ROOT CANAL TREATMENT

Disruption of the nerve and/or blood vessel within a tooth may warrant the necessity for a root canal treatment. This area of dentistry is called Endodontics.

Root canal therapy (RCT) is needed when the blood or nerve supply of a tooth (known as the pulp) becomes injured through decay or trauma (including repeated drilling). There are phases through which the pulp deteriorates and if left untreated the affected tooth will develop an abscess on its root-tip. In the acute phase, an abscess may cause a swelling in the mouth.

There is a full range of pain associated. In the early stages of nerve deterioration, hot and cold stimuli will usually cause an intense wave of pain that lingers. The next phase leads to spontaneous onset of discomfort from the tooth without any stimulus, rhyme or reason. When the nerve dies there is no pain, but once time moves on and the abscess forms a pressure builds up making the tooth sore to put pressure on.

The aim of the treatment is to remove all toxic/damaged tissues from within the root canal. These canals are cleaned, sterilised and then sealed to prevent any further infection. Root canal treatment is a skilled and time-consuming procedure and may require two or more appointments. All root canal treatment instruments are single use.

A local anaesthesia is used and it should feel no different to having an ordinary filling done. Sometimes where the patients pre-existing pain is acute and severe, it may be difficult to soothe the nerves enough to touch them totally pain-free, but we spend time explaining the steps of treatment to help manage a successful procedure.

Most courses of treatment will involve two or more visits. At the first appointment, the infected pulp is removed. Any abscesses, which may be present, can also be drained at this time. The root canal is then cleaned and shaped and dressed with some medicines. A temporary filling is put in and the tooth is left to settle. The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.

Modern techniques have ensured that sterilization of the inner root-canal system is maximized. However, the complexities of the root structure can mean that our straight files are redundant against a proportion of tortuous chambers.

 

Overall success is placed at ~87%, however improved chance of success is gained if the treatment is carried out in the early stages of infection.