Root Canal Therapy
Root canal treatment saves a tooth whose nerve has become infected — and has a considerably worse reputation than it deserves.
Inside every tooth is a soft core containing nerve and blood supply. When deep decay, a crack or an injury lets bacteria reach it, that tissue becomes infected. Root canal treatment removes it, disinfects the space and seals it, so the tooth can stay.
Signs a tooth may need it
- Persistent, throbbing toothache, often worse lying down
- Prolonged pain to hot or cold after the source is removed
- Pain on biting or when the tooth is touched
- Swelling or tenderness in the gum near the tooth
- A tooth that has darkened compared with its neighbours
About the reputation
Root canal treatment is remembered as painful largely because people arrive in severe pain from the infection itself. The treatment is what stops it. Done under anaesthetic, the appointment is generally comparable to having a filling — long, but not agonising.
Common questions
- Would it be simpler to just have the tooth out?
- It is quicker, but it leaves a gap that then needs replacing with an implant, a bridge or a denture — usually at greater cost and complexity than saving the tooth. Keeping your own tooth is almost always the better outcome where it is possible.
- Will the tooth need a crown afterwards?
- Often, particularly for back teeth. A tooth that has had root canal treatment becomes more brittle and is more likely to fracture, and a crown protects against that.
More about this
Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed. Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.
Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy:
- An abscess (or pimple) on the gums.
- Sensitivity to hot and cold.
- Sometimes no symptoms are present.
- Swelling and/or tenderness.
Reasons for root canal therapy:
- Decay has reached the tooth pulp (the living tissue inside the tooth).
- Infection or abscess have developed inside the tooth or at the root tip.
- Injury or trauma to the tooth.
What does root canal therapy involve?
A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).
While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva. An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed with special dental instruments.
Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.
At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking, and restore it to its full function.
After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.
You will be given care instructions after each appointment. Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.
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