Root Canal Treatment

One of the most important goals of dentistry is to help patients maintain their teeth for life. When a tooth is compromised to the extent that the pulp inside becomes inflamed or infected, root canal treatment may be the solution to enable the tooth to be retained.

When is root canal treatment needed?

The pulp is the innermost part of a tooth and contains nerve fibres and blood vessels. It may become damaged due to deep decay, extensive dental work, trauma to the tooth, a crack, periodontal (gum) disease or extreme wear. The symptoms of an inflamed pulp are usually pain in the form of sensitivity to cold or hot and then progression to a constant toothache. However, sometimes the pulp can deteriorate without any symptoms at all.

In cases where such inflammation does not resolve, the pulp eventually dies. Infection of the pulp by oral bacteria usually follows. This infection tracks down the root canals leading to infection and damage of the bone surrounding the end of the roots - at this stage the tooth usually becomes painful to chew on and to touch. Left untreated, the pain will escalate, an abscess will form, and the tooth would eventually need to be removed.

How does root canal treatment work?

Root canal treatment aims to remove the inflamed or infected pulp, disinfect the root canals, and then seal the root canals so that they will not become re-infected. After a root canal treatment, the pain resolves, the damaged bone around the tooth heals and the tooth can be kept.

X-rays are taken during the procedure to determine the number, shape and precise length of canals. This is important to ensure that all canals are thoroughly disinfected.

Root canal treatment is usually performed over several appointments to allow time for anti-bacterial dressings to disinfect the canals. The use of local anaesthesia during treatment ensures that the entire procedure is pain free.

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1. An opening is made through the top of the tooth into the chamber where the pulp is found.
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2. The pulp is removed, and the root canal/s are cleaned and shaped using endodontic files. Anti-bacterial dressing is placed and remains in the canals between appointments. The opening is sealed with a temporary filling.

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3. At the next appointment, the temporary filling will be removed, and after cleaning, the root canal/s will be filled with a material called gutta percha.
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4. Finally, a core filling is placed to seal the opening in the tooth. The tooth is now ready to receive a crown.

Endodontist referral

An Endodontist is a specialist in root canal treatment. Difficult cases may require referral to an Endodontist to achieve the best possible outcome.

Crown placement

Clinical research has shown that root canal treated teeth are structurally weaker and therefore more prone to fracture. This is especially true of back teeth that receive heavy forces. Hence, a crown is often recommended for such teeth to restore their function and help protect them against breakage.