Root Canal Therapy (Endodontics)
Root canal therapy is a treatment used to repair a tooth where the pulp (nerve) has become infected, usually due to tooth decay or trauma.
It is an often straightforward procedure that will relieve dental pain and save the natural tooth.
Root canal treatment involves removing the infected pulp and replacing it with a synthetic substitute. After the procedure the strength and original appearance of the tooth will be restored using a filling or dental crown.
Once the treatment is completed, the tooth will continue to remain healthy and functional. However, it will no longer feel sensation such as temperature (hot and cold) or pressure.
What is endodontics?
Endodontics is the area of dentistry that focuses on treating the inside of the tooth. This includes the pulp (the tissue at the centre of each tooth that contains nerves and blood vessels) and the tissues surrounding the roots of a tooth.
Why is root canal treatment necessary?
Root canal treatment is necessary when the pulp of a tooth becomes infected. This treatment allows us to save the natural tooth, rather than extracting it.
The pulp can become infected if the harder outer layers of the tooth are damaged due to decay or trauma, as it exposes the interior of the tooth to bacteria.
Once the pulp becomes infected, it loses its ability to fight the spread of the infection.
The aim of a successful root canal treatment is to remove the bacteria and prevent it from getting back into the tooth.
If the infection is left untreated it can spread into the surrounding bone. Abscesses (pus-filled pockets) may then form at the root(s) of the tooth, and there may be localised bone loss in the jaw around the ends of the infected root canal(s).
The tooth will continue to be weakened by the bacteria and may break down completely. Eventually the tooth will need to be extracted (removed).
What causes the pulp infection?
Infection occurs when bacteria begin to grow in the dental pulp.
Bacteria can enter the pulp if the harder outer layers of the tooth are damaged and leave the soft interior exposed.
Reasons for this damage can include:
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A large or deep area of tooth decay
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Decay beneath an existing filling (especially if it is a deep filling)
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Decay beneath an existing restoration (for example a dental crown)
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A fracture, crack or chip in the tooth (which can have a number of causes including trauma, or habitual teeth grinding which is also known as ‘bruxism’).
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A blow to the face which may bump the tooth or cause it to become loose in the socket (for example a sporting injury).
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Advanced, untreated gum disease (periodontitis).
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Extreme wear of the tooth or teeth.
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Extensive dental work to the tooth.
It’s important to note that sometimes this damage can be too minor to detect with the naked eye, so you may not know it is even there. That’s why it’s so important to attend your regular dental check-ups, so we can detect and prevent problems in their early stages.
An untreated pulp infection may also spread into the surrounding bone, forming an abscess at the end of the tooth root. As the body’s immune system reacts to the infection, it sends white blood cells to the area to try and eliminate the bacteria. Pus includes a mixture of live and dead white blood cells. When there is no way for pus to drain, it forms an abscess.
What is the procedure for root canal treatment?
1. Root Canal treatment involves removing the infected pulp and replacing it with a synthetic substitute. The procedure is generally completed over three appointments.
2. Firstly, the dentist takes an x-ray will drill into the tooth to access the pulp chamber. The infected pulp, along with any decay, is carefully removed.
3. A very fine file is then used to clean and shape the empty root canals. The inside of the tooth (including the root canals) will then be disinfected and flushed out to remove any remaining bacteria and debris.
4. To protect the inside of the tooth and prevent further infection, the root canals are filled with a synthetic material called gutta percha and sealed.
5/6. The final step is to seal the tooth structure and restore its structural integrity and original appearance. The type of restoration required will depend on the amount of structural damage to the tooth, but may include composite resin, a dental crown, or a dental crown with a post and/or core.
How to prevent the need for root canal treatment
By practicing good oral hygiene daily, you can reduce your risk of needing root canal therapy (and other dental procedures) in the future. This includes brushing twice per day, flossing daily, drinking fluoridated water and eating a healthy diet.
It’s also important to attend your regular preventative care appointments so any problems can be detected and treated in their early stages.