What is a Root Canal?
Teeth are held in the jaw by their roots. Front teeth normally have one root, but teeth further back have more.
At the core of each tooth is a soft mass of tissue called the pulp. In a healthy tooth, the pulp contains living fibres, cells, nerves and a blood supply, extending into the root(s) through the root canal(s).
Decay or injury can destroy the living pulp. Because dead pulp lacks a blood supply, it is more prone to infection, leading to an abscess and toothache.
Root canal treatment means the removing damaged or dead pulp and filling the space left. The remaining tooth can then be repaired.
Why do I need root canal treatment?
The tooth will not be able to heal its self. Without treatment, the infection will spread, bone around the tooth will begin to degenerate. Pain usually worsens until one is forced to seek dental treatment. The only alternative is usually for the tooth to be extracted. Though the removal of the tooth is cheaper, the space left behind may require a denture, a bridge or an implant which can be more expensive that the root canal treatment. If you have the choice, it’s always best to keep your own teeth.
What will my dentist do?
An X-ray can show the number and shape of the tooth canals, and also signs of infection in the surrounding bone. Teeth can have a number of roots and some roots are easier to fill than others, because of their shape.
To keep root canal dry during treatment the dentist may stretch a sheet of thin rubber around the tooth, on a frame outside the mouth, this is called ‘rubber dam’. Having this fitted makes the treatment more comfortable.
You will be given a local anaesthetic, and ten an opening is made through the top of the tooth, down into the pulp.
The dentist then uses narrow files to remove the dead pulp from the core of the tooth and from the root canals(s).
At this point, the dentist may put in a temporary filling and possibly also give you antibiotics if any infection has spreads beyond the tooth. If so, you will have to return for another appointment this will give the infection time to settle.
In the next stage, the dentist fills the root canal(s). A filling is then placed in the remaining cavity in the top of the tooth. Or, if necessary, a crown can be placed on the top of the tooth, supported by a post placed inside of the filled root canal.
What are the risks and complications?
Root canal treatment has about 60% success rate. Sometimes a case needs to be redone due to diseased canal off shoots that went unnoticed or the fracturing of a canal-filling instrument used, both of which rarely occur. Occasionally, a root canal treatment will fail altogether, marked by a return if pain.
What are the benefits?
Pulp damage can cause toothache but the pain will usually end very quickly when the root canal is cleaned out.
Without a root filling, a tooth with a dead pulp would probably have to be taken out in the end. There is also possibility of infection spreading beyond the tooth itself.
What happens after treatment?
Natural tissue inflammation may cause discomfort for a few days. A follow up review can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth and see you dentist regularly.