Endodontics is the branch of dentistry that involves the prevention, diagnosis and treatment of diseases of the dental pulp and associated tissues.
The dental pulp lies at the centre of the tooth and extends into the roots, where it is housed inside very fine canals. The dental pulp’s purpose is to provide the tooth with nutrients and a defence against bacterial insult or trauma. During prolonged periods of insult from deep decay, cracks, or trauma, the pulp can become inflamed and necrotic, often causing toothache.
In order to save such teeth, the dental pulp space must be thoroughly cleaned and sealed, a procedure known as root canal treatment. With modern materials and equipment this treatment can be performed painlessly and with a very good success rate.
Indications that root canal treatment may be necessary are:
Prolonged sensitivity to hot or cold.
Discolouration of the tooth.
Swelling or tenderness of the tooth.
Severe decay or an injury that creates an abscess.
Spontaneous pain or throbbing while biting.
root canal treatment removes infection from inside a tooth. The inside contains nerves and blood vessels that help nourish the tooth. After this is removed, the root canals are cleaned, disinfected, filled and sealed.
root canal treatment saves teeth that would otherwise need to be extracted. Although the tissue inside is removed the tooth can still function normally. Keeping your own tooth is usually the best option and cheaper than replacing missing teeth in the long-term.
The most common cause of this infection is severe decay or a fracture that exposes the nerve to bacteria that may cause infection. Other causes include trauma, a cracked or loose filling or repeated fillings in a tooth, and occasionally gum disease.
A low sugar diet, good oral hygiene and regular visits to your dentist can help prevent the need for such extensive treatment in future.
Root canal treatment can usually be completed in one appointment but sometimes two visits may be necessary. Most teeth can be treated within approximately 1 hr.
With proper restoration and care it may last a lifetime. Proper dental care includes regular brushing and flossing, proper diet and regular dental check-ups. Root canal treated teeth are usually heavily filled and your dentist may recommend a crown to provide strength and improve its appearance. This will help extend the lifespan of the tooth.
Root canal treatments have the misplaced reputation of being very painful. With the use of modern techniques, root canal therapy typically involves little or no discomfort. Often there is pain before treatment and root canal treatment provides relief.
Cleaning the root canals may cause some slight tenderness but usually over-the-counter pain killers alleviate the discomfort. If pain persists long term or if you experience severe pain, call your dentist.
If the tooth is not treated this can lead to an abscess forming with swelling and pain.
An alternative to root canal treatment is extraction of the tooth. Loss of a tooth could create a functional problem such as chewing or an aesthetic problem. Restoring the space may involve the provision of a denture, bridge or a dental implant, the costs of which are usually higher.
Occasionally a tooth cannot be saved. The canals can be very narrow, curved or oddly shaped and there may be hidden canals. The tooth must also have sufficient bone support or the tooth may be fractured in half. Each tooth has its own difficulties.
Studies have shown that Root Canal Treatment have success rates between 85-95%. Problems can occur e.g. undetected canal/crack, decay, file breakage, residual bacteria. The list is not exhaustive.
Retreatment, surgery or extraction may be needed if appropriate.
Teeth that have had root canal treatment can last as long as natural teeth, however, in some cases the treatment can fail or symptoms can persist. In these cases it may be possible to carry out the treatment again. Retreatment is usually more complicated than initial treatment and the success rates can be lower (approx 65%).
Yes. If your dentist discovers problems during the procedure we may recommend a referral to a specialist known as an ‘endodontist’. The endodontist can use the latest technology and techniques to try and save the tooth but this is usually more costly (from approximately £350 for a dentist with a particular interest in endodontics).