Root canal treatment involves the removal of dead or diseased pulp tissue from within a tooth as well as the cleaning and shaping of the root canal thereafter to receive a filling. The common causes of pulpal injury are decay, trauma and excessive wear.

Benefits of treatment.

Root canal treatment saves natural teeth that have sustained irreversible pulpal injury. It prevents (or delays in some cases) the need for teeth extraction and the accompanied need for their replacement. It is also used to as an option of last resort to treat hypersensitive teeth that do not respond to conventional treatment. Occasionally it is used as part of a treatment plan to restore teeth that are maligned.

What will the dentist do?

The dentist will initially numb the tooth to be treated using local anaesthetic and isolate the treatment area using a rubber dam. The rubber dam prevents saliva contamination and accidental ingestion of root canal instruments and materials used during the procedure. The dentist will thereafter proceed to remove decayed areas and gain access to the pulp chamber using the dental drill. Infected (or dead) pulp tissue is subsequently removed using hand instruments and the root canal system is cleaned using a mild disinfectant solution. The root canal is shaped using small files before being sealed with an inert material called gutta-percha. Your dentist may use various devices, such as x-ray imaging equipment, apex locator, loupes or a dental microscope to aid him during the procedure.

How long will it take?

Root canal visits takes about 60 minutes on average and may require multiple visits, depending on the shape and number of canals present as well as the nature of your condition. Front teeth have the advantage of being in a more convenient location and usually have a single large ovoid canal whereas back teeth usually have multiple fine canals which are harder to access. Patients who present with chronic infection, resulting in damage to the surrounding tissues (e.g. sinus tract, cystic changes etc.) should expect a longer follow-up period with their attending dentist.

What is the experience like?

The experience is variable depending on the nature of the pulpal injury. Existing inflammation and infection can reduce the effectiveness of local anaesthetic agents, resulting in a “hot tooth”. In such an event, medication are often prescribed by your dentist to calm the tooth down prior to root canal treatment.

Fortunately, such situations are uncommon and most patients will experience little or no pain during the procedure. Your dentist may use root canal medicaments and place a temporary filling in between visits.

What to expect after treatment?

The tooth and its surrounding gum may feel slightly tender over the next few days due to inflammation. Your dentist may prescribe you analgesics to help you manage the discomfort. After a short observation interval, your dentist will likely recommend that the root canal treated tooth be protected from the potential risk of fracture with either a crown or an onlay. A root canal treated tooth functions like any other normal tooth and can potentially last a life time with good personal oral hygiene and professional care.

Are the any risks involved?

Root canal treatment is a common and safe procedure with high success rates (>90% for first treatments). Failures are often associated with the presence of complicated canal systems, recalcitrant infections or tooth fracture. Root canal treatment when carried out in vertically cracked teeth have a guarded prognosis as it is hard to predict or prevent crack propagation from occurring during and after the completion of treatment.

Other potential risks include the possibility of root canal wall perforations, fractured instruments, apical irritation from instruments and disinfectant solutions. The prevalence of these complications have reduced with the adoption of modern materials, technique and equipment. A very small number of patients have also been reported to have swallowed small root canal instruments or experienced soft tissue irritation from the disinfectant solution used during the procedure when it was not possible to use a rubber dam.