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Endodontic Therapy

What is root canal treatment?

Root canal treatment, also known as Endodontic Therapy, is a highly successful procedure that can save badly damaged teeth from extraction.  Millions of dental patients benefit from root canal treatment every year.

Badly decayed, broken or traumatised teeth can develop infection or inflammation of the pulp, or ‘nerve’, causing pain and sensitivity.  In order to treat the pain, the infection must be removed.  This is achieved either by removal of the tooth or removal of the infected pulp via endodontic treatment.

Root canal is the process of cleaning and removing the infected pulp and dressing with sedative medicaments to remove all infection present.  The root canals are filled with a composite filling material and sometimes later treated with a crown.

Why do we need root canal treatment?

Infection, inflammation of the pulp can be caused by:

  • A large cavity
  • Trauma or injury
  • Gum or periodontal disease
  • Cracked and chipped teeth
  • Repeated dental work and fillings
  • Extreme wear

The pulp of the tooth contains nerves, blood vessels and connective tissue and is important for the normal growth, development and health of the tooth. Bacteria inside the mouth can gain access to the pulp of the tooth, resulting in pain.  Bacteria, as well as trauma to a tooth can also cause inflammation of the pulp.  If left untreated, the pulp will become infected and possibly die. The infection causes painful symptoms such as throbbing, sensitivity to temperature, pain when chewing, swelling, and or soreness in gums surrounding the tooth.

How is root canal treatment performed?

All dentists are trained to perform root canal treatment.  There are also endodontic specialists who usually handle more complicated cases.

X-rays are paramount in establishing an overall view of the infected area over the course of the whole treatment.  The Dentist will then administer a local anaesthetic to eliminate any pain during the procedure.  A thin sheet of latex, (rubber dam), is placed over the tooth to isolate it from moisture and prevent bacteria from contaminating the exposed canals.

Access canals are made via a dental drill, and it is during this process that the dentist can identify the canal pathways.  The number of canals can vary; i.e. front teeth or ‘anterior teeth’ often have only one or two canals. Premolars or ‘bicuspids’ typically have one or two, and ‘posterior’ molars usually have three to four.

Your dentist will remove the inflamed and infected pulp using special instruments called ‘files’.  Each canal is cleaned, enlarged, and shaped.  Medicaments are placed inside the canals to ease inflammation and cure infection.  In severe cases, oral antibiotics may be required and sometimes several visits are needed to clear the infection.

The canals are then filled with a special filling material, called ‘gutta percha’ and the access canal is sealed.  The gutta percha protects the inside of the canals and prevents infection.

If infection does spread to the bone, it may take several months for complete healing to take place, and follow up radiographs are taken to monitor this. Usually, endodontically treated teeth have an increased risk of fracture, and in most cases, will require the protection of an artificial crown.

What are the advantages of root canal treatment?

Losing a tooth can be detrimental to your oral health.  Missing teeth can affect chewing and cause irritating food pockets.  Teeth positioned next to empty sockets can ‘tilt’ and opposing teeth can ‘over erupt’ and cause problems with the bite.  Root canal treatment enables you to save your teeth and avoid some of these problems.

What risks are involved?

Successful treatment may last many years, but will depend on your general health, age, capacity to heal and oral hygiene, the condition of your gums and surrounding bone tissue.

Infection – While the risk of re-infection is low, the tooth may need re-treating or an extraction if this occurs.

Discolouration – Root treated teeth can darken and usually occurs due to the initial infection. Although you cannot prevent this from occurring, there are many ways to improve the appearance.

Weakness – Teeth that have had infected nerves and root canal treatment are generally weaker than a normal tooth.  It is essential to have the tooth properly restored after treatment.  Your dentist can recommend the best treatment for your specific case.

Broken Files – Although rare, files can and have been known to break in a canal of a curved tooth. Your dentist will advise you if this occurs and in most cases you would be referred to a specialist for further treatment.

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