When is root canal treatment needed?

The crown of the tooth is made up of a hard white enamel layer and a thicker dentine layer. Both these hard layers protect the innermost soft tissues of the tooth called the pulp. The dental pulp contains blood vessels and nerves and extends from the crown to the tips of the root or roots.

Root canal treatment involves the removal of the pulp from the tooth when it becomes inflamed or infected due to either deep decay, an extensive restoration that involves the pulp, cracked or fractured tooth due to trauma, excessive wear of enamel and dentine exposing the pulp and sometimes as a result of severe gum disease.

Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discolouration of the tooth, swelling, and tenderness of the overlying gum or a bad taste in the mouth. On the other hand there may be no symptoms at all.

If pulp inflammation or infection is left untreated it may eventually cause pain, swelling and loss of the supporting bone.

What are the advantages of root canal treatment?

Root canal treatment saves teeth that would otherwise have to be extracted.

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. the discomfort can be relieved by taking mild analgesics available over the counter at the pharmacy. However if the pain persists and is severe or a swelling develops you should contact the practice.

How is root canal treatment carried out?

  • Removal of the inflamed or infected pulp is the first step in saving the tooth. Local anaesthetic is given and an opening made in the crown of the tooth to gain access to the pulp.
  • Specially designed hand and rotary files are used to clean the root canals and shape them to a form that can be sealed. Debris within the canals is removed by flushing with an anti-bacterial solution. Root canal treatment may be done in single or multiple visits depending on the complexity of the tooth. In between treatment appointments medicaments may be placed within the canals and the tooth is covered with a temporary dressing.
  • The canals are finally filled with an inert thermo-plastic called gutta-percha. The tooth should be restored to full shape and function by either a permanent filling or a crown, as soon as possible as there could be a risk of tooth fracture due to biting forces. A non-vital root filled tooth is more brittle than a vital one.

Radiographs are often taken to determine the length of the root and to monitor the various treatment stages.

Care of the root treated tooth

As far as possible, avoid chewing or biting on the tooth being treated until you have it permanently restored with either a filling or a crown. Excessive pressure at any stage may crack or fracture the tooth. Most endodontically teeth last as long as natural teeth following permanent restoration.