Root canal treatment involves the removal of the pulp tissues from the tooth in the event that the tooth gets infected or inflamed. The pulp can be infected or inflamed due to either deep decay or an extensive restoration that involves the pulp; cracked or fractured teeth due to trauma; excessive wear of enamel and dentine exposing the pulp and sometimes as a result of severe gum disease. Root canal treatment removes any infection in the root canal as prevents you from having to remove the infected tooth.
The need for root canal treatment usually arises from injury to the dental pulp. Signs of irreversible pulp damage include spontaneous pain, prolonged sensitivity to heat or cold, discolouration of the tooth, swelling, tenderness in the gum tissue around the tooth, or a bad taste in the mouth. Sometimes, pulp devitalization can even be asymptomatic, often going undetected. However, this does not mean that it should be left untreated. A nonvital tooth may eventually lead to infection around the root tip, causing pain on biting and the formation of an abscess. In cases where treatment is delayed, this localized infection may eventually spread, leading to more pain, swelling and the loss of supporting bone. Timely root canal treatment can help to save your tooth and avoid the need for extraction.
Your dentist will first examine your teeth to determine the cause of the toothache or infection. X-rays and 3D scans may be taken for complex cases or to look out for issues that may complicate treatment like root blockages and hidden root curvatures. For cases where the infection is severe or there are secondary problems such as bone loss around the tooth, your dentist may recommend that you have the infected tooth removed instead, and replaced in future once the infection has cleared.
First, local anesthesia will be administered to numb your tooth. Your dentist will then isolate your tooth with a perforated rubber sheet to ensure a clean working field and to prevent you from swallowing or inhaling any tiny root canal instruments. Next, any existing decay and defective fillings are removed. Your dentist will create an opening through your tooth to gain access to the root canal system. Once all the root canals are located, they will be disinfected, shaped and cleaned, then filled. The access cavity is covered and sealed with a filling to prevent bacteria from entering the tooth. An X-ray will be taken to ensure the root filling is in place.
Sometimes, your dentist will place antibacterial and pain relief medication inside your tooth and leave them to work for a period of 1 to 2 weeks before placing the root filling permanently. In such cases, an additional visit is required and a temporary filling will be placed to last till the next appointment. Try to avoid chewing on the tooth being treated until you have it permanently restored with either a filling or a crown. Excessive pressure at this stage may crack or fracture the tooth.
After root canal treatment, the remaining tooth structure often requires additional structural support to reduce the risk of fracture in the long term. This can be accomplished by crowning the tooth. Once crowned, most root canal treated teeth last as long as natural teeth. To find out more about dental crowns, click here.
Some factors which limit the success of root canal treatment are:
In such cases, either a referral to an endodontist (root canal specialist) will be made or alternative treatment options will be presented.
Some potential complications and risks of root canal treatment include root canal perforations, irritation at the apex of the tooth from disinfectant solutions, fractured files and reinfection of the root canal system. However, these are rare, especially if a thorough examination and assessment has been carried out beforehand.