Root Canal Treatment
When the dental decay spreads to the inner core of the tooth called pulp which is rich in blood and nerve supply, your dentist will clear the contents of the nerve canal to ensure you are free of pain. This is filled with an inert material and called as root canal treatment. Most dentists are trained to do this using specialized equipment. If the work is particularly complex, your dentist may refer you to a specialist in root canal treatment, known as an endodontist.
Before having root canal treatment, your dentist may take a series of x-rays of the affected tooth.
Your dentist will place a rubber sheet (dam) around the tooth to ensure it is dry during treatment. The dam also prevents you swallowing or breathing in any chemicals the dentist uses. Your dentist will open your tooth through the crown – the flat part at the top – to access the soft tissue at the centre of the tooth (pulp). They'll then remove any infected pulp that remains. If you have a dental abscess, which is a pus-filled swelling, your dentist will be able to drain it at the same time.
After the pulp has been removed, your dentist will clean and enlarge the root canal so it can be easily filled. A temporary filling may be used to allow time for infection to settle down. Some root canal treatment can be carried out in a single visit based on the degree of infection and how effectively the canals can be cleaned.
At the second visit, the temporary filling and medication within the tooth is removed and the root canal filling will be inserted. This, along with a filling, seals the tooth and prevents reinfection. Root-filled teeth are more likely to break than healthy unrestored teeth, so your dentist may suggest placing a crown on the tooth to protect it. In some cases a root-filled tooth may darken, particularly if it has died as a result of injury like a knock to the tooth. There are several ways your dentist can treat discolouration, such as whitening the tooth using chemicals.
If there's only a small amount of tooth left after the root canal treatment, a post can be cemented in the root canal and used to help keep the crown in place. Root canal treatment is usually successful at saving the tooth and clearing the infection.
One review of a number of studies found 90% of root-treated teeth survived for 8-10 years.
The study also found having a crown fitted to the tooth after root canal treatment was the most important factor for improving tooth survival rates. If an infection does return, however, the treatment can be repeated. Alternatively, if treatment has already been carried out to a high standard and the infection remains, a small operation to remove the root tip (an apicoectomy) may be carried out to treat the infection.