Root Canal Treatment (Endodontics)
Root canal treatment is a dental procedure that is used to treat infection at the centre of a tooth (root canal system).
The infection is usually caused by bacteria that live in the mouth and invade the tooth. This can happen after:
-damage to teeth as a result as trauma (e.g. fall)
The infection may eventually lead to an abscess. An abscess is an inflamed area in which pus collects and can cause swelling of the tissues around the tooth.
To treat the infection in the root canal – the bacteria needs to be removed.
This can be done by either removing the tooth called an extraction, this is sometimes the only option if there has been extensive loss of tooth structure or where the decay extends under the gum level, or attempting to save the tooth by removing the bacteria from the root canal system – called a root canal treatment or therapy.
How is root canal treatment performed?
Root canal treatment is carried out by your dentist over two or more appointments.
Before having a root canal treatment your dentist may take an x-ray of the affected tooth, this will allow your dentist to build a clear picture of the root and canal(s) and assess the extent of the damage.
Root canal treatment is usually performed under local anaesthetic. Your dentist will make an opening in the top of the tooth to gain access to the centre of the tooth called the pulp.
Narrow instruments are used to remove the infected tissue from the canals. The canals are then cleaned, your dentist will use files to shape and prepare the canals, and this can be time consuming and may take a number of visits. Your front incisor and canine teeth (biting teeth) usually have a single root containing one root canal. The premolars and back molar teeth (chewing teeth) have two or three roots, each containing either one or two root canals. The more canals the longer the treatment.
Medication is placed into the canals between visits to kill any remaining bacteria; a temporary filling will be placed to seal the tooth. If you have symptoms from the infection, such as a raised temperature or large swelling, you may be given antibiotics to help manage and prevent further infection.
At your next visit, the temporary filling and medication within the tooth will be removed and the root canal filling will be inserted. This, along with a filling, will seal the tooth and prevent re-infection.
Root-filled teeth are more likely to break than healthy unrestored teeth, so your dentist may suggest placing a crown on the tooth to protect it.
Risks to treatment
Although it is rare you should be aware of the possibilities of accidents whilst root canal treatment is being undertaken.
- Instruments may break with the tooth during cleaning and shaping. This maybe left within the tooth or may need to be removed by a specialist.
- If all canals cannot be accessed cleaned and fully filled it will reduce the long term prognosis of the tooth.
- Dentistry is not an exact science and therefore, there cannot be any assurances nor guarantee that the treatment will be successful. Due to the individual patient differences there exists a risk of failure, relapse or worsening or your condition despite care provided.
Root canal treatment is usually successful at saving the tooth and clearing the infections.
One review of a number of studies found that 90% of root-treated teeth survived 8-10years. The study also found that having a crown fitted to the tooth after root canal treatment was the most important factor for improving survival rates.
The survival of the tooth depends on a number of factors including;
- How much of the natural tooth remains
- How well you keep your teeth clean
- The biting forces on the tooth.
If an infection does return the treatment can sometimes be repeated. If the treatment has already been carried out to a high standard and the infection remains, a small operation to remove the root tip (an apicectomy) may be carried out to treat the infection.
Unfortunately, even despite the best efforts the tooth is unable to be preserved and an extraction of the tooth is the only option left.
Specialist Root Canal Treatments
Endodontist is a dentist who specialises in root canal treatment (endodontics) – your dentist may suggest to you to see an endodontist.
Endodontist can provide you with a higher success rate due to their expertise in this area; they have a range of extensive materials and equipment to aid them to get the possible outcomes and to ultimately preserve your tooth for longer.
We unfortunately, at the moment, do not offer specialist endodontist appointments at the practice but work closely with nearby practices that we can refer to.
Your dentist will discuss specialist referrals further with you if required.