Root Canal Treatment - Anatomy of a Tooth

A tooth consists basically of a crown and a root. The crown is the part that you can see in your mouth (above the gum line). The root (under the gum line) is the part that anchors the tooth in the jaw. More or less in the middle of the tooth is pulp chamber (composed of nerves and blood vessels).

Why and when do I need Root Canal Treatment?

The most common reasons are:

• dental decay accumulative effects of placing several fillings over time
• accumulative effects of placing several fillings over time
• traumatic injury

When the pulp becomes irreversible damaged due to bacterial infection or injury, it will die and will need to be removed. The main symptoms of a dying pulp are pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling of the surrounding tissues. However, sometimes there are no symptoms.

If left untreated the dead pulp tissue and bacteria inside the tooth adversely affects the surrounding bone by forming an the main symptoms being that the tooth hurts when bitten on, it is sore to touch and there may be swelling.

You may be given antibiotics which are useful in treating root canal infections to help relieve the symptoms in the short term, and is indicated where there is swelling, a temperature, or other systemic signs of infection. In a dead tooth there is no blood supply to carry the antibiotics to the source of the infection inside the tooth. Antibiotics only treat the infection in the surrounding bone. Although the pain might go after a course of antibiotics, the infection will reoccur later because bacteria are still present within the untreated dead tooth.

What choices do I have?

Once the nerve and blood vessels are irreversibly damaged, there are only two choices:

• Extraction - a last resort as this often leads to other complications such as drifting, inability to chew food, food trap areas which can lead to further decay and gum disease. A permanent gap in your teeth could ultimately cause problems with your jaw joints.
• Root Canal Treatment and referral to an Endodontist who is a dentist with special training in diagnosing and treating problems associated with the inside of the tooth. They work with specialised instruments and powerful microscopes to aid with diagnosis and treatment.

Root Canal (Endodontic) Treatment – how does endodontic treatment save the tooth?

The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, a channel inside the root, then fills and seals the space. The treatment can be done in one or several visits that can vary from 30 minutes to two hours, depending on the specific tooth and the nature of the damage.

Will I feel pain during or after the procedure?

In reality the process of doing a root canal should not hurt. You should be numb and the tooth should have no feeling. For some teeth, profound local anaesthesia may be difficult to achieve due to the infection. What really hurts is the reason a root filling is needed in the first place; the patient is already in pain before the root canal is started. In some cases where the tooth has died off already, a patient may not experience any pain or discomfort. He/she may not even be aware of the problem.

How will the tooth be restored?

Normally a root treated tooth becomes brittle thus the final, ideal permanent restoration on all back teeth is usually a crown. A crown covers the entire tooth to protect is from breaking or chipping, and protects the root canal from becoming contaminated. Contamination may lead to early failure and this is important to avoid. For previously crowned teeth, or for some front teeth that do not have fillings or decay, a permanent filling may be all that is needed. It is important to make sure that a permanent restoration is carried out as soon as possible as the unrestored tooth is susceptible to fracture.

Finally

There is nothing routine about doing a root canal. Every tooth is unique just as every person is unique. The value of root canal therapy is not what it costs, but the value of knowing you have done everything possible to save your natural teeth, a non-replaceable commodity.

No one expects to get the performance and quality of a luxury car for the price of a bicycle. In life you generally get what you pay for, advanced dental treatment such as root canal treatment, is no different.

If you have been referred from a dentist outside our practice we will write to your practitioner stating that the endodontic treatment has been completed and your tooth is now ready for restoration.