Root Canal Treatment

What is Root Canal Treatment?

Root canal treatment means removal of the pulp that is found inside every tooth. Pulp is the term for all the tissues inside the canal, i.e. nerves, arteries and veins. After the pulp has been removed the tooth can no longer reacts to its environment and no longer trouble you. The huge advantage of Root Canal Therapy is that it gives the tooth a second life - the alternative is an extraction.

After removal of the pulp and nerve tissue the empty canal system will now be filled up with special sealants and filling material to ensure no infection is present. Root canal treatment is a complex dental procedure and can take numerious appointments to complete. This new clean root canal system now forms the basis or foundation that supports the visible part of the tooth above the gum line.

Reasons for Root Canal Treatment

Tooth trauma or tooth decay(caries) has damaged the nerve beyond repair

The nerve is hypersensitive (tooth ache) due to the exposed root surfaces or a prior dental procedure

The nerve has died (a dead nerve will result in the formation of an abscess if it is not removed). Any bacteria that accumulate in the close pulp chamber or root system will eventually destroy tissues and lead to the formation of liquid (pus). The pus, together with rising pressure inside this close chamber can lead to intense pain and swelling, that represent a tooth abscess. Very often little to NO PAIN is present during the development of a chronic abscess.

The Root Canal Treatment Procedure

Root Canal Treatment can be done in a single visit, but most often is done in 2 or more appointments. Curved roots, hidden canals, calsification of canals or recurring infection in previously root treated teeth can sometimes complicate the procedure dramatically and makes Root Canal Therapy a very lengthy and complicated process.

1) First Visit:

After very good anesthesia, the tooth is opened up and the inside pulp chamber is cleaned out.

From this chamber towards the root tips, 1 to 4 (can be more) canals are found, that lead to the root tip or apex.

A temporary filling is placed to close the opened tooth until the next visit

2) Final Visit:

After the tooth is numb up the temporary filling is removed and further cleaning and shaping of the canals take place.

This could be very time consuming, because each canal (sometimes there are 4 or more) needs to be located and cleaned right down to the root.

The exact length of the canals needs to be determined with the help of x-rays and modern digital apex locators.

With the help of rotary instruments the canals will be shaped, cleaned and finally dried, using a series of paper points.

The dried canals get sealed off, by using rubber points called gutta perca points. This can be seen as white lines on a x ray afterwrads.

Now follows a possible Post & Core to strengthen the tooth structure.

A final restoration follows which is often a dental crown to protect the tooth against breakage.

Please note: Covering the tooth with a dental crown after root canal treatment is very important as the tooth now is under extreme high risk for fracture or breakage. Many times if the fracture is vertical the tooth cannot be saved and needs to be removed.

After The Nerve Has Been Removed

Discoloration is likely to occur later, but bleaching and crowning are good options to restore the colour to its original state. If the tooth is a front tooth that is more visible during smiling and talking, it might be necessary to do internal whitening. In the long run the tooth becomes more susceptible to fracture and it is advisable to strengthen the tooth with some form of restoration, usually a dental crown.

Can I feel any Pain Or Discomfort Afterwards?

Following Root Canal Therapy the tooth sometimes feels traumatized and tender. It can also be painful for the first few days. This pain does not originate from inside the tooth, but is itself a response from your body's immune system. Inflammation takes place in the tissue surrounding the root and causes pain. Another factor is that if there was an infection, like an abscess, the tooth is more likely to pain afterwards, because of a stronger reaction from your body's immune system. We will prescribe antibiotics to counter any flare-up of infection in the coming days after the root canal treatment.

Treatment For Root Canal Therapy

A) AFTER The FIRST APPOINTMENT When The Canals Are Still Open And Unfilled

Take anti-inflammatory medication for the first 1-2 days to alleviate excessive inflammation

Your tooth is very weakened, because of the temporary filling.

DON'T bite on hard objects or eat hard crusty or sticky food that can damage your tooth

The temporary filling is very porous and might flake

Very little to moderate pain is still possible when biting down until your final visit

B) AFTER The FINAL APPOINTMENT And When Treatment Is Complete

Expect some pain that can last for about 72-hours. It can be controlled with anti-inflammatory medication.

Make sure your final filling / crown is not too high in the bite, because this can cause unnecessary discomfort. Contact your dentist to ease the restoration if necessary.

Report back to your dentist after 6 months for follow up x-rays to determine if everything is still in order. Sometimes a painless re-infection can occur.

Make sure you get a good final restoration / crown as soon as possible after the root canal treatment to prevent possible fracture. (The tooth is now non-vital and will get more brittle in time)