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Root Canal (Endodontic) Treatment
Root canal treatment (also known as endodontic therapy) aims to clean, shape and fill the entire root canal of a tooth. A root canal infection can be caused by several things, including decay, injury and possibly also gum disease. Root canal treatment can repair your damaged tooth without it having to be removed.
About root canal treatment
The aim of root canal treatment is to get rid of the damaged pulp and the bacteria that are causing the infection. It involves removing inflamed or dead nerves and blood vessels from the centre of your tooth. This is done by drilling a hole through the top of your tooth to the root canal and removing the dead tissue. The empty root canal system is then cleaned, filled and a permanent seal put over the top of your tooth. The procedure may be carried out over one or two visits to your dentist.
Why have root canal treatment?
Your teeth have a core of blood vessels and nerves at their centre. This living tissue is called the pulp and is in a space called the root canal. The number of root canals varies depending on how far back the tooth is in your mouth. Front teeth often have just one root canal, while back teeth may have three or more.
If your tooth is injured or has severe decay, the pulp can be damaged and the blood vessels may die. This results in a "dead" tooth which is likely to get infected because it's no longer protected by your immune system.
There are a number of ways that a tooth's pulp can be damaged. These include : -
All of these conditions can lead to bacteria getting trapped in your teeth. There is then the possibility that the tooth pulp will become infected, causing blood vessels and nerves to die.
Without treatment, a collection of pus (abscess) can form at the root tip. This can lead to pain and swelling and may cause damage to the bone around your tooth. If you don't have treatment to remove the infected tissue, you may have to have the whole tooth taken out (extracted).
Endodontic treatment can often be performed in one or two visits and involves the following steps : -
- The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a dental dam over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
- The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
- After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called gutta-percha. The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
- After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
After the procedure
You may find that you have some discolouring in the tooth that has been treated, although this is less common now as techniques have advanced. However, if your tooth does discolour, you may be able to have treatment to correct it.
After treatment it's important that you take care of your repaired tooth as you would any other. Brush your teeth at least twice a day and visit your dentist regularly.
What are the risks?
It's unlikely that you will have any further problems following root canal treatment. However, if your tooth does become infected again, your dentist can repeat the procedure, although the rate of success is reduced with subsequent treatments.
Very occasionally after root canal treatment, you will still have inflammation at the tip of your tooth. You may need to have a procedure called an apicectomy to remove the root tip.
What are the complications associated with root canal treatment?
- Breaking off of the dental instruments or files in the root canal while cleaning the pulp chamber. This can be removed later but only by a specialised endodontist.
- Infection as a result of incomplete treatment or filling as a result of the root canals being complex or not being detected on the X-ray
- Poor response of certain bacteria to the root canal treatment
FAQs : -
Is root canal treatment painful?
Root canal treatment procedures are relatively comfortable and often painless as the tooth is anaesthetised during treatment. After treatment, the tooth may be sensitive or tender for a few days due to inflammation of the surrounding tissues. This discomfort can be relieved by taking mild analgesics or painkillers available over the counter at the pharmacy.
However, if the pain persists, or gets worse (e.g. more intense; swelling), you should contact your dentist as soon as possible.
What are the symptoms of pulp nerve damage?
There are several common symptoms of pulp nerve damage. Each individual may experience the symptoms differently. These symptoms may include : -
- pain in the tooth when biting down
- tooth pain while chewing
- oversensitivity of the teeth with hot or cold drinks
- facial swelling
- The symptoms of pulp nerve damage may resemble other oral health conditions. You should consult a participating dentist for a diagnosis.
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