Root Canal Treatment

Root canal treatment (or endodontic treatment) is the most maligned of all dental procedures. It has an undeserving reputation for pain. If the treatment is performed properly and with care it should be completely painless, and no worse than a filling. It’s just a longer procedure, normally over 2/3 visits.

The treatment involves the removal of the dental pulp, often referred to as the nerve. In fact the pulp is the living tissue inside the tooth and contains:

1. Blood vessels.
2. Nerve fibres.
3. Lymph tissue.

The pulp is contained in the pulp chamber and root canals of the tooth and is surrounded by the solid structure of the tooth dentine and enamel.

Why do we have the dental pulp (nerve)?

Initially the pulp is responsible for the growth and development of the tooth as it erupts, then it maintains the health of the tooth structure providing nutrients and producing secondary dentine (to repair damaged tooth) and it has a sensory function responding to extremes of temperature and tooth decay (tooth ache).

Why root canal treatment?

We do endodontic treatment to: 1 Stop the pain. 2 Remove the infection / abscess. 3 Save the tooth.

What are the causes?

1. Untreated tooth decay from deep cavities left untreated
2. Severe gum disease
3. Injury to the teeth

What happens?

Untreated decay spreads through the tooth to the pulp chamber, then bacteria enter the pulp and cause inflammation and death of the pulp tissue. At first the tooth becomes painful and sensitive, then the pain increases and becomes continuous, then when the pulp dies the bacteria spread through the root and cause an abscess around the roots. This leads to increased and often severe pain and the tooth becoming very sensitive to bite and touch. If left untreated at this stage the infection will spread leading to swelling of the face and spread of infection with nausea and fever. When it gets to this stage managing the problem becomes much more difficult and antibiotics will be needed as well as root canal treatment (antibiotics on their own will not cure the cause of the pain, only delay it for a while).

How can Root canal treatment help?

1. By removing the infected pulp you stop the spread of infection
2. Stop the pain
3. Save the tooth and maintain its function

When you treat the tooth you remove the infected pulp, drain the abscess, disinfect the canals removing the harmful bacteria, seal the canals and restore the tooth. This procedure normally takes 2/3 visits to complete.

After treatment you may have to crown heavily restored teeth as they are weakened to preserve their form and function.

What’s the alternative?

There is only one and that is extraction of the tooth. Obviously at the time you may be tempted by the lower cost of extraction versus root canal treatment, and a quick end to your pain, but often this is a big mistake because the loss of teeth leads to other problems such as over eruption and movement of opposing teeth and the future cost and problems of that can be greater.

Summary:

1. Prevention is better than cure. Don’t leave that cavity/broken tooth until it hurts, by then it is already too late and it will cost you more.
2. Why suffer pain unnecessarily, get that tooth fixed now.
3. Many patients come in with toothache, get the tooth dressed, make appointments to complete treatment and then fail to keep their appointments because the pain has gone. Don’t be in any doubt – the pain will come back with a vengeance after a few months and you will have to start all over again.