Root Canal Treatment
Root canal treatment may be required to save a tooth in which the pulp has suffered irreversible damage.
The pulp is comprised of blood vessels and nerve tissue, and runs through the roots of the tooth and into the crown. Damage may occur as a result of deep decay, a large previous filling, cracks in the tooth, or trauma.
A tooth requiring root canal treatment may present in a number of ways.
Lingering pain to hot stimulus, or pain coming in waves may indicate a tooth with an irreversibly inflamed pulp.
A throbbing pain that comes on by itself, or severe pain to biting pressure may indicate a tooth in which the pulp has already broken down or died off, resulting in an abscess, an infection at the end of the root. Untreated, the pain will continue and the infection may worsen.
Some teeth requiring root canal treatment might not be painful at all. Discolouration or darkening of the tooth, swelling in the adjacent gums, or recurring lumps nearby may also indicate a dead or infected tooth.
Along with the history and presenting symptoms, x-rays and other tests will be performed to establish the source of the pain. If it is determined that the damage to the pulp is irreversible, the dentist may recommend either root canal treatment to save the tooth, or extraction.
What does root canal treatment involve?
Local anaesthetic will first be administered, and the tooth isolated with rubber dam. A small access hole is drilled into the tooth. An x-ray is taken to confirm the correct length of the root canals to be cleaned. Small files of increasing diameter are then used to clean out any remaining pulp tissue from the canals. A molar tooth will typically have three to four canals, an incisor tooth only one. Antibacterial solution is used to disinfect the canals which are now free of tissue. An antibacterial or sedative dressing will be placed into the canals and a temporary restoration placed in the access hole.
The root canal treatment will usually be completed two weeks after the initial appointment. A previously painful tooth should be markedly improved in the first 24 hours after root canal treatment, and should be symptom free by the second appointment. At this time, the prepared canals are filled and sealed. A permanent restoration is then placed in the tooth. As most teeth requiring root canal treatment are heavily filled or otherwise weakened, the restoration needs to cover the whole tooth. A crown will often be recommended to achieve this and return it to normal function.
Is root canal treatment painful?
Root canal treatment is one of the most feared dental procedures! Often this is because it is associated with the severe presenting tooth ache. However, the majority of patients report that once “numb” from the local anaesthetic, root canal treatment is not more uncomfortable than having fillings done.
