It all started when the tooth got damaged some how
A root canal is a filling that is placed right through the middle of the tooth, to replace a missing pulp (nerve), when it has become infected. When the pulp of a tooth has bacteria breeding inside it, it dies.
This may be due to
- tooth decay
- a crack in the tooth
- trauma to the tooth
- an unbalanced strain on the tooth because of missing teeth, or
- a deep filling that is close to the nerve
Root canal treatment will then be needed to try and keep the tooth, when the pulp is infected.
Another treatment option can be to remove the tooth, however there are consequences of losing teeth. The jaw bone that holds the teeth in place shrinks back, in a process called resorption, which may change the shape of the face, over time. The bite can also change if teeth shift into the space left by the tooth after it is removed.
Today there is a very good chance that dentists can help you to keep teeth that are badly damaged using root canal treatment (with a 95% success rate) and/or crown work to strengthen the broken down tooth, if recommended.
Root canal therapy is a two visit appointment, and usually takes a few hours. The inside of the tooth, including inside the roots is cleaned out entirely, and the tooth is sealed inside.
The tooth is no longer alive, but in most cases it can still be kept. The other option is to remove the tooth, and sometimes teeth are left for so long, and crumble away, with no option other than to remove them.
The root canal procedure normally involves being numbed up with local anaesthetic, clipping a small rubber mat over the infected tooth, and cleaning and flushing out the infected pulp, and removal of the infected tooth structure. Antibiotics are placed through the root canal system, and the tooth is sealed in the first stage of treatment, which takes approximately 1 hour. Some teeth are easily attended to because the canals are accessible and straight up and down. Other times the root system is very complex, with up to five opening inside the tooth, which travel down 2.5cm in narrow canals, with hooks etc, which can be extremely difficult to access and clean.
The second appointment for 1 hour, involves flushing the inside of the tooth and the sealing of the canal(s) with latex points and a specialised cement, and sealing of the access point.
Sometimes a referral to an endodontist (root canal specialist) is required to successfully treat a complex case. Due to the complexity of molar teeth and upper premolars, and with severe trauma to a tooth, we will ask you to attend an assessment with an endodontist. If required, we will place a crown over the damaged tooth for you.
We strongly recommend a dental crown to strengthen and maintain the tooth for years to come, for all molar teeth and upper premolar teeth,and teeth with little real tooth structure remaining. Without it you will have a high risk of re-infection or tooth fracture. Some teeth do not require crowns after root canal treatment.
It is important to recognise that discomfort can be associated with root canal treatment, however this can be minimised by attending to a problem earlier rather than later. The worst case is for someone who presents with a badly infected tooth, which is already very painful, and has been painful for some time. Usually this happens because someone doesn't realise that they have a cavity, they are frightened of the dentist and putting it off, or because they didn't get around to it. When teeth are attended to quickly, the treatment is normally not painful.