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What is root canal treatment?

Root canal treatment is the name given to the cleaning, shaping and filling of the nerve chamber of a tooth that has died due to a large carious cavity, trauma or extensive restoration.

Why do I need root canal treatment?

This type of treatment is usually required if you have:-

· A painful tooth with a dying nerve or dental abscess
· A gumboil that is discharging infection into your mouth
· A previously root treated tooth that has recurrent infection
· A painless dead tooth with infection at the roots (usually found on an X-ray)
· Before crown or bridgework to ensure the future of these treatments

What does it involve?

For a tooth that is very painful, your first appointment will aim to get you out of pain. Under a local anaesthetic, any decay is removed along with the nerve. An antiseptic, calming medicine is then sealed in the tooth with a temporary filling. This procedure is called a pulpectomy and normally takes about 30 minutes.

Once a painful tooth has settled down, or for teeth that have died but are not painful, a minimum of 2 further appointments are required.

The aim of treatment is to kill off any bacteria in the infected tooth and keep them out. To do this most effectively, it is necessary to seal out your saliva. We often use a rubber sheet that is placed over the tooth called a “rubber dam”. This also protects you against the chemicals and instruments that the dentist is using.

The first appointment is to clean and shape the inside of the nerve chamber of the tooth (root canal preparation).

The second to place a filling right to the end of the root to seal out the bacteria (root canal filling) and to place filling to restore the tooth above the gum. For heavily broken down teeth, a crown or inlay may then be required to prevent future tooth fracture.

How long will it take?

The time taken for this treatment varies between patients and whether it is a front or back tooth. Back teeth have more roots, all of which need to be cleaned, shaped and filled. A typical example for a front tooth is two 30 minute appointments. For a back tooth, a minimum of two 1 hour appointments is usually required.

How much does it cost?

The cost varies depending on the length of time required to complete the treatment. Your dentist will give you an estimate of the cost for your tooth. Sometimes, for teeth that are heavily infected or that continue to be painful, it is necessary to change the antiseptic dressing inside the tooth several times. Should this be needed, there may be an additional fee for a re-dressing. Your dentist will explain this to you should it be necessary.

How successful is the treatment?

The success of the treatment depends upon how effectively the nerve chamber is cleaned and filled and the quality of the seal of the final filling or crown on the tooth and can be from 85-95%. Teeth that are treated before infection sets in have a better chance of success than those that are left untreated for a long time. If a tooth has had a root canal treatment once before, this reduces the chances of success to about 70%.

Are there any complications of treatment?

At Smile, we use the most up-to-date equipment and materials. Complications can arise should the tooth have particularly curved roots, access to the tooth is restricted or if the infection is severe. Rarely the instruments can separate and get stuck in the roots of the tooth, or it may be impossible to get the instruments to the very end of the root due to a blockage. These complications can reduce the success of this treatment. Your dentist will warn you if these complications seem likely or should they occur.

Are there any alternatives to root treatment?

The alternative to root canal treatment is extraction of the tooth. For teeth that are not extensively filled and have good bone support, we prefer to try to save them as losing teeth can put additional stress on other teeth and lead to problems with over-eruption and tipping of the remaining teeth. If you chose to have an extraction, the dentist will advise you on ways to replace it with a bridge, denture or dental implant.

What if I do not have this treatment?

Even though you may have no symptoms from the tooth, a dead tooth can become infected at any time causing pain and distress that we would like to avoid. Once it is infected, it can reduce the chance of success of root canal treatment. It is certainly unwise to have any other complex work like a crown or bridge on a tooth for which this treatment has been advised.