Root Canal treatment
- What is Root Canal Treatment?
A way to save your tooth
Root canal treatment or endodontic treatment is the only means of saving a tooth in which the nerves and blood vessels within the tooth have been damaged or have died. The damage may have been caused by deep decay, a crack or trauma. If the tooth is not treated an abscess or infection may ensue, which can be painful and debilitating.
- Why has your dentist referred you?
To give you the most accurate diagnosis and best treatment and therefore the best chance of keeping your tooth
Root canal treatment (and especially re-treatment) can be a complex and demanding procedure. Your dentist has decided that it is in your best interest to have your endodontic treatment carried out by an endodontist who has the particular expertise and equipment to carry out these procedures.
- How is the Root Canal treatment carried out?
By cleaning the tooth from the inside
The purpose of the Root Canal treatment is to remove the bacteria and the infected contents of the root canals and to disinfect the inside of the tooth. Once this has been completed and the tooth is free of infection, the root canals are filled and a temporary dressing is placed over the root fillings. Your dentist then completes the restoration of the tooth.
- What if treatment is not carried out?
You may risk losing the tooth and have more discomfort
If root treatment is not done, then the tooth has to be extracted. Even though you may not have any symptoms at the time, failure to eradicate infection may lead to sudden formation of a painful abscess and/or spread of the infection which may be more difficult to treat and take longer to heal.
- What are the alternatives to Root Canal treatment?
It may better for you to have the tooth extracted and possibly replaced with either an implant or a bridge. The decision is not always clear cut and may depend on a number of factors – clinical, financial and emotive.
- Is Root Canal treatment painful?
No, because local anaesthetic is used
Local anaesthetic is used at every stage of the procedure to ensure your comfort. Following treatment, the tooth may feel a little tender for a few days, but this can be normally controlled with the same medication that you might use for a headache. You will be advised of the need for medication at the end of the appointment.
- How long does Root Canal treatment take?
This will vary from case to case
This will depend on the complexity of the root canals and any problems that are encountered. To achieve success it is important that the procedure is not rushed. A one, to one and a half hour appointment is usually required on the first visit; further time required can be gauged at the end of this appointment. Often it is possible to complete treatment in one visit. Re-treatment cases usually take a little longer than first time treatments. It may be necessary to follow up on the treatment on a regular basis to monitor healing.
- What is the likelihood of success of Root Canal treatment ?
Root canal treatment and re-treatment have a success rate in excess of 95%
With the use of a high-powered operating microscope and other modern techniques, our treatments are very predictable. It should however be remembered that it is impossible to guarantee the success of any medical procedure. Even with the best treatment, healing may not occur due to circumstances beyond the control of the dentist. Should this occur, further steps may be required to eradicate the infection.
- What happens after root canal treatment?
You will usually need a crown on the treated tooth
It is essential that you return to your dentist so that the tooth can be properly restored. You will need to have a crown fitted on the tooth to prevent fracture. Until it is fitted you should take care not to bite too hard on the tooth.
- Do I need a referral from a general dentist for Root Canal treatment ?
No, you can contact us independently
You do not need to be referred by your dentist and if you would like a second opinion, then we are happy to provide one. You will probably need a consultation appointment first, but we can discuss this with you when you call. If you have any questions please feel free to email the practice and we will endeavour to contact you as soon as possible.
In order to understand what Endodontic Treatment or Root Canal Treatment is, it helps to know something about the anatomy of a tooth.
Teeth have several layers.
- The outside layer of the tooth is composed of a hard layer called Enamel.
- The Dentine layer which is protected by the Enamel layer has at its centre a soft tissue known as the Pulp.
- The Pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding Dentine and Enamel during tooth development. The Pulp receives its nourishment supply from vessels which enter the end of the root.
Although the Pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.
WHY WOULD I NEED ENDODONTIC TREATMENT?
Endodontic Treatment or Root Canal Treatment is necessary when the Pulp becomes inflamed or infected.
The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth.
If Pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
SIGNS AND SYMPTOMS
Indications for treatment include
- Prolonged sensitivity to heat or cold
- Discoloration of the tooth
- Swelling of the gum adjacent to the tooth
- Tenderness of the tooth especially to biting or adjacent gums. Sometimes there are no symptoms and the first sign of a problem maybe radiographic evidence collaborated with additional diagnostic testing by the Endodontist
HOW CAN ENDODONTICS HELP ME?
The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canal system and then seals the prepared space. Most treatment is now performed in a single appointment ranging from 45-120 minutes (depending on the number of canals). Once treatment is completed, you will be instructed to return to your dentist for a permanent restoration. The restoration of the tooth is an important part of treatment because it seals the cleaned and filled canals from the oral environment, protects the tooth and restores it to function.
