Root Canal Treatment

What is root canal treatment?

iStock_000004537309MediumRoot canal treatment (also called endodontics or RCT) is needed when the blood or nerve supply of the tooth (known as the pulp) is irreversibly inflamed or infected through decay, damage caused by deep fillings, a crack in the tooth or the trauma of an impact.

Why is root canal treatment needed?

The pulp is the soft issue that contains the nerve and blood vessels inside a tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaw.  The most common cause of pulp death is a deep cavity or a cracked tooth.  Both of these problems can let germs (bacteria) enter the pulp which can cause an infection inside the tooth.  When the pulp is diseased  or injured and can’t repair itself, it dies.  When the infected pulp is not removed, pain and swelling can result.  Certain by-products of the infection can injury your jaw bones, forming a “pus-pocket” called an abscess.   Left without treatment your tooth may have to be removed.

Does it hurt?

No. A local anaesthetic is used and it should feel no different to having an ordinary filling done.

What does it involve?

root-canal-treatment-before-afterThe aim of the treatment is to remove all infection from the root canal. The root is then cleaned and filled to prevent any further infection. Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist. Sometimes, depending on the situation and the individual tooth concerned, it may be possible to carry out the treatment in one appointment.

At the initial appointment, an opening is made through the crown of the tooth and the infected pulp is removed. Any abscess, which may be present, can also be drained at this time. The root canal is then cleaned and shaped ready for the filling. A temporary filling is put in and the tooth allowed to settle. The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.

I’ve heard that root treated teeth discolour, is this true?

A root filled tooth can sometimes darken after treatment. If there is any discolouration, there are several treatments available to restore the natural appearance.

Does it always work?

Root canal treatment is usually very successful. Overall success rates are probably about 85%. However, if the infection comes back the treatment can be repeated, though the success rate is reduced, second time around.

Are there any side effects?

Generally no. Because root treatment is rather fiddly, the appointments are longer than for example a filling, so your jaw may feel a bit tired afterwards. Occasionally, there can be some pain when the anaesthetic has worn off, but this is usually mild and self limiting. Rarely, it is possible to stir things up and to have more significant pain in the days afterwards, in which case you should contact the surgery and prompt treatment will be provided. This does not affect the long term outcome.

What if I don’t have the treatment?

The alternative is to have the tooth out. Once the pulp is destroyed, it can’t heal and it is not recommended to leave an infected tooth in the mouth. Although some people would prefer an extraction, it is usually best to keep as many natural teeth as possible.

Will the tooth need any further treatment?

Ideally yes. It is often better to restore the tooth with a crown to provide extra support and strength to the tooth.

Where can this treatment be carried out?

Root canal treatment is normally a routine dental procedure, which your dentist will generally be happy to provide for you at the Practice. The complexity of the treatment can vary significantly and sometimes referral to a Specialist Endodontist is advisable or desired by the patient.

We are fortunate to have Mr. Robert Crawford, Consultant in Restorative Dentistry, based at the Endodontic Unit of the Eastman Dental Hospital & Institute, London, who is a registered Specialist Endodontist, working with us at the Atkinson Brignall Practice, Sevenoaks. Higher fees for specialist treatment should be anticipated, reflecting the extra level of expertise.

Do I need to treat the tooth any differently?

Root-treated teeth should be treated just the same as any other tooth. Remember to clean your teeth twice daily, preferably with a fluoride toothpaste. If the initial need for root treatment was due to decay, it is best to cut down on sugary snacks, and keep them only to mealtimes if possible. See your dentist for regular check-ups.