Root canal treatment

Root canal treatment, also known as endodontic treatment, is the process of removing infected, injured or dead dental pulp from your tooth. A tooth is made up of 3 main components: a hard protective shell referred to as enamel, a softer and sensitive middle layer referred to as dentin and a soft tissue inner layer called a dental pulp (“nerve”). Dental pulp is composed of nerve tissue, lymph tissue and blood vessels and is considered to be the vital part of a tooth. If dental pulp is sufficiently traumatised – whether by exposure to oral bacteria via deep dental caries, a fracture in the tooth that enters the pulp or a forceful blow to the face – the tooth begins to die and root canal therapy is often required in order to prevent or eliminate infection and prevent tooth loss. If dental pulp becomes infected it needs to be removed, otherwise the tooth can cause pain and/or swelling. Your dentist may notice the infection from a dental x-ray or from other changes within the tooth. If left untreated, an infected tooth can cause serious oral health problems.

Each root canal treatment procedure starts with a local anaesthetic (freezing). To protect your tooth from bacteria in your saliva during treatment, the dentist places a rubber dam around the tooth being treated. Then the dentist makes an opening in the tooth to reach the root canal system and the damaged pulp. Using very fine dental instruments, the dentist removes the pulp by cleaning and enlarging the root canal system. After the system has been cleaned, the dentist fills and seals the canal and the opening of the tooth is then sealed with either a temporary or permanent filling. Root canal treatment may be done in 1 or 2, very occasionally more, appointments. After root canal treatment, your tooth may be tender for the first week or two. Bad pain or swelling are NOT common – if this happens, call your dentist.

After the root canal treatment, your tooth has to be restored (fixed) to look, feel and work as much like a natural tooth as possible. Your dentist may use a permanent filling or a crown to restore your tooth. The choice of restoration will depend on the strength of the part of the tooth that’s left. A back tooth will likely need a crown because chewing puts a great deal of force on back teeth. If there is not enough of the tooth left, posts may be used to help support the crown.

You can still get a cavity or gum disease after a root canal treatment. Root canal treatment does not protect your tooth from other types of damage. With proper care and regular dental visits, the tooth could last as long as your other teeth. Most of the time, a tooth that has had root canal treatment can be saved. However, there are cases where everything possible has been done to save the tooth and still the tooth must be extracted.

Most root canal treatments are successful. But in some case a second root canal treatment is needed – this is called retreatment. When retreating a tooth, the root canal filling material is taken out and the canal system is recleaned, reshaped and refilled.

Sometimes root canal surgery (“apicectomy”) is needed when a regular root canal treatment cannot be done or when it has not worked. Surgery is done to check the end of the root for fractures (cracks), to remove parts of the root that could not be cleaned during regular root canal treatment and to clear up an infection that did not heal after regular treatment.

Our dentists in Westport Dental Centre have vast experience and postgraduate training in root canal treatment of both front and back teeth as well as in restoring them to the highest possible outcome. Very occasionally we may however need to refer you for the root canal treatment to a specialist endodontist. An endodontist is a dentist who has completed a minimum of 3 years’ university post-graduate specialty training in endodontics. Endodontics is a specialty of dentistry concerned with the treatment of the dental pulp of the tooth. If your child’s primary (baby) tooth is damaged and needs root canal treatment, we may refer you to a paediatric dentist for this procedure. A paediatric dentist has at least 2 years of extra university training in treating children.

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