Root Canal

Saving your tooth with a root canal has the benefits of:
• A better bite and more efficient chewing.
• Keeping your natural teeth.
• Protecting your other teeth from wear and tear.

Your dental practitioner will take x-rays of the tooth and the area around it. The area will usually be numbed with a local anaesthetic and the tooth may then be covered with a small rubber sheet (rubber dam) isolating it, and any decay removed. The pulp chamber is accessed through the top part of the tooth. The pulp is removed and the canal system cleaned, shaped, disinfected and sealed. A permanent or temporary filling will be placed at the access site. Further treatments such as a crown might be advised.

Root canal treatment may take some time to complete over more than one visit depending on complexity.

In most cases, root canal treatment is successful and the tooth should settle over a few days and no longer cause pain. However, there is always some risk depending on the condition of the tooth, your oral hygiene, and the biting forces on the tooth.

Risks and complications include:

Mild temporary pain/discomfort due to inflammation of the tissues surrounding the tooth.

The tooth might darken over time. There are procedures available which may lighten the tooth if this occurs.

Tooth fracture may occur due to reduced strength and durability of the tooth. Thi may lead to tooth extraction.
This risk is reduced when a crown fitted.

Uncommon risks and complications:

The fine metal files used to clean inside the root canals may break during use and remain in the tooth, this may or may not affect the success rate of the root canal treatment.

Depending on the size and shape of the roots, there is some risk of creating a hole
in the side of a tooth root during the cleaning process, this is called a perforation.

If you experience persistent pain, return to your treating dental practitioner.

If you develop an infection return to your treating dental practitioner.

Root canal tratment might fail. The tooth may require further treatment or even extraction.

With all procedures there is a possibility that it may not work. This applies to root canal treatment as well as any other treatment. There are a variety of reasons why it may not work. some of these reasons include but are not limited to:

Failure to adequately disinfect, leaving bacteria in the canal system, resulting in recurrence of infection.

Failure to instrument all the canal system.  In some teeth the root canals can be incredibly small (often as small as one tenth of a millimetre across or even smaller). Dentists who carry out a lot of root canals usually utilise high powered magnification to help them find and treat such small canals.

Failure to fill and seal the root canals adequately, allowing bacteria from the mouth to reinvade the root canal system and set up infection again.

Inappropriate instrumentation technique that does not allow for adequate disinfection and sealing of the root canals.

Severe fracture of the tooth leaving remnants that cannot be fixed again.

If the dentist feels there is a significant risk of treatment failure, possible causes will be discussed, so you can make an
informed decision regarding treatment.

The dentist will always fill the hole in the tooth after the root canal treatment. However, in some case the tooth may need a crown to protect the tooth, reducing fracture risk. Root filled teeth tend to be significantly weaker than healthy teeth and are prone to fracture. Not all teeth need crowns after root canal treatment, but it is common for the back teeth that do most of the chewing to need a crown after completion of  root canal treatment. Your dentist will advise.

Yes, all dentists have training in Endodontics (the subject that covers root canal treatment). However, some dentists choose to continue with extensive post graduate training in this field, using advanced treatments, commonly with aid of a microscope. They also perform many more root canal treatments than the average general dentist? As a result, they tend to have a significantly higher success rate across the board in both complex and simple cases. It is not uncommon for a general dentist to offer the patient the choice of having them do it or referring it to a practitioner with more training and expertise if they feel the latter will offer a high chance of success. In some cases, the general practitioner will feel that a case is beyond their skill set and refer to a suitably qualified colleague.

The cost of root canal treatment is variable and depends on the complexity of each case. This complexity is influenced by type of tooth, its position in the mouth, what condition it is in and also to a lesser degree the patients’ medical history. You will be made aware of the cost of
treatment before embarking on the treatment.

With modern anaesthesia and techniques, root canal treatment is generally a pain free procedure. However it is likely that the patient will get some post-operative discomfort after the anaesthetic has worn off. In the vastmajority of cases this can be controlled with regular over the counter pain relief such as ibuprofen and paracetamol.