What is it?
Root canal treatment is a way of saving teeth which would otherwise need to be extracted, provided there is enough of the tooth remaining to fill afterwards.
The most common reason for a tooth to need root canal treatment is an infected pulp. The pulp is the part of the tooth which contains nerves and blood vessels – it is soft, fleshy and living, and lies deep down inside the tooth. It has small extensions all the way down the root of the tooth, which are housed in tiny narrow tunnels called root canals. Some teeth, like molars, have several roots, and each root may contain more than one root canal. If the bacteria that cause decay are allowed to advance deep enough into the structure of the tooth that the pulp becomes infected – it usually means the pulp will die. First it becomes inflamed, and because it is enclosed within a solid structure it cannot swell as other inflamed tissues in the body would. This is toothache! The infected pulp may then spill through a tiny opening at the end of the root called the apical foramen, and cause inflammation in the ligament which holds the tooth in the socket. In heavily infected cases an abscess may develop. When any pressure is applied to the tooth – for example when you eat – the inflammed tissues at the end of the root are compressed, which is painful!
If caught in time, an inflamed pulp could recover with just a simple filling. However if it is too late, the only way to treat the problem is to extract the tooth, or remove the pulp – root canal treatment.
A tooth may also need root canal treatment if the pulp has died for another reason. For example if a tooth receives a blow, the trauma to the pulp may cause it to die even without the presence of infection.
Sometimes we may need to root treat a tooth even when the pulp is perfectly healthy. For example if the only way to rebuild a badly broken down tooth is to place a post in the root, then it will first need root canal treatment.
There are a lot of myths and horror stories about root canal treatment which cause many people to be apprehensive when it is required. However with local anaesthetic it is a simple, painless procedure which can save your tooth and feels little different to having a filling. The procedure is more technically complicated though, so root treatment is usually spread over two or three visits.
What is Root Canal Treatment?
In simple terms, it means removing infected or damaged pulp tissue from inside a tooth. This tissue contains the nerves and blood vessels which help to ‘feed’ the tooth and keep it healthy.
If the infection is mild, an antibiotic may cure it, but if the pulp is badly infected, the only remedy is to remove it. After this, the pulp chamber and root canals are cleaned out and disinfected, then filled and sealed and finally the tooth is restored.
What is the alternative to Root Canal Treatment?
You could have the tooth treated temporarily, but it will eventually cause problems again and need root treatment later. The only other option is to have it extracted.
Why not extract it?
Although extraction is cheaper than root canal treatment, unless you have the tooth replaced – which is more expensive- there are other things to consider. The teeth on either side will move together, affecting biting and chewing. Also, the shape of the gum and eventually the bone can change, altering your facial shape. This becomes more noticeable if losing the one tooth leads to further disease and loss of even more teeth. You could end up looking like a different person!
But the treatment is expensive, isn’t it?
A natural tooth is irreplaceable. After all, your own tooth is far better at chewing and biting than an artificial one, and it will feel normal and natural in your mouth after treatment. Saving it can also minimise the possible problems mentioned above, and it could also last you a lifetime, so it’s a very small price to pay. Just think of it compared with the cost of a week’s holiday!
How many appointments are necessary?
Sometimes you may need only one visit, but often two or three are necessary.
How long will the tooth last?
Although the pulp is removed, the surrounding gums and bone keep the tooth in place. It may be more brittle than before, but with a root filling, and with proper care (regular brushing,flossing and dental check-ups), your tooth could last a lifetime.
What does the procedure involve?
First, you will need an examination and x-ray. Then a local anaesthetic is given and an opening is made in the crown (top) of the tooth.
The pulp is removed from the pulp chamber and root canals, then the canals are cleaned out thoroughly and smoothed into a shape that can be filled more easily. Medication may be placed in the canals and an antibiotic prescribed if the infection has spread beyond the tooth.
If more than one visit is necessary, the cavity in the tooth will probably be filled with a temporary dressing until the next appointment. However, if the gum and bone are badly infected, perhaps from an abscess, it may be left open to heal.
When the root canals are clear of infection, the next stage is to fill and seal them to stop them becoming re-infected. This can be a difficult job because the root canals may be uneven or twisted, or have side branches, or may be awkward to get at.
After this, x-rays are ususally taken to see that the canals are properly filled. The opening in the top of the tooth is then filled with a permanent restoration.
Is it painful?
With modern anaesthetics you should feel little or no pain and the original toothache will be cured. After the treatment, an over-the-counter painkiller will remedy any initial discomfort. If the pain continues for several days, or if it is very bad, call your dentist as soon as possible.