Root Canal Treatment
Root canal treatment (also called endodontics) is needed when the blood or nerve supply of the tooth (known as the pulp) is infected or significantly inflamed through decay or injury.
What does it involve?
The aim of the treatment is to remove the pulp of the tooth from the root canal.
Symptoms can range from a dull ache to severe pain and the tooth may be tender when you bite, if root canal treatment (RCT) is not carried out then infection can spread.
The symptoms of a dead or dying pulp include:
pain when eating or drinking hot or cold food and drink
pain when biting or chewing
swelling under or near the tooth involved
As the condition progresses, these symptoms may disappear as the pulp dies. Your tooth then appears to have healed, but the infection can now in fact spread through the root canal system.
Further symptoms eventually occur, such as:
pain when biting or chewing returning
swelling of the gum near the affected tooth
pus oozing from the affected tooth
the tooth becoming a darker colour
It's important to see your dentist if you develop toothache. If your tooth is infected, the pulp can't heal by itself.
How are root treatments done?
Root treatments can take a number of visits depending on how complex the root is or whether the infection settles. There are a variety of techniques used for cleaning and shaping the root canals which involve the use of fine instruments called files. On occasion these files can break inside the tooth which may require further treatment or referral if this occurs. Your dentist will be able to discuss with you the likelihood of fracture of files which may be more likely in certain circumstances. Sometimes it is possible to complete a root treatment even with a piece of a file inside a tooth, however it may also be necessary to monitor the outcome or refer to a specialist if the breakage of the file compromises a good outcome.
Sometimes your dentist may deem a tooth too difficult to root treat from the outset and offer you either an extraction of the tooth or a referral to a specialist, they will discuss this with you should this occur.
What happens after a tooth is root treated?
Depending on whether the tooth is infected or not, the treatment may take a number of visits to complete. Patients can experience some tenderness or soreness in the tooth after a root treatment and occasionally the tooth may not settle down and further treatment or a re-treatment may be required. If the root treatment is not successful in resolving the symptoms (if present) then the tooth may ultimately need to be removed. Your dentist should be able to discuss the prospect of success with you and whether there are any particular reasons why an individual tooth might have a higher risk of failure. Despite the best techniques being used, success cannot be guaranteed particularly in teeth with a complex anatomy. The majority of root treatments are, however, successful and avoid the loss of a tooth which can create more significant problems.
What other treatment may be required?
When teeth are root treated it is important to understand fully any future treatment that is required in order to protect that tooth. Root treated teeth have often already suffered a significant amount of damage and it may be necessary to protect them with a crown or some other long-term solution. The root treatment may save a tooth but there is often a significant amount of additional treatment required because of the earlier damage to the tooth before it needed root treatment. Root treated teeth can look darker than non-root treated teeth and your dentist will be able to discuss any cosmetic treatment needed to address this where necessary.