Root Canal Therapy

Summary

A tooth is made up of the crown which is the visible part above gum level and the roots in the bone below the gum. Three layers contribute to the crown; enamel, dentine and the pulp. The pulp is a hollow part in the centre of the tooth that is made up of soft tissue which contains nerves, blood vessels and connective tissue.  The roots contain canals that extend from the pulp to the apex (tip) of the tooth, these allow the pulp to gain access to blood supply.

Root canal is a treatment option for teeth that have:

  • Infection or abscess at the roots of a tooth.
  • A deep cavity that has spread into the pulp and affected the nerve.
  • Trauma
  • Nerve death – which can be caused from trauma, disease or unknown reasons.
  • Fracture to the tooth – which involves the pulp
  • Extreme wear

A tooth can function without the pulp. This is why we can proceed with root canal treatment to remove any sensation and discomfort involved in the pulp. This allows us to prolong the life of the tooth, avoiding the tooth removal option.

Symptoms You May Experience Which Indicates You May Require Root Canal Treatment

  • Constant discomfort that could also disturb you whilst sleeping
  • Sensitivity to heat or cold
  • Swelling around the gums
  • Tooth discolouration
  • Tenderness when applying pressure
  • In some cases the tooth can become slightly mobile

In certain circumstances symptoms may not be evident when pulp is infected or damaged; a radiograph or vitality test is usually taken to diagnose problems.

Procedure

Root canal treatment is done in 2-3 stages at separate appointments.

It is necessary for the dentist to take a radiograph before the beginning of treatment to reveal and help plan the number, size and depth of the canals. At each visit an additional radiograph may be taken to see progress in finding the correct lengths of the canals in the tooth root.

The crown of the tooth is opened up to access the pulp and then using special files the nerve is removed. Each canal in the root is cleaned, enlarged and shaped to prepare for an internal filling that will extend from the pulp right through to the tip of the root.  During each stage the tooth will be dressed with medications that contain anti-bacterial and anti inflammatory to clear up any infections. A temporary restoration is placed until the final stage is complete.

root-canal-treatment
The tooth will now be without sensation and sealed so you can expect a functional tooth after treatment. The success of a root canal is greatly dependent on your oral hygiene so keeping up with preventative care appointments is essential. Most root canal treatment has 90-95 percent chance of success, however if your dentist encounters complications they will inform you during treatment and discuss your options.

To gain the maximum life span out of a tooth it is recommended to place a crown. This provides the ultimate protection and eliminates the risk of cracking or breaking the tooth.

Teeth that require Root Canal treatment are quite often heavily restored or very broken down. The root canal treatment can also make the tooth more brittle.

root-canal-treatment-x-ray

Radiograph taken after root canal treatment this shows the root filling placed in each canal

If a root canal treatment is too difficult or has complications during the treatment we may need to refer your case to an Endodontist. An Endodontist is a specialist that specialises in Root Canal treatments only.

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