Root Canal Treatment
When is Root canal treatment necessary?
When decay is allowed to advance deep into a tooth, it eventually reaches the tooth ‘pulp’. The pulp is where blood vessels and nerve fibres are located within a tooth to keep a tooth vital. This is why teeth feel sensitive to cold and can cause pain. Decay is essentially bacteria eating into a tooth and when the bacteria get access to the pulp, they proliferate and eventually cause an infection within the tooth, all the way down to the spaces within the roots of the tooth. If left untreated, the infection can keep spreading from the tooth and into the adjoining jaw tissues, causing pain and sometimes swelling of the face or jaw.
If the tooth is not too damaged by the decay, it can still be salvaged with root canal treatment.
Root canal treatment usually involves 3 visits. There is usually an interval of 1-2 weeks between each visit.
The first 2 visits involve cleaning the infected pulp out of the tooth and root spaces or canals. This usually leads to an alleviation of pain and swelling.
The 3rd visit is where the root spaces are filled and sealed to prevent re-entry of bacteria. The rest of the tooth can then be filled with a filling material to replace tooth structure lost from decay.
Radiographs are a necessity during root canal treatment of a tooth. This is because the dentist cannot see below the gum line how the root structure looks like and needs to take images (X-ray images with radiographs or cone beam scans) to allow them to carry out the procedure adequately.
Usually, a crown is then placed over the tooth. This is often necessary as the remaining tooth structure might be quite diminished and weakened from the initial decay and the crown ensures it is protected from chewing forces and does not fracture.
Root canal treatment must be carried out with the use of a rubber dam.
This is a legal requirement.
Tooth isolated with rubber dam for root canal treatment
This is because strong disinfecting solutions are used to cleanse the tooth as well as small, fine instruments called files that are used to clean the fine canals within the roots. The rubber dam ensures there is no risk of accidental ingestion and/or aspiration of these solutions and instruments. The rubber dam also ensures a dry operating field and prevents contamination of the tooth with saliva as it is being treated.
Root canal treatment need not be painful as the tooth is anaesthetised. The appointment can vary in length from 45 to 90 minutes depending on the tooth being treated.