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Root Canal Treatment

The aim of root canal treatment (also called 'endodontic' treatment) is to save a tooth where the nerve has been badly damaged due to decay, disease or injury. Many millions of teeth each year are saved from extraction by having root canal treatment.

Most people prefer to save their tooth because it generally will function better than an artificial tooth. Your own tooth is usually stronger and more efficient for biting and chewing. Cleaning and maintenance of a natural tooth are much easier. However good an artificial tooth can be, it will never be more than just a substitute for a real tooth.

Infection or Inflammation of the Pulp

Infection or inflammation of the pulp (which is the nerve inside the tooth) can be caused by:

Symptoms may include pain, sensitivity to heat or cold, tooth discolouration, and swelling or soreness in the gums surrounding the tooth. If the nerve cannot repair itself, it will initially become inflamed. If it is not treated, it will die and become infected. Root canal treatment is then needed to save the tooth.

To improve the chance of success, root canal treatment should start as soon as possible. All root canals in the affected tooth must be treated. The front teeth usually have one or two root canals. Premolars typically have one or two root canals. Molars usually have three or four root canals.

If the nerve of the tooth is not treated quickly, severe pain and abscesses (infection at the ends of the roots) can occur. If an abscess if left untreated, infection can damage the bone surrounding the root. If the tooth does not have root canal treatment, it will have to be removed.

Procedures of Root Canal Treatment

A radiograph is needed to examine the tooth initially. Local anaesthetics is given to block the pain. A thin sheet of latex, called rubber dam, is used to isolate the tooth and keep it clean and dry during treatment.

An opening on the tooth is made to reach the pulp and inflamed / infected pulp tissues are removed with special instruments called files. Each root canal is cleaned and shaped. Anti-inflammatory and anti-bacterial medicines may be put inside the root canal to help stop the inflammation and infection. If a severe abscess has formed, oral antibiotics tablets may be needed to help treat the infection.

You may need to make several visits to complete the treatment and a temporary filling will protect the inside of the tooth during visits. Pain or discomfort, if any, usually lasts no more than a few days, and will not be experienced by every patient. Some people may want to take a mild pain reliever such as Aspirin, Ibuprofen or Paracetamol.

Several radiographs are needed to check the shape and length of the root canals during and after the treatment. After the pulp have been removed, the tooth is not 'dead'. The tooth can survive without the pulp because it is nourished mostly by tissues around it.

In a small number of cases, the end of the root may need to be removed to help treat an abscess. This is called apicectomy. If it is indicated, you will be given more information about this treatment.

Completion of Root Canal Treatment

To protect the inside of the tooth and prevent further infection, the root canals are filled, and the pulp chamber is sealed. A post may be inserted inside the tooth if it lacks enough structure to support an artificial crown. A crown is then recommended because:

For details about crowns, please see Crown and Bridge page.

Possible side effects of root canal treatment

As with all dental and medical treatments, root canal treatment has risks. The following list of possible side effects is intended to inform you about some of the potential problems. As other uncommon complications may occur, the list is not complete. If you have any concerns about possible risks or complications, please do not hesitate to ask for more information.

  1. Loss of tooth: While root canal treatment can save most teeth, it is not possible to guarantee that it will be successful in every case.
  2. Infection: Infection is likely to resolve completely but re-infection is possible, but low. If the tooth is re-infected, it can be treated again or removed.
  3. Discolouration: In some cases the tooth can become darker, which can be treated by bleaching, or an artificial crown or veneer.
  4. Pain or discomfort: Some people may continue to have pain or discomfort around the tooth during and following treatment. If pain is severe or lasts more than a few days, additional treatment may be needed.
  5. Weakness: An endodontically treated tooth may be not as strong and durable as a normal tooth. This especially true for the back teeth (molars) and this is why a crown is recommended.
  6. Altered feeling: During and after treatment, the tooth may feel slightly different from the other teeth. This should disappear gradually. If feeling persists, further treatment may be needed.
  7. File fracture: Special metal files are used to clean the inside of the root canals. These instruments are very fine and occasionally may break during use. Special procedures may be needed to remove the broken portion of the file, or you may be referred to a Specialist. In some cases, it may not be possible to remove the fragment.