, a tooth may not heal as expected after initial treatment. This can happen for a variety of reasons:
- Difficulty in cleaning very fine, narrow canals, leaving unclean portions of the root.
- Complicated canal anatomy, perhaps with extra, undetected canals.
- Further bacterial leakage around the filling/crown or a fracture allowing contamination.
A re-treated tooth can function well for years, or even a full lifetime. However, once a tooth has been previously treated, the success rates of further re-treatments drop to about 80%.
Procedures for Re-Treatment
The procedure for re-treatment is similar to that of a normal treatment. After the space is cleaned and shaped, the root canals are filled with a rubber-like material called 'gutta-percha' to seal the root canals. In most cases, a temporary filling is used to close the opening. After you have seen us for a final consultation, you must return to your dentist to have the temporary filling replaced and the tooth restored to further protect and seal it from bacteria contaminating the canals. If the tooth lacks sufficient structure to hold the restoration in place, your dentist may place a post inside the tooth before the tooth is built up with a solid core.
Surgery is often a final option for teeth that remain infected or have an otherwise inaccessible area. While Endodontic surgery is certainly an advanced procedure, rest assured that our team at EndoCare are highly qualified to provide you with the best care possible.
Where as normal root canal treatment will involve us accessing the root of the tooth through the crown, surgery involves making an incision in the gum to allow us to seal the root from the other side. This may be done as a stand-alone procedure or in conjunction with conventional root canal treatment.
The most common procedure is what’s known as an ‘apicectomy’. This involves making an incision in the gum and removing the very tip of the root. The end of the root canal may be sealed with a small filling. A few stitches or sutures, normally removed after a week, are also made to help the tissue heal properly.
If you have questions about root canal treatment or Endodontic surgery, please feel free to contact us and speak to a member of our team who will be more than happy to help you in any way that they can.