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Root Canal Treatment

What is Root Canal Treatment?

Root canal treatment is designed to eliminate bacteria from the infected root canal, prevent reinfection of the tooth and to save the natural tooth. The inflamed or infected pulp is removed during root canal treatment and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed.

Why do I need a root canal treatment?

Root canal treatment is necessary when the dental pulp and the soft tissue and nerves inside the tooth become inflamed or infected. There are a whole host of reasons why you might need root canal treatment:

  • Deep decay

  • Repeated dental procedures on the tooth

  • Faulty crown

  • Crack, chip or fracture in the tooth

  • Dental trauma​

If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess. If abscesses are left untreated, they can spread to other parts of the head and neck and cause severe health implications.

What are the alternatives to root canal treatment?

The alternative to root canal is to have the tooth extracted. Having a tooth extracted can impede chewing and appearance and, in some cases, teeth can drift into the space. Replacing the lost tooth usually involves the provision of a prosthetic replacement such as a denture, bridge or a dental implant and the costs of these are variable.

How successful is root canal treatment?

Root canal treatment can have success rates of up to 90% if carried out to a good standard, allowing the tooth to remain in function. Problems can occur if the tooth develops decay or the restoration on the tooth fails, or on occasions despite high quality treatment, the tooth may not heal as expected. Further endodontic treatment or surgery may be carried out if appropriate. A tooth that develops a crack can also be a cause of failure and may result in the loss of the tooth.

Why does treatment fail?
Endodontic treatment can fail for a number of reasons:

  • It was not possible to treat narrowed or curved canals well enough or the canals were not fully cleaned during the initial procedure.

  • The tooth may have additional complicated anatomy that was not found during the initial treatment.

  • The final restoration did not protect the tooth and root canal from further infection or fracture or the final restoration leaked due to recurrent decay, fracture or gaps being present around the restoration.

What happens during the root canal procedure?

The first appointment will be an in-depth consultation with the dentist who is carrying out the procedure. This will include a full assessment on the tooth in question including radiographs and testing on the tooth. This will help the dentist to assess the case difficulty and give you estimated appointment visits and lengths. The clinician will also go through the risks and benefits of the root canal procedure and be able to give you other options of treatment.

Root canal treatment may take 1 – 3 visits, and could take approximately 1hour to 1hr30 minutes. The treatment may be completed within 1 visit but additional visits may be required.

The first appointment is the procedure itself where the infected pulp is removed. The tooth will normally be numbed with an injection of local anaesthetic in order to be able to access the pulp (the middle part of the tooth). The tooth will then be isolated with something called rubber dam. This is a rubber sheet that is fitted over the tooth so only the tooth being treated is exposed to prevent bacteria and saliva from contaminating it. This also prevents the disinfectants that are used during the procedure from entering your mouth and preventing you from swallowing them. The tooth is then drilled and the pulp/ canals are accessed. Small metal files are used to clean down each root canal and solutions are used to fully disinfect the canals. The canals are then dried before rubber points are bonded into each canal. A restoration can then be placed on top to restore your tooth back to its usual size and shape.

Sometimes the canals can be quite infected, in which case the tooth will be left with a disinfectant and temporary filling for a couple of weeks to help the tooth to settle down before the root filling can be completed.

What should I do after I have had a root canal treatment?

If you have had the tooth numbed, then you will have a tingling sensation for a few hours after the treatment has been completed. Avoid eating until the numbness has worn off to prevent biting your lip or tongue and to protect the tooth/ root filling. You may use the tooth as normal once the numbness has fully gone.

The tooth must receive a definitive restoration after the root canal treatment to prevent bacteria from re- entering the canals and prevent the root filling from failing. On the day of the root canal treatment, the dentist would normally place a general restoration and see how the tooth responds to treatment. The tooth can be left like this for up to 3 months. If the tooth has responded well to the root canal treatment and the tooth is asymptomatic then we would recommend a partial or full coverage crown/ onlay to fully protect the tooth and root filling which will prevent the tooth from fracturing and the root filling from failing.

How should I avoid having root canal treatment in future?

The most common reason for having root canal treatment is dental decay that has spread and entered the middle part of the tooth called the pulp.

To prevent this from happening then try to avoid acidic/sugary food or drinks. Try not to snack on these types of things throughout the day as this will mean the teeth are exposed to sugar or acid

attacks constantly throughout the day. It is best to keep these types of foods or drinks to meal times only and preferably only once a day.

  • Brush for 2 minutes twice a day with a manual or electric toothbrush (preferably an electric toothbrush as they are clinically proven to remove more plaque compared to a manual toothbrush).

  • Clean between the teeth with floss or interdental brushes/ sticks at least once a day. -Use a toothpaste which contains at least 1450ppm fluoride

  • Change your toothbrush or electric toothbrush head at least every 3 months.

  • See the dentist and hygienist regularly

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