What is root canal treatment?
Root canal treatment involves removing damaged or infected tissue from the inside of a tooth. Most people refer to this tissue as the tooth’s ‘nerve’. So in this advice sheet, that’s what we will do.
Teeth are not completely solid. They contain a hollow space which contains the nerve of the tooth. This nerve plays an important role in the growth and development of the tooth, but once the tooth is fully grown this is less important. If the nerve becomes irreversibly damaged or infected so that it has to be removed, it will not affect your ability to enjoy food. The tooth will still remain attached to the surrounding jawbone, and continue to be nourished by the surrounding tissues.
Why is root canal treatment being suggested?
Our bodies have a sophisticated defence mechanism to help us deal with bacteria (infection). If the nerve of a tooth degenerates, bacteria can enter. Irritants from within the tooth can then leak out to the surrounding area. The body tries to seal off the infection but the bacteria can at times overwhelm this process. The result can be pain and swelling associated with the tooth (a dental abscess).
Root canal treatment aims to clean out the nerve space of the tooth. Most of the time, if this is done complete healing can occur.
The individual steps of root canal treatment
· Making the tooth numb. Most often it is advisable to have the tooth made numb to avoid any possible discomfort during treatment, although this is not always necessary.
· Placing a rubber dam around the tooth A rubber dam is a sheet of rubber which is placed over the tooth being worked on, to isolate it from the rest of the mouth.
· Gaining access. On back teeth the dentist gets to the nerve space by drilling through the biting surface of the tooth. On front teeth the access is made through the back of the tooth.
· Cleaning the tooth out The dentist can then clean out the nerve space using a series of small instruments, called files, some drill driven and some hand-held. Additionally they will wash the tooth out periodically so as to help flush away any debris. It is usually necessary for the dentist to take one or more X-ray pictures of your tooth during this treatment.
· Temporary filling At the end of the appointment, the dentist will usually place a temporary filling in the hole in your tooth. This may feel a little rough, and it may wear down a bit in between appointments, but it is very important because it prevents new bacteria getting into the tooth from the mouth
· Further appointments Sometimes root canal treatment can be completed in a single visit. However, often two or three appointments, occasionally more, are needed
· Filling the root canal When the tooth has been thoroughly cleaned out, the space where the nerve used to be is filled
· Permanent restoration When treatment is completed, a durable restoration must be placed in the access hole on the tooth to prevent leakage.
Will there be discomfort after the procedure?
The tooth can certainly feel somewhat tender for up to a week after an appointment and after the root has been filled. The popular brands of painkillers which you can buy at the chemist should help with this. It is wise to be gentle with the tooth for a few days. It is important, however, to keep it clean by toothbrushing.
Alternatives to root canal treatment
Extraction of the tooth is usually the only viable alternative. Sometimes it is a preferred treatment, if the tooth is very broken down and would be extremely difficult or impossible to restore, or if it is a tooth which does not affect appearance or chewing. The dentist should be able to advise you as to whether any replacement for a missing tooth is required.
How long will a tooth which has had root treatment last?
With proper restoration and care, such a tooth may last for many years
Is root canal treatment always successful?
There is a good success rate for this treatment generally but sometimes there is no obvious explanation for why a seemingly good treatment fails to be successful.
Occasionally, if a root canal treatment has proved unsuccessful, treating the tooth again can solve the problem.
Finally it is worth pointing out that root treated teeth still need to be looked after as well as your other teeth. If the tooth is relatively weak, it may need a crown to help protect it. Usually this can be done by your own dentist, even if you have needed to see someone else for the root canal treatment
Contact Details:
Maxillofacial Unit
Portsmouth Hospitals NHS Trust
Queen Alexandra Hospital
Cosham
Portsmouth PO6 3LY
Tel: 023 92286000
Author: Heather Beckett
Date Produced: July 2004
Review Date: July 2006
Ref No:
MAXILLOFACIAL UNIT