Root canal therapy

What is root canal therapy and why is it necessary?

Root canal therapy (RCT) is a treatment used to remove infected or damaged tissue from inside your tooth and root.  It is needed if:

- Decay has reached the living tissue (pulp) inside the tooth and has caused irreversible damage. The pulp dies and collects as pus at the end of the root (an abscess)

- The pulp has died as a result of trauma (a direct knock or blow) to the tooth. This often happens in childhood but it may not become a problem until many years later.

- Part of the tooth has fractured through the pulp

- The tooth has required numerous large or deep fillings

- The tooth has lost a lot of its bony support due to gum disease

 

                          

When the pulp becomes infected you feel a dull continuous throb which often wakes you up at night. You can’t apply any pressure to the tooth, or eat properly because it causes pain. You may gain some relief from painkillers but it returns. The gum around the tooth may be swollen or red and tender. You may feel that the bite is changed. These symptoms are caused by a build up of pressure within the closed root canal system; the pus has got nowhere to drain to. Sometimes, if the pulp has died very slowly over a long period of time, you may not feel all of the symptoms described above. Chronic (slow to develop) abscesses are sometimes a chance finding on an X-ray, with the patient unaware of the problem.

RCT involves an injection to make the tooth numb, followed by opening up of the pulp chamber. This releases some of the pressure, removes the source of the infection from inside the root. It can take some time to ensure the root canals are fully cleaned and sterilised and shaped in such a way as to allow a filling material to completely block off the root from its tip to the crown.  X-rays are taken to work out how many, how long and what shape the roots are. Where possible, the treatment is carried out with the tooth isolated under a latex sheet called a rubber dam, which prevents contamination from bacteria in the the mouth and protects you from swallowing or inhaling any of the tiny files used during the treatment:

                   

Molar teeth usually have 3 or 4 canals. Premolar teeth usually have 1or 2 canals. Incisors and canines usually have 1 canal. It usually takes a number of appointments to complete the treatment.

What happens afterwards?

The opening to the tooth is sealed with a filling material. The tooth itself is likely to discolour over time and often a crown is needed to strengthen the tooth and restore its looks.  

What is the alternative?

The only alternative is to extract the tooth which also removes the source of the infection and allows the area to heal. Click here to read about missing teeth