Endodontic Treatment
Root Canal Treatment
What is a Root Canal?
Root canal treatment, known as ‘root canal’ or endodontic treatment, is treatment of a tooth with a dead or dying dental pulp. This is also known as the ‘nerve’ of the tooth. Usually root canal treatment is required because the pulp has become inflamed or infected by bacteria. Our aim is to save the tooth from extraction by only removing the inflamed/infected pulp and then filling up the space with an appropriate material so it is sealed off properly. Saving your own tooth is important as generally it will be stronger and better to chew and bite with than having a gap or having an artificial tooth.
Why would you need a Root Canal?
Teeth become inflamed or infected with bacteria, and cause pain. This pain presents as either extreme sensitivity or tenderness to biting, or in the worst case, with swelling in the mouth or face. Sometimes there is also tooth discolouration.
Infection or inflammation of the pulp is caused by:
- a deep cavity
- breakdown of a filling or crown
- trauma
- gum disease
- crack or chip in the tooth
- extreme wear
- extensive dental work
Different teeth have different anatomy with front teeth , canines and premolars usually having one or two canals, and molars three or four canals. All root canals in the affected tooth must be treated.
Root Canal complications
As with any dental procedure, there can be complications. These include:
- Failure of integration, where the titanium and bone don’t blend properly
- Failure of the implant crown – internal screws can loosen and break
- Gum disease around the implant – this can happen in the same way it can happen to teeth.
- If canals, calcification or anatomy compromise treatment, referral to a specialist may be required
- Failure of the root canal treatment for reasons such as invisible cracks, resistant bacteria or abnormal anatomy. If the risk of complications is high, or if there is difficulty in accessing the canals, or perforation of the root or bifurcation of roots occur, a specialist referral or extraction of the tooth may be required.
- Special fine files are used in the procedure which can occasionally fracture during the treatment. A specialist referral may be required in this case.
- Flare up pain or sensitivity following the procedure.
- Hypochlorite/bleach burn due to irrigation of the canals.
- Loss of temporary filling material in between appointments.
- Reinfection may occur months or years after the tooth has been treated, usually due to further decay, trauma or cracked tooth/filling that has allowed bacteria to re-enter the tooth. A specialist referral may be required for re-treatment or tooth may need to be extracted.
- Discolouration of tooth, this may be addressed with bleaching or coverage of the tooth with direct/indirect materials.
- Uncomfortable or strange feeling- this may occur because the tooth no longer has a pulp or due to the cleaning procedure. Most patients become accustomed to this over time.
- Fracture of tooth upon completion especially for the molars (back teeth), so usually a full coverage restoration to protect the tooth is recommended- either with a directly placed overlay or a crown.
There are some patients who are not good candidates for implants, but for most people they are the restoration of choice when a tooth is missing.
