Root Canal Treatment

Why you may need a root canal treatment

Root canal (endodontic) treatment is performed on a tooth when its nerve has been irreversibly inflamed and/or infected. This is generally termed loosely as tooth infection.

The very outer layer of a tooth is enamel under which dentine lies. Under these protective layers of enamel and dentine lives the pulp which contains blood supply and nerve. This is the reason you can feel sensitive or even pain from a tooth. The pulp has an amazing capacity to fight off an insult, such as that from tooth decay, but only to a certain extent.

When tooth decay has been left untreated for a while, the fighting capacity of the pulp starts to weaken. Eventually, the pulp is overwhelmed by bacteria from the decay, leading to tooth infection. At this stage, to save the tooth, you will need a root canal treatment; otherwise, the tooth needs to be extracted.

Endodontic treatment

Root canal treatment involves multiple stages.

Extirpation

This is generally done as an emergency appointment when a patient presents with pain and the findings above are found.

Generally, your dentist will remove any decay from the tooth and any existing fillings from which bacteria might have gotten entry to the tooth in the first place. Access is then gained into the inside of the tooth (root canal system). The canals are then cleaned and disinfected, following which medicament is placed. The tooth is then temporised.

The main purpose of this appointment is to get you out of pain. During the procedure above, your dentist will also determine if the tooth can be saved through a root canal treatment. If the tooth cannot be saved, extraction is then advised. Most often than not, your dentist can tell you from the start whether the tooth is savable or requires extraction. Sometimes, though, is may not be apparent until all decay and existing fillings are removed.

Canal Preparation

When it have been established that root canal treatment is feasible to save the tooth, your dentist, in consultation with you, then moves to this stage.

This stage involves re-gaining access to the root canal system that has been previously disinfected and medicated. The canals are then prepared to certain shapes, sizes, and lengths to allow for filling materials to be inserted (root canal fillings). Following canal preparation, the canals are re-medicated. The tooth is again temporised.

Canal Obturation (Root Fillings)

This appointment constitutes the final stage of the root canal treatment. The root canal system is again accessed. Root fillings are then inserted.

The main reason for this appointment being separate from canal preparation appointment is to allow more healing around the root area to occur.

Following this, the tooth may be permanently restored or temporised, depending on the extent of tooth structure loss.

Tooth restoration following an endodontic treatment

Most often than not, by the time a tooth requires a root canal treatment, destruction to tooth structure by decay is quite extensive enough. Following the completion of root canal treatment, restoring the tooth with a simple filling may not be sufficient; often, this tooth requires more advanced restorations, such as onlay or crowns (with posts and cores, if necessary).