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Root canal treatment

Teeth are held in the jaws by their roots. Front teeth normally have one root, but teeth further back have more. At the core of each tooth is a soft mass of tissue called the pulp. In a healthy tooth, the pulp contains living fibres, cells, nerves and blood supply, extending into the root(s) through the root canal(s).

Decay or injury can destroy the living pulp. Because dead pulp lacks a blood supply, it is more prone to infection, leading to an abscess and toothache.

What is root canal treatment?

Root canal treatment (also called endodontics) is needed when the blood or nerve supply of the tooth (known as the pulp) is infected through decay or injury. Treatment involves removing the damaged or dead pulp and filling the space left .The remaining tooth can then be restored.

Why is root canal treatment needed?

If the pulp becomes infected, the infection may spread through the root canal system of the tooth.  This may eventually lead to an abscess.

If root canal treatment (RCT) is not carried out, the infection will spread and the tooth may need to be taken out.

What Happens?

An x ray will be taken to show the number and shape of the canals and also any signs of infection in the surrounding bone. Some teeth are easier to fill than others.

To keep the root canals dry, we may stretch a thin sheet of rubber around the tooth, called rubber dam. This will make the treatment more comfortable for you, and also prevents bacteria in your saliva from re-infecting the prepared root canals during treatment.

You will be given a local anaesthetic, and then an opening is made through the top of the tooth, down into the pulp. The dentist will use narrow files to remove the dead pulp from the core of the tooth and from the root canal(s). An irrigation fluid is used to flush out debris and bacteria from within the canal. In most cases, the treatment is completed in one long visit, but on occasion, a temporary filling may be placed and a second appointment made to give the tooth a chance to settle down before finally placing the root filling at a later date.

Once the root canal(s) are filled a filling is placed. If there has been extensive tooth substance lost, a crown or an inlay (a filling made in a laboratory) will be offered. This will protect the weakened tooth, which becomes brittle after root canal treatment, and reduce chances of the tooth fracturing later. Sometimes a post may be needed to support a crown.

Root filled teeth can become darker than other teeth, but bleaching can be used to make them look lighter.

Does it hurt?

No.  A local anaesthetic is used and it should feel no different to having an ordinary filling done. It is not uncommon for patients to fall asleep during the treatment!

What are the Benefits?

Pulp damage can cause toothache, but the pain will end very quickly when the root canal is cleaned out.

Without a root filling, a tooth with a dead pulp would probably have to be taken out in the end. There is also a possibility of infection spreading beyond the tooth itself.

Root fillings are usually successful and can last many years, but re-treatment is also possible if infection recurs . The success of a root filling will be predicted by either a good, guarded or poor prognosis. Referral to a private endodontist (specialist dentist in root canal treatments with further training) is also an option for any tooth, but particularly so for one that has a poor or guarded prognosis. The cost of this varies, but can be anything from £250 to £ 850.

What will my tooth look like after treatment?

In the past, a root filled tooth would often darken after treatment.  However, with modern techniques this does not usually happen.  If there is any discolouration, there are several treatments available to restore the natural appearance.

What if it happens again?

Root canal treatment is usually very successful.  However, if the infection comes back the treatment can be repeated.

What if I don’t have the treatment?

The alternative is to have the tooth out.  Once the pulp is destroyed, it can’t heal and it is not recommended to leave an infected tooth in the mouth. Although some people would prefer an extraction, it is usually best to keep as many natural teeth as possible.

Will the tooth be safe after treatment?

Yes.  However, it is better to restore the tooth with a crown to provide extra support and strength to the tooth.

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