Endodontic Treatment, often called root canal treatment (RCT) is designed to save a tooth that has been badly damaged due to decay, cracks, other disease or injury. It is an end stage treatment for a tooth, the alternative is extraction (tooth removal).
Teeth can be treated with this process but a outcome will vary according to the initial status of the tooth and the final restoration that can be provided. The timeframe of success will vary. Root canal treatment may not be appropriate or possible in some cases, and extraction may be the best, or only option.
General dental practitioners are trained to perform root canal treatment, however in some instances patients may be referred by their dentist to a specialist called an ‘Endodontist’ who has special qualifications in root canal treatment. This may be if there are very curved canals, fine canals, cracks that need assessement or difficulty with accessing the area of the mouth. Specialists use microscopes and other specialised diagnostic imaging to determine the approach for treatment.
Infection or inflammation of the pulp (nerve):
Infection or inflammation of the pulp can be caused by:
- Repeated dental work to the tooth
- Breakdown of a filling or crown
- A deep cavity and decay
- Gum Disease
- Crack or chip in the tooth
- Extreme wear
Symptoms may include pain, sensitivity to heat and cold, tooth discolouration, swelling or soreness in the gums surrounding the tooth. Sometimes there may be no symptoms and the dentist will find a problem with the nerve in your routine dental check up. In the early stages the nerve becomes inflammed, if managed early, the treatment may be a filling or other restoration. If it is not treated, the pulp will eventually become irreversibly damaged, die and become infected. Root canal treatment is then needed to save the tooth.
The Root Canal Treatment Procedure:
Your Dentist or Endodontist will examine the tooth and take an x-ray, and a local anaesthetic is usually given to block pain. 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, an opening through the tooth is made. You dentist will remove the inflamed or infected pulp with specialised intruments. The instrumets used in our practice are either only used once or only used on one patient.
Each root canal is cleaned, enlarged and shaped. Medications are then placed inside the canals to help stop the inflammation and infection. Root canal treatment is usually done over two to three visits, and each visit is two to four weeks apart. A temporary filling will be placed to protect the inside of the tooth between visits.
Pain or discomfortmay occur following each stage of treatment. It usually lasts no more than a few days, and will not be experienced by every patient. Some people may need a mild pain reliever such as paracetamol or ibuprofen.
Completion of Treatment:
To protect the inside of the tooth and prevent further infection, the root canals are filled, and the pulp chamber is sealed. The tooth is still vulernable to cavities, fractures, trauma, etc, you should continue to practice good oral hygiene,including brushing, and flossing and regular check-ups.
Fitting a Crown:
Your Dentist may recommend that the tooth requires a crown. Usually a tooth that has had root canal treatment has an increased risk of fracture without the protection of a crown, so one should be fitted soon after treatment.
Typically made of porcelain, metal alloys, gold, or a combination of both the crown is needed to:
- Protect, strengthen and further seal the tooth
- Restore normal occlusion (the way the upper and lower teeth contact each other during biting and chewing)
- Restore an acceptable cosmetic appearance