Root Canal Treatment

What is root canal treatment?

Root canal also known as endodontics is required when the nerve or blood supply of the tooth ( the pulp) is infected through decay caused by bacterial invasion or injury. The aim of this treatment is to preserve the tooth for as long as possible.

The pulp is made up of soft tissue that includes blood vessels and nerves, also known as the nerve within the tooth. When the pulp gets infected it leads to pulpitis or inflammation of the pulp and its death (necrosis). This can result in an acute alveolar abscess, which is a very painful condition.

To maintain the tooth, root canal treatment is required to clean out the dead tissue and infection and help protect the tooth by filling the canals to stop the same infection recur.

Symptoms :

If you suffer from dental pain or toothache the dentist can determine if you require an endodontic (root canal) treatment through examinations.

Normally the X-rays will show that the pulp has been infected by bacterial infection. The pulp will start to die and bacteria would spread showing one of symptoms below

  • Sensitivity to hot or cold foods and drink
  • Sharp pain when biting or chewing
  • Loose tooth

As the infection spreads these symptoms often disappear as the pulp dies. However, the infections will in fact spread through the toot canal system and symptoms will eventually reoccur such as

  • Return of sharp pain when biting or chewing
  • Swelling if gums around the infected area
  • Swelling in your face or cheek
  • Tooth becoming darker
  • Pus coming out of infected tooth
  • Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief, if the abscess ruptures

The pulp can’t heal by itself and leaving the tooth infected will make things worse so it is important that if you experience any of the above symptoms then contact is immediately. Without treatment your tooth may have to be removed.

Causes :

The main reason for root canal infection is due to penetration of bacteria into the tooth pulp which is the innermost part of tooth containing blood vessels, nerves and connective tissue. The bacteria could enter the dental pulp and spread all the way down to the root. Some of the ways the bacteria can invade the pulp and infect it are

  • Dental decay or deep Cavity
  • Damaged or cracked tooth
  • Tooth displacement or dental avulsion
  • Multiple dental treatments on same tooth
  • Tooth Anatomy of the patient
  • Gum disease
  • Trauma or extreme wear

 

Benefits :

  • Relief from Pain
  • Prevent spread of infection
  • Saves the infected tooth and protects surrounding teeth too
  • Restore the natural shewing and biting
  • Avoid need for any other costly dental treatment to restore the missing tooth

 

Procedure

Before beginning the treatment the dentist will take some X-rays of the affected tooth to get a clear picture of the root canal and assess the extent of the infection. To treat the infection in the root canal the bacteria needs to be removed which can be achieved by

  • Removing the tooth (extraction) : If the affected tooth can’t be saved, your dentist will pull (extract) the tooth and drain the abscess to get rid of the infection
  • Perform a root canal procedure :
    • Removing the pulp – The dentist will place a rubber sheet around the tooth to keep the area dry and clean during treatment. The dentist will open the tooth through the crown to access the soft tissue at the centre of the tooth (pulp). He or she will then remove the infected pulp and drain any dental abscess (pus filled swelling) if present at the same time
    • Cleaning and filling the root canal – Once the pulp has been removed the dentist will clean and enlarge the root canal so that it can easily be filled as the canals are very narrow making it difficult to fill.

 

Our dentist at NW1 Dental Care will use the latest flexible titanium rotary files with specialist rotary motors to enlarge the canals and shape them efficiently so that they can be filled. Root canal files are only used once so as to minimise cross infection and fracture.

Once located and shaped, the length of the canal is measured using high tech equipment called an apex locator. The canals are also thoroughly irrigated with anti-bacterial disinfectants to get rid of any residual bacteria.

This is the most complicated part of the treatment and may take several hours to complete, and might need to be carried out over more than one visit if required. If the treatment is done over few visits then the dentist may put small medication in cleaned canal to prevent it from bacteria and seal the tooth using temporary filling. The dentist might also prescribe antibiotics if required

  • Sealing and fixing the tooth – This is the last stage.  The temporary filling and medication from the tooth is removed if the treatment is carried out in more than one visit.

Finally the root canal is dried with an absorbent paper point and filled and sealed with root canal filing  – gutta percha a rubbery material, which completely fills and the canals and seals the tooth to prevent infection from reoccurring. The tooth is then usually filled with a tooth coloured composite and patient is advised to cover the tooth with a crown in the future to prevent the tooth from fracturing.  Once a tooth has been root treated the tooth structure becomes weaker and is more prone to fracture

  • Taking antibiotics : If the infection is limited to the abscessed area, you may not need antibiotics. But if the infection has spread to nearby teeth, your jaw or other areas, your dentist will likely prescribe antibiotics to stop it from spreading further. He or she may also recommend antibiotics if you have a weakened immune system
  • Open up (incise) and drain the abscess : The dentist will make a small cut into the abscess, allowing the pus to drain out, and then wash the area with salt water (saline). Occasionally, a small rubber drain is placed to keep the area open for drainage while the swelling decreases.
Alternatives to root canal treatment?

The main alternative is to extract the affected tooth which would result in patient having a missing tooth. This tooth could then be restored with a dental implant treatment to normal functions like your natural teeth, prevent movement of other teeth and bring back your beautiful smile

Aftercare or recovering from endodontic treatment :

The patient must take care when recovering from endodontic treatment. They should avoid biting or chewing on hard food until treatment is complete. After the treatment the restored tooth shouldn’t be painful although patients may feel sensitive or mild discomfort for a few days.  Over the counter painkiller can be taken to relieve any discomfort.

