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.
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.
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
- 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
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.