What is root canal treatment?

Root canal treatment, also known as endodontics, is the treatment of problems with the pulp tissue inside the tooth. When this tissue or the tissue surrounding the tooth root is diseased or damaged due to decay, trauma, repeated dental procedures, or a crack, root canal treatment can save the tooth and relieve the associated pain.

When performing a root canal, Naomi removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, and fills and seals the space.

After performing the procedure, you return to your own dentist to have a restoration placed. Your dentist will advise on the appropriate restorative treatment. After restoration, the tooth continues to function like any other tooth.

What is an Endodontist?

An Endodontist is a dentist who has completed further training in root canal procedures. They perform routine as well as difficult cases, including root canal treatment and surgery.

Because they limit their practices to treating root canals, they treat these types of problems every day which increases your chances of saving your teeth. They use their special training and equipment to treat difficult cases, such as teeth with narrow or blocked canals, unusual anatomy and diagnosing oral & facial pain.

Why would I need root canal treatment?

Root canal treatment is required when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

What are the symptoms of needing root canal treatment?

Symptoms include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, swelling, or draining pus on the gum or face. Sometimes, there may be no symptoms.

What if I just take antibiotics?

Root canal infection occurs within the tooth and therefore does not heal with oral antibiotics. Antibiotics may ease the symptoms for a period of time however the underlying infection will still persist unless treated with root canal treatment or extraction. Antibiotics work systemically (throughout the body) and as root canal infection is localized within the hard tissues of the tooth the infection is not affected by antibiotics. Naomi only prescribes antibiotics if a patient is pyrexic (has a high temperature) as a result of the infection. Normally antibiotics are not prescribed regardless of how infected the tooth is as the root canal treatment itself treats the infection. If a patient is on antibiotics when they present for treatment they will normally be asked to stop taking them if treatment is feasible.

What are the chances of success?

Success rates for endodontists are high at 90 to 95%. The more established an infection is, the hardier the infection and the more resistant the infection is to treatment; however success rates can still reach 90% in established cases.

Retreatment success rates are lower but are typically between 70-80%. The reason for the initial root treatment not working affects the prognosis of the retreatment. If the treatment aims are not achieved then the prognosis would be lower. At the initial consultation it would be discussed with you the likelihood or otherwise of whether or not the treatment aims can be achieved.

What are the alternatives to root canal treatment?

Though root canal treatment is intended to help save your tooth, this is not always possible. Often, the only alternative to endodontic treatment is extraction of the tooth. We advise patients to discuss the restorative options with their dentist should they require an extraction.

Will I feel anything during the procedure?

The tooth is numbed using a local anaesthetic and in the vast majority of cases there is no discomfort. If a tooth has a well established infection there is no risk of feeling anything during the treatment. There are times when there may be some discomfort but we know before we start the treatment if this is likely or not and in these cases we take extra measures to try to minimize any possible discomfort.

Should I expect any problems between appointments?

You can expect there to be some tenderness for a few days but there is often no tenderness at all. If you take the recommended anti-inflammatories then this usually prevents problems. In very rare instances patients may have a flare-up. A flare-up is an acute inflammatory response. Even with every effort they will occasionally occur. You will have Naomi’s mobile number and she is happy for patients to contact her between appointments with any queries or problems. Naomi will always see a patient for the treatment of a flare-up and treatment normally involves redressing the tooth and medication.

Do I need to do anything before or after the appointments?

You should eat as normal before your appointments. Naomi normally recommends anti-inflammatories for a few days after each appointment and you will be advised at the treatment appointment. After your final appointment, you need to return to your own dentist to place a permanent restoration in the tooth. This is important as it can affect the success of the root canal treatment.

How do I book an appointment?

Most of our patients are referred by their dentists but patients can contact the practice directly. We can book a consultation with treatment time allowed but if there are any queries about the diagnosis or whether root canal treatment is feasible then occasionally we prefer to book consultations separately to treatment appointments. Please see our contact details below.

Images reproduced with permission from the American Association of Endodontists.