The root canal after care involves mostly taking care of your teeth by maintain good oral hygiene, avoid consuming excessive sugary food, brushing, flossing and regular dental check-ups are recommended.

How painful is the root canal treatment ?

This is the biggest concern for all patients who are to undergo root canal treatment. At NW1 Dental care we ensure that any treatment we carry out is comfortable and pain free as possible for our patients. We use latest injection techniques and strong anaesthetic before starting the procedure to make sure that patient won’t feel anything in the entire treatment

How long does it take for the root canal treatment ?

We normally aim to complete the treatment in single visit of one and two hours. However, in some instances it might require more visits depending on complexity of the case i.e tooth affected, number of canals to be treated or spread of infection

If you come as an emergency visit we will aim to take care of immediate pain and infection control, then everything else is resolved in next visit.

What happens after the root canal treatment ?

Patients might experience some discomfort after the treatment, which usually settles in a few days. Patients can take their usual pain killers to relieve the pain.

Root canal success rate prognosis ranges from 70-90% over 5 years.

However root treated teeth can discolour over time. If the tooth has a small access filling only then we can try to internally bleach the discolouration. If this does not work or the tooth is severely discoloured then covering the tooth with a tooth coloured veneer or crown is another option. Your dentist will inform you of all the choices available for your specific concern.

Do I need to be referred by a dentist ?

If you experience the symptoms you can contact us directly and seen with one of our dentists who work on endodontic treatments. We would book a consultation appointment so that the dentist can diagnose your case and advise the patients on all aspects of treatment.

If the pain is severe then you can also book an emergency appointment with NW1 Dental care so that we can stop the immediate discomfort and complete the treatment on same visit or next depending on complexity of the case

Cost of Root canal treatment?

The front teeth usually have one canal and back teeth have more canals. The cost of the root canal treatment depends on several factors such as

  • The position of the tooth
  • The complexity of canal system
  • Curvature of the roots of the teeth
  • of nerves in the tooth
  • Previous root canal therapy on the infected tooth

Sometimes its best to have the tooth removed and then restore it with a dental implant.

What happens if you wait too long for the treatment or not performed at all when needed?

If the patient doesn’t get the treatment done the tooth will remain infected and the bacteria infecting the tooth could spread, infect bone and also infect more teeth. This would eventually lead to pain and swelling. In some instances the affected tooth or several teeth might have to be removed

If you decide not to have the root retreated. You could alternatively have the tooth taken out. Once the pulp has be destroyed, it will not heal back. Therefore it is not not recommended to leave an infected tooth in the mouth, to avoid further complications.

How long will the restored root canal tooth last?

The restored tooth could last a lifetime if you continue to take proper care of your gums and teeth and maintain good oral hygiene. However, routine dental check-ups are recommended.

What if it happens again?

Root canal treatments are usually very successful, however there are a number of reasons why root canal treatment unexpectedly fail, this could either be one of the following:

  • Fractured crown or leaking filling material.
  • Narrow or curved canals not treated during the original procedure.
  • New decay developed
  • Saliva has entered the restorative structure.

Retreatment is usually more complicated than initial root canal treatment as the tooth is usually fully restored with a permanent restoration. This can range from a simple filling to a full crown or as part of a bridge. In addition to this a post may have been placed inside the root prior to a final filling being placed. This creates difficulty because access to the root canals is more difficult.

Additionally the canals will have been filled with root filling material. Therefore this has to be removed before they can be instrumented and cleaned again. All of these obstructions make the process more complicated. However it is still possible to treat

Testimonials



Came with urgent treatment and left the same day with a brand new tooth-even better than my old one!All the staff were professional & friendly.Will highly recommend.Thanks nw1 Dental Care team! Akvile Alejunaite
The dentist and staff were really friendly and did a great job! Caitlin Gomez
I got clear braces with NW1 dental care last year!! I had them on for 4 months and it was the best thing I’ve ever done, It’s been more then a year now and i’m still constantly smiling! Amina Hunte
I had stitches removed in my upper left side roof of mouth and under left lip. I had a lovely female dentist who was so gentle and fabulous. It was all done in 14 minutes and I highly highly recommend this practice. Super! Madeleine Backlund
Excellent service , Dr Bodane was a true professional, you can see that she really cares about ensuring the patient is happy.! Will definitely use again. Jumoke Awomosu
Brilliant service and charming team. Five stars all the way. Fred Beatson-Hird
Great service, really impressed with the results. Very helpful staff and the dentist that had done the procedure was very friendly and my treatment was great. Very convenient location and I would recommend this place to others. Happy with my experience Tatyana Dubow
Booking an appointment was quick, easy and convenient. My dentist was lovely, professional and absolutely fantastic. I’ll definitely recommend this practice to friend and family, in fact I already have! Ms H
Really easy and straightforward, Anima gave me great advice and got exactly the results I was after. Thank you. Mr M
Great to see a new face in the surgery. The new dentist Dr Anima is very attentive and seems genuinely interested in any oral hygiene. I look forward to my next visit. Mr C
Very friendly warm welcome. Anima was excellent, helpful and answered all questions. Very professional service and comfortable experience. I will recommend and be coming back. Mr K


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