April 28, 2018

Having a Root Canal Treatment

Root canal treatment is one of those procedures that everyone thinks is going to be extremely painful, but in fact many people will not feel any more discomfort than when having a dental filling. This treatment is an excellent way of preserving the natural tooth, and the success rate is as high as 96%1, depending on the tooth being treated. Many people who have had a root canal treatment will find that tooth lasts a lifetime, especially if they have a good oral hygiene routine.

It’s always better to preserve as much of the natural tooth is possible, and the alternative to having a root canal is to have the tooth extracted. This would mean it would need replacing with a bridge, an implant or a partial denture. All of these options would be more expensive, and would be far more time-consuming than having a root canal procedure. Most dental insurance policies cover the cost of root canal treatment.

What is a Root Canal?

The root canal is the cavity in the centre of the tooth, containing the pulp. The pulp is the soft part of the tooth that contains all the nerves which are capable of sensing whether something is hot or cold, and a tooth can function perfectly well without these nerves. If the pulp becomes infected then it must be removed before the infection can spread.

A pulp can become infected if the tooth has become damaged or decayed, as this will enable bacteria to penetrate the root canal. If the bacteria build up then it can create an abscess which is a pus filled pocket that forms at the root of the tooth. It’s essential to treat this infection as it can cause bone loss around the tip of the root, and the infection can spread to the surrounding teeth and bone structure.

Sometimes there may be no symptoms at all, but signs of infection include:

  • Having severe toothache, especially when biting down
  • Noticing an increased sensitivity to hot and cold foods
  • Noticing the gums surrounding the tooth are swollen
  • Sometimes the affected tooth can look discolored

 

What Does the Root Canal Procedure Involve?

If your root canal treatment is straightforward, then your dentist may carry out the procedure at the dental office. If it’s likely to be more complicated they may refer you to an endodontist who specializes in this type of treatment. You’ll need to have an x-ray so your dentist can determine the extent of the infection, and whether or not it has damaged any of the surrounding tissues and structures.

The area will be anaesthetized before the dentist drills into the tooth to access the pulp. After this the infected pulp and nerve can be removed. The root canal must be thoroughly cleaned, and if the infection is extensive your dentist may place medication topically, and could recommend you take a course of antibiotics to make sure the infection is properly cleared. If you do have extensive infection then the root canal might be sealed with a temporary filling material, as your dentist will want to make sure it is completely clean before sealing it permanently. During the next day or two the tooth may feel a little more sensitive than normal, especially if there was extensive pain or infection. This can generally be controlled using over-the-counter pain medication, and most people find they can return to work the next day. It’s best to be a little careful about chewing, as a temporary repair can mean the tooth is a little weaker than normal. The next step is to permanently fill and restore the tooth.

Sometimes teeth which require root canal treatment have already had a large filling or have become decayed, and will need crowning. This makes sure the tooth is completely sealed so bacteria cannot get in, and should ensure the remaining tooth structure is preserved.

Occasionally root canal treatment may not be successful, and the tooth can become re-infected, or because the root of the tooth has cracked. Depending on the problem it might be necessary to have the tooth treated again, either by your dentist or an endodontist in order to try and save the tooth. In general, teeth which require additional treatment2 are more likely to be molars in the upper jaw.


References

  1.  1. Peak JD, Hayes SJ, Bryant ST, Dummer PMH. Endodontics: the outcome of root canal treatment. A retrospective study within the armed forces (Royal Air Force). British Dental Journal. 2001; 190: 140-144
  2.  2. Hoen M, Pink FE. Contemporary Endodontic Retreatments: An Analysis based on Clinical Treatment Findings. Journal of Endodontics. 2002; 12: 834-836