In addition to conventional endodontic treatment your dentist may have referred you for Endodontic Retreatment, Endodontic Surgery, Cracked Tooth or Traumatic Injury
Endodontic (Root Canal) Treatment, Step By Step
Preliminary treatment to remove the decay and the source of infection of the pulp is necessary, along with a determination of whether the lost tooth structure can be restored. If a fracture of the tooth has reached the pulp, or infection is associated with gum disease, it could be more difficult, if not impossible, to save the tooth.
The general sequence of a root canal procedure is as follows:
Local anaesthesia is administered via injections to numb the tooth to be treated and the surrounding tissues. If the pulp in a tooth is acutely inflamed, and therefore very painful, it may take a while to get it numb, but your dentist will not start the treatment until it is.
|Isolation of the infected tooth from the rest of mouth to facilitate root canal treatment.|
This allows the root canal treatment to be carried out in a sterile environment free from contamination by bacteria found in saliva or the rest of the mouth.
A small access hole is drilled through the biting surface of an affected back tooth or from behind a front tooth, allowing access to the pulp chamber and root canals for treatment.
The diseased and dead pulp tissue is removed from the tooth with specially designed instruments used to clean out the root canals and pulp chamber. This is not painful; the area is numb and the tissue being removed is either dead or dying. Once the pulp, along with the nerves contained in it, is removed, the tooth itself can no longer feel pain.
The canals are disinfected with antiseptic and antibacterial solutions.
The canals are then shaped with tiny flexible instruments to allow them to receive root canal fillings and sealers. The canals are washed and cleaned again to remove root canal debris prior to sealing them.
Root canal fillings are selected that will exactly fit into the freshly prepared canals. Usually a rubber-like material called gutta-percha is used to fill the canal space. It is a thermoplastic material (“thermo” – heat; “plastic” – to shape), which literally is heated and then compressed into and against the walls of the root canals to seal them. Together with adhesive cement called a sealer, the gutta-percha fills the prepared canal space. Sealing the canals is critically important to prevent them from becoming reinfected with bacteria.
A temporary or permanent filling material will then be placed to seal the access hole that was made to treat the canals, and the dental dam is removed. If the tooth lacks sufficient structure to hold a restoration (filling) in place, the dentist or endodontist may place a post (either metal or a very strong plastic) in one of the canals inside the tooth to help retain it.
|Root canal filling material (guttapercha) is placed in the canals and the tooth is sealed with a temporary filling to protect it from contamination. Then a crown is usually placed over the tooth to seal and protect it from recontamination and future damage.|
After the procedure, an antibiotic may be prescribed to treat or prevent infection. Be sure to follow the instructions of your dentist or endodontist carefully. After-effects of treatment are minimal, generally lasting from a couple of days to about a week. It is normal to have some minor discomfort after treatment including slight soreness that can usually be managed with over-the-counter (aspirin, ibuprofen) medications or prescription (codeine-type) drugs, or a combination of the two.
Your tooth will need a permanent restoration — a crown — to replace lost tooth structure, and provide a complete seal to the top of the tooth. Your endodontist will send you back to your general dentist to determine which type of restoration is best for you. This step is of particular importance since many studies show that if the filled root canals are recontaminated with bacteria from the mouth, there could be a recurrence of infection around the tooth.
Knowledge Is Power
Almost like the root system of a plant, the root canals of a tooth have a main branch and many smaller side branches, and the whole system needs to be sealed during root canal treatment to be successful long term. Since root canals are very small spaces, they require a great deal of precision and care to treat well. Therefore, most root canal specialists today use state-of-the-art technology including digital (radiographic) imaging to diagnose root canal problems, and after treatment to verify that the canals are properly sealed; ultrasonic instrumentation to remove old canal fillings and posts and clean canals; and operating microscopes to accurately locate, visualize and seal root canal systems; it really is quite high-tech.
At Quintessence Family Dentistry & Wellness, We have found that people who are nervous tend to lack information about endodontic (root canal) treatment; knowledge gives them the power to understand what’s to come and to eliminate their fears. We hope that this step-by-step explanation will alleviate any apprehension. Root canal treatment really does relieve pain, not cause it — and saves teeth.
Dr. Gaurav Ghosh has been a practicing Implantologist and Root canal treatment specialist for many years now. A unique combination of high energy and patience, Dr. Gaurav Ghosh is an accomplished Root canal treatment specialist in Bangalore who thrives on helping patients calm their anxieties to make their experience a pleasurable one.
Dr. Gaurav Ghosh stays on the cutting edge of technology by participating in study clubs, dedicated to various aspects of the profession and attending seminars. He is an avid believer in continuing education and has completed many certified courses in all aspects of dentistry.