Root canal treatment, also known as Endodontic treatment, may scare you or make you feel anxious. However, this is usually because you are not familiar with the dental procedure and had heard about some common misconceptions regarding them.
Do you know that in some situations, root canal treatment may be the only option to save your natural tooth and avoid you from having to get the tooth extracted?
Saving your natural teeth whenever possible, is always the best option because nothing artificial can replace the look or function of a natural tooth. Therefore, it is important for you to understand about root canal treatment and to always consider it as a treatment option!
What is a root canal?
The top part of the tooth that we can see in our mouth is call the crown, but our teeth comprises more than that. The part of the tooth that is below the gums and in the bone is known as the roots.
The roots make up about two-thirds of the entire tooth and is responsible for holding the tooth in place with the help of connective tissue, surrounding gums and bone.
Every natural tooth structure contains a pulp chamber at the center of the tooth between the crown and the tooth’s root canals.
The pulp chamber is filled with a soft tissue, also known as the pulp. These pulp tissues contain all the nerves, blood vessels, and connective tissues in our teeth, which enter through the base of the tooth root, travel up through the root canal space, and gather at the pulp chamber.
What is Root Canal Treatment?
In the event the pulp tissue and nerve tissue from your natural tooth gets inflamed or infected (usually due to deep tooth decay or fracture/ crack due to trauma) and end up causing severe pain, you may need to undergo root canal treatment (also known as endodontic treatment) to save the teeth, which otherwise may have to be extracted.
Root canal treatment involves carefully cleaning of the canals to remove bacteria and pulp of the tooth. The main objectives of root canal treatment are disinfection and prevent reinfection.
This treatment can be performed by general dentists or specialists known as endodontists.
Root canal treatment consists of one or two appointments (or more), depending on the complexity of the tooth structure and number of canals.
Your front teeth usually have a single root containing 1 root canal, whereas the premolars and back molar teeth usually have 2 or 3 roots, each containing multiple root canals (either 1 or 2 canals). The more canals a tooth has, the longer the treatment will take to complete.
Root Canal Treatment procedure
Preparing for root canal treatment
Before the start of root canal treatment, your dentist may take an x-ray of the affected tooth. This allow them to have a picture of the root canal and assess the extent of tooth decay or any other damage.
Root canal procedure is also carried out under local anaesthesia to numb the diseased tooth before commencing on the treatment – therefore even though you will still feel some pressure on the tooth, there is usually no pain during the procedure.
Access cavity and removing the pulp
During the first visit, an opening is drilled to gain access to the pulp chamber in order to remove the infected pulp tissue from the affected tooth with small files.
A rubber sheet (known as rubber dam) will be placed around the tooth in order to isolate it and keeping it free from contamination throughout the treatment.
After the pulp is removed, the canals will then be cleaned and enlarged using a series of small files in increasing size order to shape them into regular shape so they can be filled. Along the way, disinfection solution will be used to rinse the root canals frequently too.
Once the canals have been shaped up to appropriate length and size, medicament will be placed into the canals before closing them up with temporary filling material.
During the interval between appointments, the medicament placed into the canals will help to eliminate left over bacteria, reduce inflammation and prevent contamination.
Cleaning and filling the root canals
In the next appointment, your dentist will remove the temporary filling material, clean the root canal system before checking to ensure that the infected tooth is ready to be sealed up permanently.
Some x-rays may be taken along the way to check that the root canals have been cleaned and shaped to the correct length.
Finally, your dentist will place biocompatible material (such as gutta percha – a rubber like material) into the root canal and seal the opening with a permanent filling, and subsequently followed by a permanent crown if required.
Root Canal Treatment side effects
- Discomfort: You may feel some mild discomfort such as tenderness while chewing after the procedure. This is more common if there was pain or severe bacterial infection before endodontic treatment was initiated. Usual painkillers such as paracetamol can usually be used to relieve this discomfort. You are also advised to go on a softer diet until the final restoration has been completed.
- Inflammation/ reinfection/ swelling: As root canal treatment is an invasive procedure, it can irritate the tooth’s surrounding tissues such as the gums. However, this is only temporary and will last up to 3 or 4 days and can be relieve with painkillers.
- Tooth discoloration: After the infected tissue and nerves are removed, there may be slight discoloration to the tooth but many patients do not notice this at all. This discoloration will also no longer be visible once a permanent crown is placed on.
- Tooth cracking: Root canal treated teeth will never be as strong as they were before. This is why crowns are usually recommended following root canal treatment to strengthen the outer area of the tooth again.
Root canal treated teeth require regular home care such as brushing twice daily and flossing regularly. Post-treatment reviews are usually scheduled to assess healing status.
How successful is root canal treatment?
According to the American Association of Endodontists, over 41,000 root canals are performed in the United States every day. That means that more than 15 million root canals are completed each year.
Root canal treatments are usually successful at saving tooth and clearing the infection.
According to study, the overall success rate after 4-6 years is approximately 81%, with a range from 74% to 92% , depending on several factors such as the severity of infection prior to commencing the root canal therapy. [1]
Having a crown fitted to the tooth after root canal treatment is important for improving tooth survival rates. The survival of your tooth depends on a number of factors, including:
- how much of the remaining tooth structure remains
- how well you keep your teeth clean
- the biting forces on the tooth
In the event if an infection does return, the root canal treatment can be repeated and your dentist may refer you to a root canal specialist called an endodontist for retreatment.
Don’t delay or postpone making an appointment as the longer you wait, the chance of saving the tooth decreases.
The problem may even spread and infect the structures and tissues below the tooth, resulting in tooth extraction as the only option left eventually.
If you have experienced the pain (regardless of spontaneous pain or dull aching pain), please contact your dentist as soon as possible for a consultation.
At Ocean Dental, we have dental X-ray machines for panoramic X-ray (OPG), Periapical X-ray (PA) and CBCT (for 3D scans) to aid in thorough examination.
Schedule an appointment or check out our services for root canal treatments/ endodontic treatment!
References
- Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment. J Endod. 2003 Dec;29(12):787-93. doi: 10.1097/00004770-200312000-00001.
- Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature – part 1. Effects of study characteristics on probability of success. Int Endod J. 2007 Dec;40(12):921-39. doi: 10.1111/j.1365-2591.2007.01322.x.